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Cited by 100Bariatric Surgery and OutcomesLiver Disease Diagnosis and TreatmentOrgan Transplantation Techniques and Outcomes

Bariatric Surgery as an Efficient Treatment for Non-Alcoholic Fatty Liver Disease in a Prospective Study with 1-Year Follow-up: BariScan Study

Nickel, Felix, Tapking, Christian, Benner, Laura, Sollors, Janina, Billeter, Adrian T., Kenngott, Hannes G., Bokhary, Loay, Schmid, Mathias, von Frankenberg, Moritz, Fischer, Lars, Mueller, Sebastian, Müller-Stich, Beat P.·2018·Obesity Surgery
DOI 10.1007/s11695-017-3012-z
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Abstract

Background Bariatric surgery gains attention as a potential treatment for non-alcoholic fatty liver disease (NAFLD). The present study aimed to evaluate improvement of NAFLD after the two most common bariatric procedures with validated non-invasive instruments.Material and methods N = 100 patients scheduled for laparoscopic sleeve gastrectomy (LSG) or Roux-en-Y gastric bypass (RYGB) were included. NAFLD was evaluated preoperatively and postoperatively with liver stiffness measurement by transient elastography and laboratory-based fibrosis scores. Clinical data included body mass index (BMI), total weight loss (%TWL), excess weight loss (%EWL), age, gender, comorbidities, and the Edmonton obesity staging system (EOSS).Results There were significant improvements of BMI, %TWL, %EWL, and EOSS after bariatric surgery. Liver stiffness was significantly improved from pre- to postoperative (12.9 ± 10.4 vs. 7.1 ± 3.7 kPa, p < 0.001) at median follow-up of 12.5 months. Additionally, there were significant improvements of liver fibrosis scores (aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio 0.8 ± 0.3 vs. 1.1 ± 0.4, p < 0.001; NAFLD fibrosis score - 1.0 ± 1.8 vs. - 1.7 ± 1.3, p < 0.001; APRI score 0.3 ± 0.2 vs. 0.3 ± 0.1, p = 0.009; BARD score 2.3 ± 1.2 vs. 2.8 ± 1.1, p = 0.008) and laboratory parameters (ALT, AST, and GGT). After adjustment for baseline liver stiffness, RYGB showed higher improvements than LSG, and there was no gender difference. Improvement of liver stiffness was not correlated to improvement of BMI, %TWL, %EWL, or EOSS.Conclusions NAFLD seems to be improved by bariatric surgery as measured by validated non-invasive instruments. Furthermore, it appears that RYGB is more effective than LSG. No correlation could be detected between NAFLD and weight loss. The present study highlights the potential of bariatric surgery for successful treatment of NAFLD. Further research is required to understand the exact mechanisms.

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Authors
Nickel, F., Tapking, C., Benner, L., Sollors, J., Billeter, A. T., Kenngott, H. G., Bokhary, L., Schmid, M., von Frankenberg, M., Fischer, L., Mueller, S., & Müller-Stich, B. P.
Affiliations
  • Heidelberg University (DE)
  • Krankenhaus Salem (DE)
Corresponding author
Müller-Stich, Beat P.
ORCID
Venue
Obesity Surgery
Publisher
Springer Science and Business Media LLC
Published
2017-11-09
Volume
28
Issue
5
Pages
1342-1350
ISSN
  • 0960-8923 (ISSN-L)
  • 1708-0428
DOI
10.1007/s11695-017-3012-z
OpenAlex
W2767819524
Cited by
100
References
49
Citations by year
2026: 4 · 2025: 7 · 2024: 7 · 2023: 9 · 2022: 18 · 2021: 13 · 2020: 15 · 2019: 20 · 2018: 7
FWCI
11.76
Type
journal article
Language
en
Open access
closed
Licence
www.springer.com/tdm (unspecified)
Locations
  • Obesity Surgery (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
  • Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
  • Health Sciences › Medicine › Surgery › Organ Transplantation Techniques and Outcomes
Keywords
non-alcoholic fatty liver disease, bariatric surgery
MeSH terms
Adult, Female, Follow-Up Studies, Gastrectomy, Humans, Liver Cirrhosis, Male, Middle Aged, Obesity, Morbid, Laparoscopy, Postoperative Period, Prospective Studies, Research Design, Retrospective Studies, Gastric Bypass, Weight Loss, Comorbidity, Body Mass Index, Treatment Outcome, Bariatric Surgery, Elasticity Imaging Techniques, Non-alcoholic Fatty Liver Disease

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