Surgically Induced Weight Loss by Gastric Bypass Improves Non Alcoholic Fatty Liver Disease in Morbid Obese Patients

Overview

Journal World J Hepatol

Publisher Baishideng Publishing Group

Specialty Gastroenterology

Date 2013 Jan 29

PMID 23355916

Citations 31

Authors

Victor Vargas

Helena Allende

Albert Lecube

Maria Teresa Salcedo

Juan A Baena-Fustegueras

Jose M Fort

Joaquin Rivero

Roser Ferrer

Roberto Catalan

Eva Pardina

Santiago Ramon Y Cajal

Jaime Guardia

Julia Peinado-Onsurbe

Affiliations

Soon will be listed here.

Abstract

Aim: To evaluate the effects of surgical weight loss (Roux-en-Y gastric bypass with a modified Fobi-Capella technique) on non alcoholic fatty liver disease in obese patients.

Methods: A group of 26 morbidly obese patients aged 45 ± 2 years and with a body mass index > 40 kg/m(2) who underwent open surgical weight loss operations had paired liver biopsies, the first at surgery and the second after 16 ± 3 mo of weight loss. Biopsies were evaluated and compared in a blinded fashion. The presence of metabolic syndrome, anthropometric and biochemical variables were also assessed at baseline and at the time of the second biopsy.

Results: Percentage of excess weight loss was 72.1% ± 6.6%. There was a reduction in prevalence of metabolic syndrome from 57.7% (15 patients) to 7.7% (2 patients) (P < 0.001). Any significance difference was observed in aspartate aminotransferase or alanine aminotransferase between pre and postsurgery. There were improvements in steatosis (P < 0.001), lobular (P < 0.001) and portal (P < 0.05) inflammation and fibrosis (P < 0.001) at the second biopsy. There were 25 (96.1%) patients with non alcoholic steatohepatitis (NASH) in their index biopsy and only four (15.3%) of the repeat biopsies fulfilled the criteria for NASH. The persistence of fibrosis (F > 1) was present in five patients at second biopsy. Steatosis and fibrosis at surgery were predictors of significant fibrosis postsurgery.

Conclusion: Restrictive mildly malabsorptive surgery provides significant weight loss, resolution of metabolic syndrome and associated abnormal liver histological features in most obese patients.

Citing Articles

Improvement of Metabolic-Associated Fatty Liver Disease by Magnetic Resonance Spectroscopy in Morbidly Obese Women Undergoing Roux-en-Y Gastric Bypass, following a Postoperative Mediterranean-like Diet.

Ruiz-Tovar J, Llavero C, Rodriguez-Ortega M, De Castro N, Martin-Crespo M, Escobar-Aguilar G Nutrients. 2024; 16(14).

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Mid-term Effects of Bariatric Surgery on Metabolic Dysfunction-Associated Fatty Liver Disease Remission and Predictive Factors: A Prospective Study with a Focus on Non-invasive Diagnosis.

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Bariatric surgery improves postprandial VLDL kinetics and restores insulin-mediated regulation of hepatic VLDL production.

Yildirim V, Ter Horst K, Gilijamse P, van Harskamp D, Schierbeek H, Jansen H JCI Insight. 2023; 8(16).

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Therapeutic Potentials of Reducing Liver Fat in Non-Alcoholic Fatty Liver Disease: Close Association with Type 2 Diabetes.

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Comparative effectiveness of medical treatment metabolic surgery for histologically proven non-alcoholic steatohepatitis and fibrosis: a matched network meta-analysis.

Billeter A, Reiners B, Seide S, Probst P, Kalkum E, Rupp C Hepatobiliary Surg Nutr. 2022; 11(5):696-708.

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