Advertisement

Obesity Surgery

, Volume 29, Issue 4, pp 1195–1201 | Cite as

Long-term Results of Bariatric Surgery for Non-alcoholic Fatty Liver Disease/Non-alcoholic Steatohepatitis Treatment in Morbidly Obese Japanese Patients

  • Daisuke Uehara
  • Yosuke Seki
  • Satoru KakizakiEmail author
  • Norio Horiguchi
  • Hiroki Tojima
  • Yuichi Yamazaki
  • Ken Sato
  • Masanobu Yamada
  • Toshio Uraoka
  • Kazunori Kasama
Original Contribution
  • 222 Downloads

Abstract

Background

Patients with morbid obesity are complicated with metabolic diseases and have a high incidence of non-alcoholic fatty liver disease (NAFLD), including non-alcoholic steatohepatitis (NASH).

Methods

We report on a follow-up study of a cohort included 102 obese patients (55 males and 47 females, mean age 42.9 ± 10.6 years) undergoing bariatric surgery for the management of morbid obesity. Abdominal computed tomography was performed before and 1 year after surgery. Anthropometric and biochemical measurements were performed at 1, 3, and 5 years after surgery.

Results

The mean body mass index (BMI) of the NAFLD patients improved from 42.5 ± 8.3 kg/m2 to 28.5 ± 6.9, and 29.1 ± 5.7, 29.7 ± 5.5 kg/m2 at 1, 3, and 5 years, respectively. The liver fat accumulation and visceral fat areas were significantly improved at 1 year after surgery. The decrease in the BMI, waist-hip ratio, body fat percentage, and basal metabolic rate remained decreased for at least 5 years after surgery. Blood test findings including AST, ALT, γ-GTP, uric acid, albumin, CRP, HDL cholesterol, LDL cholesterol, triglycerides, and homeostasis model assessment insulin resistance (HOMA-IR) were also still improved at least 5 years after surgery.

Conclusion

Bariatric surgery is useful for ensuring the long-term treatment of NAFLD/NASH in morbidly obese Japanese patients. Bariatric surgery is a therapeutic option for patients resistant to conventional treatment.

Keywords

Non-alcoholic steatohepatitis Non-alcoholic fatty liver disease Morbidly obesity Bariatric surgery Long-term treatment 

Abbreviations

NAFLD

Non-alcoholic fatty liver disease

NASH

Non-alcoholic steatohepatitis

NAFL

Non-alcoholic fatty liver

LRYGB

Laparoscopic Roux-en-Y gastric bypass surgery

APMBSS

Asia-Pacific Metabolic and Bariatric Surgery Society

BMI

Body mass index

FPG

Fasting plasma glucose

FIRI

Fasting blood insulin

HOMA-IR

Homeostasis model assessment insulin resistance

Notes

Compliance with Ethical Standards

This study was approved by institutional review board (IRB) of both Yotsuya Medical Cube and Gunma University Hospital.

Conflict of Interest

The authors declare that they have no conflict of interest.

Supplementary material

11695_2018_3641_MOESM1_ESM.docx (26 kb)
ESM 1 (DOCX 25 kb)

References

  1. 1.
    Shuai X, Tao K, Mori M, et al. Bariatric surgery for metabolic syndrome in obesity. Metab Syndr Relat Disord. 2015;13:149–60.CrossRefGoogle Scholar
  2. 2.
    Seki Y, Kakizaki S, Horiguchi N, et al. Prevalence of nonalcoholic steatohepatitis in Japanese patients with morbid obesity undergoing bariatric surgery. J Gastroenterol. 2016;51:281–9.CrossRefGoogle Scholar
  3. 3.
    Liang RJ, Wang HH, Lee WJ, et al. Diagnostic value of ultrasonographic examination for nonalcoholic steatohepatitis in morbidly obese patients undergoing laparoscopic bariatric surgery. Obes Surg. 2007;17:45–56.CrossRefGoogle Scholar
  4. 4.
    Dixon JB, Bhathal PS, O’Brien PE. Nonalcoholic fatty liver disease: predictors of nonalcoholic steatohepatitis and liver fibrosis in the severely obese. Gastroenterology. 2001;121:91–100.CrossRefGoogle Scholar
  5. 5.
    Chisholm J, Seki Y, Toouli J, et al. Serologic predictors of nonalcoholic steatohepatitis in a population undergoing bariatric surgery. Surg Obes Relat Dis. 2012;8:416–22.CrossRefGoogle Scholar
  6. 6.
    Harnois F, Msika S, Sabaté JM, et al. Prevalence and predictive factors of non-alcoholic steatohepatitis (NASH) in morbidly obese patients undergoing bariatric surgery. Obes Surg. 2006;16:183–8.CrossRefGoogle Scholar
  7. 7.
    Kakizaki S, Takizawa D, Yamazaki Y, et al. Nonalcoholic fatty liver disease in Japanese patients with severe obesity who received laparoscopic Roux-en-Y gastric bypass surgery (LRYGB) in comparison to non-Japanese patients. J Gastroenterol. 2008;43:86–92.CrossRefGoogle Scholar
  8. 8.
    Lee WJ, Wang W. Bariatric surgery: Asia-Pacific perspective. Obes Surg. 2005;15:751–7.CrossRefGoogle Scholar
  9. 9.
    The Japanese Society of Gastroenterology. Evidence-based clinical practice guidelines for nonalcoholic fatty liver disease/ nonalcoholic steatohepatitis 2014. Tokyo: Nankodo; 2013.Google Scholar
  10. 10.
    Watanabe S, Hashimoto E, Ikejima K, et al. Evidence-based clinical practice guidelines for nonalcoholic fatty liver disease/nonalcoholic steatohepatitis. Hepatol Res. 2015;45:363–77.CrossRefGoogle Scholar
  11. 11.
    Sakitani K, Enooku K, Kubo H, et al. Clinical characteristics of patients with diabetes mellitus and fatty liver diagnosed by liver/spleen Hounsfield units on CT scan. J Int Med Res. 2017;45:1208–20.CrossRefGoogle Scholar
  12. 12.
    The Japan Diabetes Society. Evidence-based practice guideline for the treatment for diabetes in Japan 2013. Tokyo: Nankodo; 2013.Google Scholar
  13. 13.
    Lassailly G, Caiazzo R, Buob D, et al. Bariatric surgery reduces features of nonalcoholic steatohepatitis in morbidly obese patients. Gastroenterology. 2015;149:379–88.CrossRefGoogle Scholar
  14. 14.
    Schneck AS, Anty R, Patouraux S, et al. Roux-en-Y gastric bypass results in long-term remission of hepatocyte apoptosis and hepatic histological features of non-alcoholic steatohepatitis. Front Physiol. 2016;7:344.CrossRefGoogle Scholar
  15. 15.
    Colles SL, Dixon JB, Marks P, et al. Preoperative weight loss with a very-low-energy diet: quantitation of changes in liver and abdominal fat by serial imaging. Am J Clin Nutr. 2006;84:304–11.CrossRefGoogle Scholar
  16. 16.
    Lackner C, Struber G, Liegl B, et al. Comparison and validation of simple noninvasive tests for prediction of fibrosis in chronic hepatitis C. Hepatology. 2005;41:1376–82.CrossRefGoogle Scholar
  17. 17.
    Furuncuoğlu Y, Tulgar S, Dogan AN, et al. How obesity affects the neutrophil/lymphocyte and platelet/lymphocyte ratio, systemic immune-inflammatory index and platelet indices: a retrospective study. Eur Rev Med Pharmacol Sci. 2016;20:1300–6.Google Scholar
  18. 18.
    Koca TT. Does obesity cause chronic inflammation? The association between complete blood parameters with body mass index and fasting glucose. Pak J Med Sci. 2017;33(1):65–9.CrossRefGoogle Scholar
  19. 19.
    Yoshioka K, Hashimoto S, Kawabe N. Measurement of liver stiffness as a non-invasive method for diagnosis of non-alcoholic fatty liver disease. Hepatol Res. 2015;45:142–51.CrossRefGoogle Scholar
  20. 20.
    Chen J, Talwalkar JA, Yin M, et al. Early detection of nonalcoholic steatohepatitis in patients with nonalcoholic fatty liver disease by using MR elastography. Radiology. 2011;259:749–56.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Daisuke Uehara
    • 1
    • 2
  • Yosuke Seki
    • 3
  • Satoru Kakizaki
    • 2
    Email author
  • Norio Horiguchi
    • 2
  • Hiroki Tojima
    • 2
  • Yuichi Yamazaki
    • 2
  • Ken Sato
    • 2
  • Masanobu Yamada
    • 1
    • 4
  • Toshio Uraoka
    • 2
  • Kazunori Kasama
    • 3
  1. 1.Department of Medicine and Molecular ScienceGunma University Graduate School of MedicineMaebashiJapan
  2. 2.Department of Gastroenterology and HepatologyGunma University Graduate School of MedicineMaebashiJapan
  3. 3.Weight Loss and Metabolic Surgery CenterYotsuya Medical CubeTokyoJapan
  4. 4.Department of Internal Medicine, Division of Endocrinology and MetabolismGunma University Graduate School of MedicineMaebashiJapan

Personalised recommendations