The Effect of Laparoscopic Sleeve Gastrectomy on the Course of Non-Alcoholic Fatty Liver Disease in Morbidly Obese Patients during One Year of Follow Up

Paulina Głuszyńska; Aleksander Łukaszewicz; Inna Diemieszczyk; Jan Chilmończyk; Joanna Reszeć; Anna Citko; Łukasz Szczerbiński; Adam Krętowski; Hady Razak Hady

doi:10.3390/jcm12124122

The Effect of Laparoscopic Sleeve Gastrectomy on the Course of Non-Alcoholic Fatty Liver Disease in Morbidly Obese Patients during One Year of Follow Up

J Clin Med. 2023 Jun 18;12(12):4122. doi: 10.3390/jcm12124122.

Authors

Affiliations

¹ Department of General and Endocrine Surgery, Medical University of Bialystok, 15-276 Bialystok, Poland.
² Department of Surgery, Independent Public Health Care Center in Lapy, 18-100 Lapy, Poland.
³ Department of Medical Pathomorphology, Medical University of Bialystok, 15-269 Bialystok, Poland.
⁴ Clinical Research Centre, Medical University of Bialystok, 15-276 Bialystok, Poland.
⁵ Department of Endocrinology, Diabetology and Internal Diseases, Medical University of Bialystok, 15-276 Bialystok, Poland.

Abstract

Background: Morbid obesity co-exists with non-alcoholic fatty liver disease in up to 90% of cases. Laparoscopic sleeve gastrectomy leads to a reduction in body mass and thus may improve the course of non-alcoholic fatty liver disease. The aim of this study was to evaluate the effect of laparoscopic sleeve gastrectomy on the resolution of non-alcoholic fatty liver disease.

Methods: The study included 55 patients with non-alcoholic fatty liver disease who underwent laparoscopic sleeve gastrectomy at a tertiary institution. The analysis consisted of preoperative liver biopsy, abdominal ultrasound, weight loss parameters, Non-Alcoholic Fatty Liver Fibrosis Score and selected laboratory parameters.

Results: Before the surgery, 6 patients were diagnosed with grade 1 liver steatosis, 33 patients with grade 2 and 16 patients with grade 3. One year after the surgery, only 21 patients had features of liver steatosis at ultrasound. All weight loss parameters showed statistically significant changes during the observation; the median percentage of total weight loss was 31.0% (IQR: 27.5; 34.5) with p = 0.0003, the median percentage of excess weight loss was 61.8% (IQR: 52.4; 72.3) with p = 0.0013 and the median percentage of excess body mass index loss was 71.0% (IQR: 61.3; 86.9) with p = 0.0036 12 months after laparoscopic sleeve gastrectomy. The median Non-Alcoholic Fatty Liver Fibrosis Score at baseline was 0.2 (IQR: -0.8; 1.0) and decreased to -1.6 (IQR: -2.4; -0.4) (p < 0.0001). Moderate negative correlations between Non-Alcoholic Fatty Liver Fibrosis Score and percentage of total weight loss (r = -0.434, p < 0.0001), percentage of excess weight loss (r = -0.456, p < 0.0001) and percentage of excess body mass index loss (r = -0.512, p < 0.0001) were found.

Conclusions: The study supports the thesis that laparoscopic sleeve gastrectomy is an effective method for treatment of non-alcoholic fatty liver disease in patients with morbid obesity.

Keywords: bariatric/metabolic surgery; laparoscopic sleeve gastrectomy; morbid obesity; non-alcoholic fatty liver disease.

Grants and funding

This research received no external funding.