Bariatric surgery recommended for severely obese patients with NAFLD

CHICAGO — Bariatric surgery improved overall status of non-alcoholic fatty liver disease among patients with obesity and showed a potential reversal of early-stage fibrosis, according to new data presented at Digestive Disease Week 2014.

Researchers compared liver biopsies performed among 152 patients undergoing bariatric surgery with additional biopsies that occurred during later abdominal surgeries post-procedure between 1998 and 2013. Comparisons were blinded and performed under standard procedures using Brunt classifications. The average time between biopsies was 2.5 years. The mean pre-operative body mass index was 52 kg/m²; average weight loss was 62% at the time of the successive biopsy.

Initial biopsies revealed steatosis (77%), lobular inflammation (42%) and chronic portal inflammation (68%) among patients. Twenty-six percent of patients had steatohepatitis, 56% had grade 2-3 fibrosis and 2% had cirrhosis. These symptoms, if they progress, can lead to potentially life-threatening disease. In the biopsies examined after surgery, resolution or improvements were observed among 86% of steatosis patients, while 8% stayed the same and 6% worsened post-operatively.

In the biopsies examined after surgery, 93% of patients with steatohepatitis resolved or showed improvement, while 5% stayed the same and no cases of worsening occurred. In addition, 56% of patients with any grade of fibrosis showed resolution or improvement post-operatively; 25% remained the same while 16% worsened.

“Our data provided objective evidence that bariatric surgery improves the liver histology in non-alcoholic fatty liver disease,” Andrew A. Taitano, MD, general surgeon and instructor at the Albany Medical College, said at the conference. According to the presentation, with fibrosis resolved or improved in over half of patients, “Bariatric surgery should be considered one of the treatments for NAFLD in patients with severe obesity.” - by Melinda Stevens

For more information:

Taitano A. Abstract #233. Presented at Digestive Disease Week 2014; May 3-6; Chicago.

Disclosure: The researchers report no relevant financial disclosures.