Clinical Research

Obesity Surgery

, Volume 22, Issue 7, pp 1016-1021

First online:

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

  • Chi-Ming TaiAffiliated withDepartment of Internal Medicine, E-Da Hospital, I-Shou UniversityInstitute of Clinical Medicine, College of Medicine, Kaohsiung Medical University
  • , Chih-Kun HuangAffiliated withDepartment of Surgery, E-Da Hospital, I-Shou University
  • , Jau-Chung HwangAffiliated withDepartment of Pathology, E-Da Hospital, I-Shou University
  • , Hung ChiangAffiliated withDepartment of Anatomic Pathology, Taipei Institute of Pathology
  • , Chi-Yang ChangAffiliated withDepartment of Internal Medicine, E-Da Hospital, I-Shou University
  • , Ching-Tai LeeAffiliated withDepartment of Internal Medicine, E-Da Hospital, I-Shou University
  • , Ming-Lung YuAffiliated withDepartment of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University Email author 
  • , Jaw-Town LinAffiliated withDepartment of Internal Medicine, E-Da Hospital, I-Shou UniversityDepartment of Internal Medicine, National Taiwan University Hospital, National Taiwan University Email author 

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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.

Keywords

Nonalcoholic fatty liver disease Nonalcoholic steatohepatitis Obesity Bariatric surgery Liver biopsy