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Published in:

01-04-2018

How bariatric surgery affects liver volume and fat density in NAFLD patients

Authors: Ran B. Luo, Toshiaki Suzuki, Jonathan C. Hooker, Yesenia Covarrubias, Alexandra Schlein, Shanglei Liu, Jeffrey B. Schwimmer, Scott B. Reeder, Luke M. Funk, Jacob A. Greenberg, Guilherme M. Campos, Bryan J. Sandler, Santiago Horgan, Claude B. Sirlin, Garth R. Jacobsen

Published in: Surgical Endoscopy | Issue 4/2018

Abstract

Introduction

Nonalcoholic fatty liver disease (NAFLD) is an epidemic in the obese population. Bariatric surgery is known to reverse multiple metabolic complications of obesity such as diabetes, dyslipidemia, and NAFLD, but the timing of liver changes has not been well described.

Materials and Methods

This was an IRB-approved, two-institutional prospective study. Bariatric patients received MRIs at baseline and after a pre-operative liquid diet. Liver biopsies were performed during surgery and if NAFLD positive, the patients received MRIs at 1, 3, and 6 months. Liver volumes and proton-density fat fraction (PDFF) were calculated from offline MRI images. Primary outcomes were changes in weight, body mass index (BMI), percent excess weight loss (EWL%), liver volume, and PDFF. Resolution of steatosis, as defined as PDFF < 6.4% based on previously published cutoffs, was assessed. Secondarily, outcomes were compared between patients who underwent laparoscopic sleeve gastrectomy (LSG) versus laparoscopic Roux-en-Y gastric bypass (LRYGB).

Results

From October 2010 to June 2015, 124 patients were recruited. 49 patients (39.5%) completed all five scans. EWL% at 6 months was 55.6 ± 19.0%. BMI decreased from 45.3 ± 5.9 to 34.4 ± 5.1 kg/m² and mean liver volume decreased from 2464.6 ± 619.4 to 1874.3 ± 387.8 cm³ with a volume change of 21.4 ± 11.4%. PDFF decreased from 16.6 ± 7.8 to 4.4 ± 3.4%. At 6 months, 83.7% patients had resolution of steatosis. Liver volume plateaued at 1 month, but PDFF and BMI continued to decrease. There were no statistically significant differences in liver volume or PDFF reduction from baseline to 6 months between the LSG versus LRYGB subgroups.

Conclusion

Patients with NAFLD undergoing bariatric surgery can expect significant decreases in liver volume and hepatic steatosis at 6 months, with 83.7% of patients achieving resolution of steatosis. Liver volume reduction plateaus 1-month post-bariatric surgery, but PDFF continues to decrease. LSG and LRYGB did not differ in efficacy for inducing regression of hepatosteatosis.

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Title: How bariatric surgery affects liver volume and fat density in NAFLD patients
Authors: Ran B. Luo
Toshiaki Suzuki
Jonathan C. Hooker
Yesenia Covarrubias
Alexandra Schlein
Shanglei Liu
Jeffrey B. Schwimmer
Scott B. Reeder
Luke M. Funk
Jacob A. Greenberg
Guilherme M. Campos
Bryan J. Sandler
Santiago Horgan
Claude B. Sirlin
Garth R. Jacobsen
Publication date: 01-04-2018
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 4/2018
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-017-5846-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

How bariatric surgery affects liver volume and fat density in NAFLD patients

Abstract

Introduction

Materials and Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Materials and Methods

Results

Conclusion

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