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Improvement in Non-alcoholic Fatty Liver Disease Score Correlates with Weight Loss in Obese Patients Undergoing Laparoscopic Sleeve Gastrectomy: a Two-Centre Study from an Asian Cohort

  • Zong Jie Koh
  • Hrishikesh Pandurang Salgaonkar
  • Wei Jie Jonathan Lee
  • Guo Wei Kim
  • Chun Hai Tan
  • Anton Cheng
  • Davide Lomanto
  • Jimmy Bok Yan So
  • Yock Young Dan
  • Asim Shabbir
Original Contributions
  • 27 Downloads

Abstract

Purpose

Incidence of non-alcoholic fatty liver disease (NAFLD) is on the rise and is one of the most common causes of chronic liver disease worldwide. Obesity and metabolic syndrome are considered the most significant risk factors. Bariatric surgery is the only treatment modality in morbid obesity which allows long-term weight loss with improvement in associated co-morbid conditions. However, the effects of bariatric surgery on NAFLD are not well established. NAFLD fibrosis score (NFS) is a validated non-invasive scoring system used to assess advanced fibrosis. We used the NFS to analyse the impact of weight loss on NAFLD following sleeve gastrectomy.

Materials and Methods

174 patients who underwent bariatric surgery between 2010 and 2016 were retrospectively reviewed. Multivariate analysis was performed using pre-operative patient characteristics, biochemical markers and TANITA body analysis measurements to determine significant risk factors for NFS > 0.675. Additionally, the NFS was calculated at 6 months, 1 year and 2 years post-operatively to determine correlation with weight loss.

Results

Pre-operatively, 13.8% of our patients had significant fibrosis by NFS. Mean change in NFS was − 0.46 ± 1.02, − 0.55 ± 0.98 and − 0.55 ± 1.12 at 6 months, 1 year and 2 years respectively. This was significantly correlated with percent of total weight loss with R coefficients of 0.253, 0.292 and 0.274 respectively (P < 0.05). 79.2% of patients with NFS > 0.675 achieved resolution by 2 years post-operatively.

Conclusion

Based on our study, we conclude that sleeve gastrectomy may be a viable treatment option for management of NAFLD in the obese.

Keywords

Bariatric surgery Non-alcoholic fatty liver disease Non-alcoholic steatohepatitis Obesity Sleeve gastrectomy 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethics Statements

This study has been approved by the institutional research ethics committee. No formal consent was required as this was a retrospective study.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Zong Jie Koh
    • 1
  • Hrishikesh Pandurang Salgaonkar
    • 1
  • Wei Jie Jonathan Lee
    • 2
  • Guo Wei Kim
    • 1
  • Chun Hai Tan
    • 3
  • Anton Cheng
    • 3
  • Davide Lomanto
    • 1
  • Jimmy Bok Yan So
    • 1
  • Yock Young Dan
    • 2
  • Asim Shabbir
    • 1
  1. 1.Department of General SurgeryNational University Health SystemSingaporeSingapore
  2. 2.Department of GastroenterologyNational University Health SystemSingaporeSingapore
  3. 3.Department of General SurgeryKhoo Teck Puat HospitalSingaporeSingapore

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