Nonalcoholic fatty liver disease is very common among morbidly obese patients.
However, the effect of weight loss after bariatric surgery on inflammation and fibrosis related to nonalcoholic fatty liver disease is still a matter of debate.
Dr Carlos Furuya and colleagues from Brazil evaluated the impact of Roux-en-Y gastric bypass surgery on nonalcoholic fatty liver disease with a follow up of 2 years.
|Steatosis disappeared in 84% after 60% excess weight loss|
|Journal of Gastroenterology and Hepatology|
The research team enrolled 18 consecutive nonalcoholic fatty liver disease patients with a body mass index over 40 kg/m2.
The patients underwent gastroplasty with Roux-en-Y gastric bypass.
The team obtained wedge liver biopsy at the operation.
After 2 years, these patients underwent percutaneous liver biopsy.
The team used the nonalcoholic steatohepatitis Clinical Research Network Scoring System for biopsy.
The researchers found at baseline, that 67% of patients had nonalcoholic steatohepatitis, and 33% had steatosis.
Cirrhosis was present in 6% of the patients with nonalcoholic steatohepatitis.
After a mean excess weight loss of 60%, steatosis disappeared in 84%, and fibrosis disappeared in 75% of the patients.
The research team observed that hepatocellular ballooning disappeared in 50%.
A slight lobular inflammatory infiltrate remained in 81%, apparently unrelated to fatty degeneration.
The researchers found that as liver biochemical variables had been found within normal limits in 92% of patients at initial biopsy.
The research team observed no difference 2 years later.
Lipid profile and blood sugar plasma concentration were closer to normal in all patients after 2 years.
Dr Furuya's team concluded, “Aspects of nonalcoholic fatty liver disease including steatohepatitis improved significantly with massive weight loss at 2 years after Roux-en-Y gastric bypass surgery.”
“No patient in this series had progression of hepatic fibrosis.”