Effects of bariatric surgery on nonalcoholic fatty liver disease: Preliminary findings after 2 years

• Published in: Journal of gastroenterology and hepatology 2007-04, Vol.22 (4), p.510-514
• Main Authors: Furuya Jr, Carlos K, De Oliveira, Claudia P M S, De Mello, Evandro S, Faintuch, Joel, Raskovski, Alessandra, Matsuda, Mitsunori, Vezozzo, Denise C P, Halpern, Alfredo, Garrido Jr, Arthur B, Alves, Venâncio A F, Carrilho, Flair J
• Format: Article
• Language: English
• Subjects: Adult; Bariatric Surgery; Biological and medical sciences; Biopsy; Body Mass Index; Comorbidity; fatty liver; Fatty Liver - blood; Fatty Liver - etiology; Fatty Liver - pathology; Fatty Liver - surgery; Female; Follow-Up Studies; gamma-Glutamyltransferase - blood; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Lipids - blood; Liver - pathology; Liver Cirrhosis - pathology; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Male; Medical sciences; Metabolic diseases; Middle Aged; morbid obesity; nonalcoholic steatohepatitis; Obesity; Obesity, Morbid - complications; Obesity, Morbid - surgery; Other diseases. Semiology
• ISSN: 0815-9319; 1440-1746
• DOI: 10.1111/j.1440-1746.2007.04833.x

Background and Aim:  Although nonalcoholic fatty liver disease (NAFLD) is very common among morbidly obese patients, the effect of weight loss after bariatric surgery on inflammation and fibrosis related to NAFLD is still a matter of debate. The aim of this study was to evaluate the impact of Roux‐en‐Y gastric bypass (RYGB) surgery on NAFLD with a follow up of 2 years. Methods:  Eighteen consecutive NAFLD patients with body mass index >40 kg/m2 undergoing gastroplasty with RYGB were enrolled, and wedge liver biopsy was obtained at the operation. After 2 years, these patients underwent percutaneous liver biopsy. Results:  At baseline, 67% of patients had nonalcoholic steatohepatitis (NASH) and 33% had steatosis, according to the NASH Clinical Research Network Scoring System (NAS) for biopsy. Cirrhosis was present in 5.5% of the patients with NASH. After a mean excess weight loss of 60%, steatosis disappeared in 84% and fibrosis disappeared in 75% of the patients. Hepatocellular ballooning disappeared in 50%. A slight lobular inflammatory infiltrate remained in 81%, apparently unrelated to fatty degeneration. As liver biochemical variables had been found within normal limits in 92.3% of patients at initial biopsy, no difference was found 2 years later. Lipid profile and blood sugar plasma concentration were closer to normal in all patients after 2 years (P