Katherine J P Schwenger1, Sandra E Fischer2, Timothy Jackson3, Allan Okrainec3, Johane P Allard4. 1. Institute of Medical Science, University of Toronto, Ontario, Canada; Toronto General Hospital, University Health Network, Toronto, Canada. 2. Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada; Division of General Surgery, University of Toronto, Toronto, Canada. 3. Division of General Surgery, University Health Network, Toronto, Canada; Department of Medicine, University of Toronto, Toronto, Canada. 4. Toronto General Hospital, University Health Network, Toronto, Canada; Department of Medicine, University of Toronto, Toronto, Canada; Department of Nutritional Sciences, University of Toronto, Toronto, Canada. Electronic address: Johane.allard@uhn.on.ca.
Abstract
BACKGROUND: In obese individuals undergoing Roux-en-Y gastric bypass (RYGB), nonalcoholic fatty liver disease (NAFLD) is seen in 75% to 100% of cases. This improves postsurgery, but some patients continue to have persistent NAFLD. OBJECTIVE: The purpose of this study was to determine the factors associated with persistent NAFLD at 12 months post-RYGB. SETTING: University Hospital, Canada, bariatric clinic. METHODS: This is a prospective cohort study of 42 patients who underwent RYGB. Liver biopsy, biochemical and clinical parameters were collected pre- and 12 months post-RYGB. Based on histology at 12 months, patients were separated in 2 groups, normal liver (NL) and persistent NAFLD. RESULTS: At baseline, NAFLD was diagnosed in 85.7% of patients and at 12 months post-RYGB, NAFLD was present in 19.1% of patients. Patients who had an NL at baseline remained with NL. RYGB resulted in significant decreases in body mass index, waist circumference, blood pressure, aspartate aminotransferase, alanine aminotransferase, fasting glucose and insulin, glycated hemoglobin, and triglycerides and significant increases in high-density lipoprotein cholesterol. Changes were similar in both groups except for waist circumference, which showed lower changes in those with persistent NAFLD. These patients also had significantly higher (P < .05) fasting glucose and insulin with a higher proportion of patients having insulin resistance compared with those with NL. CONCLUSIONS: RYGB resulted in significant improvements in liver histology, biochemical, and clinical parameters. However, despite similar weight loss, persistent NAFLD was associated with less improvement in waist circumference and worse glycemic control.
BACKGROUND: In obese individuals undergoing Roux-en-Y gastric bypass (RYGB), nonalcoholic fatty liver disease (NAFLD) is seen in 75% to 100% of cases. This improves postsurgery, but some patients continue to have persistent NAFLD. OBJECTIVE: The purpose of this study was to determine the factors associated with persistent NAFLD at 12 months post-RYGB. SETTING: University Hospital, Canada, bariatric clinic. METHODS: This is a prospective cohort study of 42 patients who underwent RYGB. Liver biopsy, biochemical and clinical parameters were collected pre- and 12 months post-RYGB. Based on histology at 12 months, patients were separated in 2 groups, normal liver (NL) and persistent NAFLD. RESULTS: At baseline, NAFLD was diagnosed in 85.7% of patients and at 12 months post-RYGB, NAFLD was present in 19.1% of patients. Patients who had an NL at baseline remained with NL. RYGB resulted in significant decreases in body mass index, waist circumference, blood pressure, aspartate aminotransferase, alanine aminotransferase, fasting glucose and insulin, glycated hemoglobin, and triglycerides and significant increases in high-density lipoprotein cholesterol. Changes were similar in both groups except for waist circumference, which showed lower changes in those with persistent NAFLD. These patients also had significantly higher (P < .05) fasting glucose and insulin with a higher proportion of patients having insulin resistance compared with those with NL. CONCLUSIONS: RYGB resulted in significant improvements in liver histology, biochemical, and clinical parameters. However, despite similar weight loss, persistent NAFLD was associated with less improvement in waist circumference and worse glycemic control.
Authors: Miller Barreto de Brito E Silva; Francisco Tustumi; Antonio Afonso de Miranda Neto; Anna Carolina Batista Dantas; Marco Aurélio Santo; Ivan Cecconello Journal: Obes Surg Date: 2021-04-13 Impact factor: 4.129
Authors: Kine Eide Kvitne; Veronica Krogstad; Christine Wegler; Line Kristin Johnson; Marianne K Kringen; Markus Herberg Hovd; Jens K Hertel; Maria Heijer; Rune Sandbu; Eva Skovlund; Per Artursson; Cecilia Karlsson; Shalini Andersson; Tommy B Andersson; Jøran Hjelmesaeth; Anders Åsberg; Rasmus Jansson-Löfmark; Hege Christensen; Ida Robertsen Journal: Br J Clin Pharmacol Date: 2022-04-25 Impact factor: 3.716