The Impact of Bariatric Surgery on Hepatic Function and Predictors of Liver Steatosis and Fibrosis
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ORIGINAL CONTRIBUTIONS
The Impact of Bariatric Surgery on Hepatic Function and Predictors of Liver Steatosis and Fibrosis Marta Borges-Canha 1,2 & João Sérgio Neves 1,2 & Fernando Mendonça 1 & Maria Manuel Silva 1 & Cláudia Costa 3 & Pedro M. Cabral 4 & Vanessa Guerreiro 1 & Rita Lourenço 5 & Patrícia Meira 5 & Daniela Salazar 1 & Maria João Ferreira 1 & Jorge Pedro 1 & Ana Leite 2 & Sara Viana 1 & Ana Sande 1 & Sandra Belo 1 & Eva Lau 1 & Paula Freitas 1,6 & Davide Carvalho 1,6 & CRIO group
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose To evaluate the variation in parameters of hepatic function and in the scores Fatty Liver Index (FLI; predictor of hepatic steatosis) and BARD (BMI, AST/ALT ratio and DM, predictor of hepatic fibrosis), 1 year after bariatric surgery. Material and Methods This is a observational retrospective cohort study in patients with morbid obesity that underwent bariatric surgery in our centre. We used two linear regression models: (1) unadjusted and (2) adjusted for surgery type, sex, age, body mass index, diabetes, and dyslipidaemia. Results The included population (n = 1955) had an average age of 43.1 ± 10 years and 85.8% were female. Diabetes was present in 32.4% of the patients, 45.1% had dyslipidaemia, and 62.2% had hypertension. Twelve percent were submitted to gastric band, 29.6% to sleeve gastrectomy, and 58.4% to gastric bypass. We observed a relevant decrease in transaminases and gammaglutamyltransferase, and an increase in alkaline phosphatase and total bilirubin. Both FLI and BARD markedly decrease 1 year after surgery (p < 0.01). Comparing the surgical procedures, sleeve gastrectomy was associated with a greater reduction of hepatic enzymes and of both FLI and BARD compared with gastric band. Comparing with gastric bypass, sleeve was associated with a greater reduction of transaminases and alkaline phosphatase, but a smaller reduction of FLI and BARD. Conclusion Bariatric surgery is associated with a reduction of the hepatic enzymes and an improvement of FLI and BARD. It may represent an effective therapeutic approach for NAFLD. Keywords NAFLD . Bariatric surgery . Obesity
Introduction Non-alcoholic fatty liver disease (NAFLD) is a metabolic liver disease characterized by a continuum of liver dysfunction,
ranging from simple steatosis to steatohepatitis and fibrosis. It can ultimately lead to cirrhosis and hepatocarcinoma [1]. According to Practice Guidance From the American Association for the Study of Liver Diseases, the definition of
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11695-020-04622-0) contains supplementary material, which is available to authorized users. * Marta Borges-Canha [email protected] 1
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Serviço de Endocrinologia, Diabetes e Metabolismo do, Centro Hospitalar Universitário de São João, Porto, Portugal Departamento de Cirurgia e Fisiologia, Faculdade de Medicina da Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
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