Obesity Surgery

, Volume 22, Issue 7, pp 1016–1021

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

Authors

  • Chi-Ming Tai
    • Department of Internal Medicine, E-Da HospitalI-Shou University
    • Institute of Clinical Medicine, College of MedicineKaohsiung Medical University
  • Chih-Kun Huang
    • Department of Surgery, E-Da HospitalI-Shou University
  • Jau-Chung Hwang
    • Department of Pathology, E-Da HospitalI-Shou University
  • Hung Chiang
    • Department of Anatomic PathologyTaipei Institute of Pathology
  • Chi-Yang Chang
    • Department of Internal Medicine, E-Da HospitalI-Shou University
  • Ching-Tai Lee
    • Department of Internal Medicine, E-Da HospitalI-Shou University
    • Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University HospitalKaohsiung Medical University
    • Department of Internal Medicine, E-Da HospitalI-Shou University
    • Department of Internal Medicine, National Taiwan University HospitalNational Taiwan University
Clinical Research

DOI: 10.1007/s11695-011-0579-7

Cite this article as:
Tai, C., Huang, C., Hwang, J. et al. OBES SURG (2012) 22: 1016. doi:10.1007/s11695-011-0579-7

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 diseaseNonalcoholic steatohepatitisObesityBariatric surgeryLiver biopsy

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

Copyright information

© Springer Science + Business Media, LLC 2011