Alterations in the Liver Fat Fraction Features Examined by Magnetic Resonance Imaging Following Bariatric Surgery: a Self-Controlled Observational Study

  • Mengyi Li
  • Di Cao
  • Yang Liu
  • Lan Jin
  • Na Zeng
  • Lixue Wang
  • Kaixin Zhao
  • Han Lv
  • Meng Zhang
  • Peng Zhang
  • Zhenghan YangEmail author
  • Zhongtao ZhangEmail author
Original Contributions



Obesity is a worldwide epidemic leading to non-alcoholic fatty liver disease. Alterations in the liver fat fraction (LFF) assessed by MRI following bariatric surgery is a promising feature; however, few studies have been fully elucidated.


To determine the alterations in the LFF features following surgery using MRI, to determine the correlation with the clinical non-alcoholic steatohepatitis score (C-NASH score), and to identify the predictive factors for postoperative score changes.


Patients (n = 69) underwent MRI to measure the LFF at baseline and 3 months postoperatively. Paired sample t tests were applied to investigate the alterations in the major parameters. Univariate analyses were performed to evaluate the factors predicting C-NASH score changes after surgery.


Compared with the baseline levels, the LFF significantly decreased 3 months postoperatively (P < 0.001). Significant positive correlations were detected between the C-NASH score and LFF levels (P < 0.001). Among the ROC curves for C-NASH score change, the AUC for the ROC curve of LFF was 0.812 (95% CI 0.707, 0.916) and the cut-off value was 6.16%. Weight at baseline was a significant predictive factor for postoperative changes when the C-NASH score was ≥ 3 (P < 0.001). The AUC for the ROC curve of weight was 0.897 (95% CI 0.782, 1.000) and 117 kg was the cut-off value.


LFF decreased following bariatric surgery, which predicted C-NASH score changes after surgery. For patients with a higher risk of NASH (score ≥ 3) at baseline and lower preoperative body weight, we noted significantly greater effects of surgery on score change value.


Bariatric surgery Liver fat fraction Magnetic resonance imaging C-NASH score 



The authors would like to thank all of the involved study investigators, staffs, clinicians, nurses, and technicians for dedicating their time and skills to the completion of this study.

Funding Information

This study was supported by National Key Technologies R&D Program (Grant No. 2015BAI13B09), National Key Technologies R&D Program of China (No. 2017YFC0110904), Research Foundation of Beijing Friendship Hospital, Capital Medical University (Grant No. yyqdkt 2017-31), and Beijing Municipal Administration of Hospitals Incubating Program (Grant No. PX2018001).

Compliance with Ethical Standards

Conflict of Interests

The authors declare that they have no conflict of interest.

Statement of Informed Consent

Informed consent was obtained from all individual participants included in this study.

Statement of Human and Animal Rights

This study was performed in accordance with the principles of the Declaration of Helsinki and was approved by the Ethics Committees of Beijing Friendship Hospital, Capital Medical University.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2020

Authors and Affiliations

  1. 1.Department of General Surgery, Beijing Friendship HospitalCapital Medical University & National Clinical Research Center for Digestive DiseasesBeijingChina
  2. 2.Department of Radiology, Beijing Friendship HospitalCapital Medical UniversityBeijingChina
  3. 3.National Clinical Research Center for Digestive Diseases, Beijing Friendship HospitalCapital Medical UniversityBeijingChina

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