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Obesity Surgery
Published in: Obesity Surgery 6/2017

01-06-2017 | Original Contributions

Effects of Bariatric Surgery on Liver Function Tests in Patients with Nonalcoholic Fatty Liver Disease

Authors: Geraldine J. Ooi, Paul R. Burton, Lisa Doyle, John M. Wentworth, Prithi S. Bhathal, Ken Sikaris, Michael A. Cowley, Stuart K. Roberts, William Kemp, Arul Earnest, Paul E. O’Brien, Wendy A. Brown

Published in: Obesity Surgery | Issue 6/2017

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Abstract

Objectives

Nonalcoholic fatty liver disease (NAFLD) affects over 80% of obese patients and is fueled by the metabolic syndrome. Weight loss is strongly advocated as a central treatment for NAFLD and has been shown to induce histological improvement. We aimed to define the patterns of improvement in NAFLD with weight loss and determine target weight goals for NAFLD resolution.

Methods

A prospective study of 84 morbidly obese patients with NAFLD undergoing bariatric surgery was conducted. Intraoperative liver biopsies were taken. Monthly follow-up, including blood tests and measurements, was performed. We monitored improvements in NAFLD by monthly alanine aminotransferase (ALT) and gamma glutamyltransferase (GGT) levels over 1 year.

Results

There was rapid improvement in ALT, particularly in the first 6 months following surgery, with statistically significant reduction in ALT at 2 months (35 vs 27 IU/L, p < 0.001). In multivariate analysis, there were significantly increased odds of ALT normalization after a %TBWL of 10–15% (odds ratio 2.49, p = 0.005). The odds of resolution increased with increasing weight loss. Triglyceride levels (odds ratio 0.59, p = 0.021) and baseline NAFLD activity score (odds ratio 0.28, p < 0.001) were also significantly related to ALT normalization. Improvements in ALT occurred prior to metabolic improvement and well before traditional ideal weight goals were reached.

Conclusion

Improvements in NAFLD occurred rapidly after bariatric surgery and were closely related to weight loss and metabolic factors. A 10–15% reduction in body weight is an appropriate target to achieve substantial improvement in ALT levels.
Trial registration number: Australian Clinical Trials Registry (ACTRN12610000049077).
Appendix
Available only for authorised users
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Metadata
Title
Effects of Bariatric Surgery on Liver Function Tests in Patients with Nonalcoholic Fatty Liver Disease
Authors
Geraldine J. Ooi
Paul R. Burton
Lisa Doyle
John M. Wentworth
Prithi S. Bhathal
Ken Sikaris
Michael A. Cowley
Stuart K. Roberts
William Kemp
Arul Earnest
Paul E. O’Brien
Wendy A. Brown
Publication date
01-06-2017
Publisher
Springer US
Published in
Obesity Surgery / Issue 6/2017
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-016-2482-8

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Biography

Arthur Belarmino Garrido Jr., M.D., PhD