The impact of bariatric surgery on nonalcoholic fatty liver disease as measured using non-invasive tests

Abstract

Background: Nonalcoholic fatty liver disease (NAFLD) is common in bariatric surgery candidates. We evaluated the effect of sleeve gastrectomy (SG) on NAFLD using validated non-invasive measures.

Methods: Patients with morbid obesity and NAFLD, planned for SG, were evaluated before and after surgery. Data collected included anthropometrics, biochemistry, adiponectin, SteatoTest™, NashTest™, FibroTest™, OWLiver® test and real-time ShearWave™ elastography (SWE).

Results: Twenty-six subjects were included in the study, mean age 44.1 ± 4.8 years, 69.2% males. One year following SG, body mass index decreased significantly from 41.7 ± 4.8 kg/m² to 29.6 ± 4.5 kg/m². Concomitantly, significant improvements in triglycerides, ALT, diabetes markers and adiponectin were observed. Mean steatosis, as measured by SteatoTest™, was significantly improved. Steatohepatitis score measured by NashTest™ and OWLiver® significantly decreased. Mean fibrosis, as measured by SWE liver stiffness and FibroTest™, did not change over time.

Conclusion: Steatosis and steatohepatitis are significantly improved by SG as measured by non-invasive measures.

Keywords: Bariatric surgery; Non-invasive tests; Nonalcoholic fatty liver disease; Nonalcoholic-steatohepatitis; Steatosis.