Surgical weight loss improves nonalcoholic fatty liver disease

Surgical weight loss results in significant improvement of liver morphology in severely obese patients, reports this month's Annals of Surgery.

Dr Samer and colleagues evaluated the effects of surgical weight loss on fatty liver disease in severely obese patients.

Nonalcoholic fatty liver disease, a spectrum that extends to liver fibrosis and cirrhosis, is rising at an alarming rate.

This increase is occurring in conjunction with the rise of severe obesity and is probably mediated in part by metabolic syndrome.

Surgical weight loss operations, probably by reversing metabolic syndrome, have been shown to result in improvement in liver histology.

The research team included patients who underwent laparoscopic surgical weight loss operations from 1999 through 2004.

There was a marked improvement in liver steatosis from 88% to 8%

Annals of Surgery

The patients agreed to have an intraoperative liver biopsy followed by at least one postoperative liver biopsy.

The team reported that 70 patients were eligible.

All patients underwent laparoscopic operations, the majority being laparoscopic Roux-en-Y gastric bypass.

The researchers found that the mean excess body weight loss at time of second biopsy was 59% and the time interval between biopsies was 15 months.

There was a reduction in prevalence of metabolic syndrome, from 70% to 14%.

The researchers observed a marked improvement in liver steatosis from 88% to 8%, inflammation from 23% to 2%, and fibrosis from 31% to 13%.

The team noted that inflammation and fibrosis resolved in 37% and 20% of patients, respectively.

This improvement corresponded to a change of 82% in grade and 39% in stage of liver disease.

Dr Samer's team concluded, “Surgical weight loss results in significant improvement of liver morphology in severely obese patients.”

“These beneficial changes may be associated with a significant reduction in the prevalence of the metabolic syndrome.”