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

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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.

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Abbreviations

NAFLD:

Nonalcoholic fatty liver disease

NASH:

Nonalcoholic steatohepatitis

RYGB:

Roux-en-Y gastric bypass

NAS:

NAFLD activity score

BMI:

Body mass index

LRYGB:

Laparoscopic Roux-en-Y gastric bypass

WC:

Waist circumference

AST:

Aspartate aminotransferase

ALT:

Alanine aminotransferase

GGT:

γ-Glutamyltransferase

HDL:

High-density lipoprotein

LDL:

Low-density lipoprotein

HOMA:

Homeostatic model assessment

SD:

Standard deviation

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Acknowledgements

This study was supported by a project of the E-Da Hospital, grant number EDAHP-98-015.

Disclosure

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan

    Chi-Ming Tai, Chi-Yang Chang, Ching-Tai Lee & Jaw-Town Lin

  2. Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

    Chi-Ming Tai

  3. Department of Surgery, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan

    Chih-Kun Huang

  4. Department of Pathology, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan

    Jau-Chung Hwang

  5. Department of Anatomic Pathology, Taipei Institute of Pathology, Taipei, Taiwan

    Hung Chiang

  6. Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 100 Tz-You 1st Road, Kaohsiung, Taiwan

    Ming-Lung Yu

  7. Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan

    Jaw-Town Lin

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  1. Chi-Ming Tai
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  2. Chih-Kun Huang
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  3. Jau-Chung Hwang
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  4. Hung Chiang
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  5. Chi-Yang Chang
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  6. Ching-Tai Lee
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  7. Ming-Lung Yu
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  8. Jaw-Town Lin
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Corresponding authors

Correspondence to Ming-Lung Yu or Jaw-Town Lin.

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Tai, CM., Huang, CK., Hwang, JC. et al. Improvement of Nonalcoholic Fatty Liver Disease After Bariatric Surgery in Morbidly Obese Chinese Patients. OBES SURG 22, 1016–1021 (2012). https://doi.org/10.1007/s11695-011-0579-7

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