Obesity Surgery

, Volume 28, Issue 1, pp 142–151 | Cite as

Morphofunctional Changes After Sleeve Gastrectomy and Very Low Calorie Diet in an Animal Model of Non-Alcoholic Fatty Liver Disease

  • Eider Talavera-Urquijo
  • Sarai Rodríguez-Navarro
  • Marc Beisani
  • Maria Teresa Salcedo-Allende
  • Aisha Chakkur
  • Marc Arús-Avilés
  • Manel Cremades
  • Salvador Augustin
  • María Martell
  • José M. Balibrea
Original Contributions



Non-alcoholic fatty liver disease (NAFLD) is the most prevalent chronic liver disease and is found in 70% of obese people. The evidence available to date suggests that bariatric surgery could be an effective treatment by reducing weight and also by improving metabolic complications in the long term. This work aimed to compare, in a diet-induced NAFLD animal model, the effect of both sleeve gastrectomy (SG) and very-low calorie diet (VLCD).


Thirty-five Wistar rats were divided into control rats (n = 7) and obese rats fed a high-fat diet (HFD). After 10 weeks, the obese rats were subdivided into four groups: HFD (n = 7), VLCD (n = 7), and rats submitted to either a sham operation (n = 7) or SG (n = 7). Both liver tissue and blood samples were processed to evaluate steatosis and NASH changes in histology (Oil Red, Sirius Red and H&E); presence of endothelial damage (CD31, Moesin/p-Moesin, Akt/p-Akt, eNOS/p-eNOS), oxidative stress (iNOS) and fibrosis (αSMA, Col1, PDGF, VEGF) proteins in liver tissue; and inflammatory (IL6, IL10, MCP-1, IL17α, TNFα), liver biochemical function, and hormonal (leptin, ghrelin, visfatin and insulin) alterations in plasma.


Both VLCD and SG improved histology, but only SG induced a significant weight loss, improved endothelial damage, and a decreased cardiovascular risk by reducing insulin resistance (IR), leptin, total cholesterol, and triglyceride levels. There were no relevant variations in the inflammatory and fibrosis markers.


Our study suggests a slight superiority of SG over VLCD by improving not only the histology but also the IR and cardiovascular risk markers related to NAFLD.


Fatty liver disease Very low calorie diet Sleeve gastrectomy Inflammation Liver fibrosis Endothelial damage Bariatric surgery animal model 


Compliance with Ethical Standards

Funding Sources

Salvador Augustin is a recipient of a Juan Rodés grant from Instituto de Salud Carlos III, Spain. The study was partially funded by grants PI12/00448 (IP: JM Balibrea), PI13/01289, and PI14/00331 from Instituto de Salud Carlos III, Spain and co-funded by European Union (ERDF/ESF, “Investing in your future”). CIBERehd is supported by Instituto de Salud Carlos III, Spain.

Conflict of Interest

Dr. Talavera-Urquijo has nothing to disclose.

Dr. Rodríguez-Navarro has nothing to disclose.

Dr. Beisani has nothing to disclose.

Dr. Salcedo-Allende has nothing to disclose.

Dr. Chakkur has nothing to disclose.

Dr. Arús-Avilés has nothing to disclose.

Dr. Cremades has nothing to disclose.

Dr. Augustin reports grants from Instituto Carlos III during the conduct of the study.

Dr. Martell reports grants from Instituto Carlos III, during the conduct of the study.

Dr. Balibrea reports grants from Instituto Carlos III, during the conduct of the study; personal fees from Johnson&Johnson (Ethicon), outside the submitted work.


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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Eider Talavera-Urquijo
    • 1
  • Sarai Rodríguez-Navarro
    • 2
  • Marc Beisani
    • 1
  • Maria Teresa Salcedo-Allende
    • 3
  • Aisha Chakkur
    • 2
  • Marc Arús-Avilés
    • 2
  • Manel Cremades
    • 4
  • Salvador Augustin
    • 2
    • 5
  • María Martell
    • 2
    • 5
  • José M. Balibrea
    • 1
    • 6
    • 7
  1. 1.Department of General and Digestive SurgeryVall d’Hebron University HospitalBarcelonaSpain
  2. 2.Liver Unit, Department of Internal Medicine, Hospital Universitari Vall d’Hebron, Institut de Recerca Vall d’Hebron (VHIR)Universitat Autònoma de BarcelonaBarcelonaSpain
  3. 3.Human Pathology DepartmentVall d’Hebron University HospitalBarcelonaSpain
  4. 4.Department of General and Digestive SurgeryGermans Trias i Pujol University HospitalBarcelonaSpain
  5. 5.Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Instituto de Salud Carlos IIIMadridSpain
  6. 6.Metabolic and Bariatric Surgery Unit, EAC-BS Center of ExcellenceVall d’Hebron University HospitalBarcelonaSpain
  7. 7.Department of SurgeryUniversitat Autònoma de BarcelonaBarcelonaSpain

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