The effect of significant weight loss on nonalcoholic fatty liver disease remains unclear.
In this study, researchers from Australia assessed the effect of weight loss on nonalcoholic fatty liver disease, including nonalcoholic steatohepatitis (NASH) and hepatic fibrosis.
The team evaluated 36 obese patients.
All patients underwent paired liver biopsies. The first biopsy was taken at the time of laparoscopic adjustable gastric band placement. The second biopsy was taken after weight loss.
|Mean weight loss was 34kg.|
Second biopsies were obtained from patients requiring a subsequent laparoscopic procedure and those with index biopsy score of 2 or greater for zone 3-centric hepatic fibrosis.
The team scored all biopsies for individual histological features and for NASH stage and grade.
The team found that the initial biopsies determined that 23 patients had NASH and 12 steatosis.
Repeat biopsies were taken at 25.6 months after band placement.
The researchers found that mean weight loss was 34kg, and percentage of excess weight loss was 52%.
They found that there were major improvements in lobular steatosis, necroinflammatory changes, and fibrosis at the second biopsy. Portal abnormalities remained unchanged.
Furthermore, they determined that only 4 of the repeat biopsies fulfilled the criteria for NASH.
The team had found that 18 patients had an initial fibrosis score of 2 or more compared with 3 patients at follow-up.
They also established that patients with the metabolic syndrome had more extensive changes before surgery and greater improvement with weight loss.
Dr John Dixon's team concluded, "Weight loss after surgery provides major improvement or resolution of obesity and metabolic syndrome-associated abnormal liver histological features in severely obese subjects".