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
- 27 Downloads
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.
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.
Based on our study, we conclude that sleeve gastrectomy may be a viable treatment option for management of NAFLD in the obese.
KeywordsBariatric surgery Non-alcoholic fatty liver disease Non-alcoholic steatohepatitis Obesity Sleeve gastrectomy
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
This study has been approved by the institutional research ethics committee. No formal consent was required as this was a retrospective study.
- 5.The World at Six Billion. UN Population Division.Google Scholar
- 24.Mi X-X, Wang L, Xun Y-H, et al. Assessment nonalcoholic fatty liver disease fibrosis score for staging and predicting outcome. Int J Clin Exp Med. 2016;9(8):16146–56.Google Scholar
- 25.Chalasani N, Younossi Z, Lavine JE, et al. The diagnosis and managements of non-alcoholic fatty liver disease: practice guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association. Hepatology. 2012;55(6):2005–23. https://doi.org/10.1002/hep.25762.CrossRefGoogle Scholar
- 36.European Association for Study of Liver. Asociacion Latinoamericana para el Estudio del Higado EASL-ALEH Clinical Practice Guidelines: non-invasive tests for evaluation of liver disease severity and prognosis. J Hepatol. 2015;63:237–64. https://doi.org/10.1016/j.jhep.2015.04.006.CrossRefGoogle Scholar
- 42.Chavez-Tapia NC, Tellez-Avila FI, Barrientos-Gutierrez T, et al. Bariatric surgery for non-alcoholic steatohepatitis in obese patients. Cochrane Database Syst Rev. 2010;20(1):CD007340.Google Scholar
- 43.Ministry of Health. National health survey 2010. Singapore: Epidemiology and Disease Control Division, Ministry of Health; 2011.Google Scholar