Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Obesity Surgery
Published in: Obesity Surgery 7/2012

01-07-2012 | Clinical Research

Improvement of Nonalcoholic Fatty Liver Disease After Bariatric Surgery in Morbidly Obese Chinese Patients

Authors: Chi-Ming Tai, Chih-Kun Huang, Jau-Chung Hwang, Hung Chiang, Chi-Yang Chang, Ching-Tai Lee, Ming-Lung Yu, Jaw-Town Lin

Published in: Obesity Surgery | Issue 7/2012

Login to get access

Abstract

Background

Obesity is a risk factor for nonalcoholic fatty liver disease (NAFLD), which appears to improve after weight loss induced by bariatric surgery in Western countries. The present study aims to determine the alterations of clinical measurements and liver histology of NAFLD after bariatric surgery in morbidly obese Chinese patients.

Methods

Between November 2006 and December 2007, 21 morbidly obese patients receiving intra-operative liver biopsy and follow-up liver biopsy 1 year after laparoscopic Roux-en-Y gastric bypass were enrolled. NAFLD activity score (NAS) and fibrosis stage were histologically evaluated.

Results

The mean body mass index fell from 43.8 ± 7.5 to 28.3 ± 4.6 kg/m2 (P < 0.01). Biochemical improvement was found in serum levels of alanine aminotransferase (P < 0.01) and γ-glutamyltransferase (P < 0.01), but not aspartate aminotransferase (P = 0.66). Histological improvement was noted in NAS (P < 0.01) and individual components, including steatosis (P < 0.01), ballooning degeneration (P < 0.01), and lobular inflammation (P = 0.02). Pre-operatively, 4 (19.0%), 11 (52.4%), and 6 (28.6%) patients were found to have NAS ≧5, 3 or 4, and ≦2, respectively. All patients had NAS ≦2 after surgery. Fibrosis stage also showed significant improvement (P < 0.01).

Conclusions

Bariatric surgery can achieve a dramatic improvement of NAFLD both biochemically and histologically in morbidly obese Chinese patients.
Literature
1.
Harrison SA, Kadakia S, Lang KA, et al. Nonalcoholic steatohepatitis: what we know in the new millennium. Am J Gastroenterol. 2002;97:2714–24.PubMed
2.
3.
Clark JM, Brancati FL, Diehl AM. Nonalcoholic fatty liver disease. Gastroenterology. 2002;122:1649–57.PubMedCrossRef
4.
Clark JM, Alkhuraishi AR, Solga SF, et al. Roux-en-Y gastric bypass improves liver histology in patients with non-alcoholic fatty liver disease. Obes Res. 2005;13:1180–6.PubMedCrossRef
5.
Pillai AA, Rinella ME. Non-alcoholic fatty liver disease: is bariatric surgery the answer? Clin Liver Dis. 2009;13:689–710.PubMedCrossRef
6.
Marchesini G, Bugianesi E, Forlani G, et al. Nonalcoholic fatty liver, steatohepatitis, and the metabolic syndrome. Hepatology. 2003;37:917–23.PubMedCrossRef
7.
Marchesini G, Brizi M, Bianchi G, et al. Nonalcoholic fatty liver disease: a feature of the metabolic syndrome. Diabetes. 2001;50:1844–50.PubMedCrossRef
8.
Marchesini G, Brizi M, Morselli-Labate AM, et al. Association of nonalcoholic fatty liver disease with insulin resistance. Am J Med. 1999;107:450–5.PubMedCrossRef
9.
Mattar SG, Velcu LM, Rabinovitz M, et al. Surgically-induced weight loss significantly improves nonalcoholic fatty liver disease and the metabolic syndrome. Ann Surg. 2005;242:610–7.PubMed
10.
Mottin CC, Moretto M, Padoin AV, et al. Histological behavior of hepatic steatosis in morbidly obese patients after weight loss induced by bariatric surgery. Obes Surg. 2005;15:788–93.PubMedCrossRef
11.
Csendes A, Smok G, Burgos AM. Histological findings in the liver before and after gastric bypass. Obes Surg. 2006;16:607–11.PubMedCrossRef
12.
de Almeida SR, Rocha PR, Sanches MD, et al. Roux-en-Y gastric bypass improves the nonalcoholic steatohepatitis (NASH) of morbid obesity. Obes Surg. 2006;16:270–8.PubMedCrossRef
13.
Barker KB, Palekar NA, Bowers SP, et al. Non-alcoholic steatohepatitis: effect of Roux-en-Y gastric bypass surgery. Am J Gastroenterol. 2006;101:368–73.PubMedCrossRef
14.
Liu X, Lazenby AJ, Clements RH, et al. Resolution of nonalcoholic steatohepatits after gastric bypass surgery. Obes Surg. 2007;17:486–92.PubMedCrossRef
15.
Furuya Jr CK, de Oliveira CP, de Mello ES, et al. Effects of bariatric surgery on nonalcoholic fatty liver disease: preliminary findings after 2 years. J Gastroenterol Hepatol. 2007;22:510–4.PubMedCrossRef
16.
Dixon JB, Bhathal PS, Hughes NR, et al. Nonalcoholic fatty liver disease: improvement in liver histological analysis with weight loss. Hepatology. 2004;39:1647–54.PubMedCrossRef
17.
Liew PL, Lee WJ, Wang W, et al. Fatty liver disease: predictors of nonalcoholic steatohepatitis and gallbladder disease in morbid obesity. Obes Surg. 2008;18:847–53.PubMedCrossRef
18.
Huang CK, Lee YC, Hung CM, et al. Laparoscopic Roux-en-Y gastric bypass for morbidly obese Chinese patients: learning curve, advocacy and complications. Obes Surg. 2008;18:776–81.PubMedCrossRef
19.
Alberti KG, Eckel RH, Grundy SM, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009;120:1640–5.PubMedCrossRef
20.
Wallace TM, Levy JC, Matthews DR. Use and abuse of HOMA modeling. Diabetes Care. 2004;27:1487–95.PubMedCrossRef
21.
Kleiner DE, Brunt EM, Van Natta M, et al. Design and validation of a histological scoring system for nonalcoholic fatty liver disease. Hepatology. 2005;41:1313–21.PubMedCrossRef
22.
Mummadi RR, Kasturi KS, Chennareddygari S, et al. Effect of bariatric surgery on nonalcoholic fatty liver disease: systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2008;6:1396–402.PubMedCrossRef
23.
Padoin AV, Mottin CC, Moretto M, et al. A comparison of wedge and needle hepatic biopsy in open bariatric surgery. Obes Surg. 2006;16:178–82.PubMedCrossRef
24.
Mathurin P, Hollebecque A, Arnalsteen L, et al. Prospective study of the long-term effects of bariatric surgery on liver injury in patients without advanced disease. Gastroenterology. 2009;137:532–40.PubMedCrossRef
25.
Chavez-Tapia NC, Tellez-Avila FI, Barrientos-Gutierrez T, et al. Bariatric surgery for non-alcoholic steatohepatitis in obese patients. Cochrane Database Syst Rev. 2010;(1):CD007340.
Metadata
Title
Improvement of Nonalcoholic Fatty Liver Disease After Bariatric Surgery in Morbidly Obese Chinese Patients
Authors
Chi-Ming Tai
Chih-Kun Huang
Jau-Chung Hwang
Hung Chiang
Chi-Yang Chang
Ching-Tai Lee
Ming-Lung Yu
Jaw-Town Lin
Publication date
01-07-2012
Publisher
Springer-Verlag
Published in
Obesity Surgery / Issue 7/2012
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-011-0579-7

Other articles of this Issue 7/2012

Obesity Surgery 7/2012 Go to the issue

Technical Innovation

Sleeve Gastrectomy Plus Side-to-Side Jejunoileal Anastomosis for the Treatment of Morbid Obesity and Metabolic Diseases: a Promising Operation

Clinical Research

Upper Gastrointestinal Swallow Study Following Bariatric Surgery: Institutional Review and Review of the Literature

Other

Perioperative Morbi-mortality Associated with Bariatric Surgery: from Systematic Biliopancreatic Diversion to A Tailored Laparoscopic Gastric Bypass or Sleeve Gastrectomy Approach

Animal Research

Roux-en-Y Gastric Bypass in Mice—Surgical Technique and Characterisation

Editorial

Insights into Proximal Pouch Dilatation Following Adjustable Gastric Banding—a Form of Inattentional Blindness?

Clinical Research

Esophageal Motility after Laparoscopic Roux-en-Y Gastric Bypass: the Manometry Should Be Preoperative Examination Routine?