Carmit Netanel1, David Goitein2, Moshe Rubin3, Yeruham Kleinbaum4, Sima Katsherginsky5, Hila Hermon6, Keren Tsaraf7, Irina Tachlytski8, Amir Herman9, Michal Safran10, Ziv Ben-Ari11. 1. Liver Disease Center, Sheba Medical Center, Tel Hashomer, Israel. Electronic address: Carmit.Netanel@sheba.health.gov.il. 2. Department of Surgery C, Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: David.Goitein@sheba.health.gov.il. 3. Department of Surgery C, Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: Moshe.Rubin2@sheba.health.gov.il. 4. Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, Israel. Electronic address: Yeruham.Kleinbaum@sheba.health.gov.il. 5. Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, Israel. Electronic address: Sima.Katsherginsky@sheba.health.gov.il. 6. Department of Surgery C, Sheba Medical Center, Tel Hashomer, Israel. Electronic address: Hila.Hermon@sheba.health.gov.il. 7. Liver Disease Center, Sheba Medical Center, Tel Hashomer, Israel. Electronic address: Keren.Tsaraf@sheba.health.gov.il. 8. Liver Disease Center, Sheba Medical Center, Tel Hashomer, Israel. Electronic address: Irina.Tachlytski@sheba.health.gov.il. 9. Department of Orthopaedic Surgery, Assuta Ashdod Medical Center, Ashdod, Israel; Goldman School of Medicine, Ben-Gurion University of the Negev, Beer Sheva, Israel. Electronic address: amirherm@gmail.com. 10. Liver Disease Center, Sheba Medical Center, Tel Hashomer, Israel. Electronic address: Michal.Safran@sheba.health.gov.il. 11. Liver Disease Center, Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: Ziv.Ben-Ari@sheba.health.gov.il.
Abstract
BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is common in bariatric surgery candidates. We evaluated the effect of sleeve gastrectomy (SG) on NAFLD using validated non-invasive measures. METHODS: Patients with morbid obesity and NAFLD, planned for SG, were evaluated before and after surgery. Data collected included anthropometrics, biochemistry, adiponectin, SteatoTest™, NashTest™, FibroTest™, OWLiver® test and real-time ShearWave™ elastography (SWE). RESULTS: Twenty-six subjects were included in the study, mean age 44.1 ± 4.8 years, 69.2% males. One year following SG, body mass index decreased significantly from 41.7 ± 4.8 kg/m2 to 29.6 ± 4.5 kg/m2. Concomitantly, significant improvements in triglycerides, ALT, diabetes markers and adiponectin were observed. Mean steatosis, as measured by SteatoTest™, was significantly improved. Steatohepatitis score measured by NashTest™ and OWLiver® significantly decreased. Mean fibrosis, as measured by SWE liver stiffness and FibroTest™, did not change over time. CONCLUSION: Steatosis and steatohepatitis are significantly improved by SG as measured by non-invasive measures.
BACKGROUND:Nonalcoholic fatty liver disease (NAFLD) is common in bariatric surgery candidates. We evaluated the effect of sleeve gastrectomy (SG) on NAFLD using validated non-invasive measures. METHODS:Patients with morbid obesity and NAFLD, planned for SG, were evaluated before and after surgery. Data collected included anthropometrics, biochemistry, adiponectin, SteatoTest™, NashTest™, FibroTest™, OWLiver® test and real-time ShearWave™ elastography (SWE). RESULTS: Twenty-six subjects were included in the study, mean age 44.1 ± 4.8 years, 69.2% males. One year following SG, body mass index decreased significantly from 41.7 ± 4.8 kg/m2 to 29.6 ± 4.5 kg/m2. Concomitantly, significant improvements in triglycerides, ALT, diabetes markers and adiponectin were observed. Mean steatosis, as measured by SteatoTest™, was significantly improved. Steatohepatitis score measured by NashTest™ and OWLiver® significantly decreased. Mean fibrosis, as measured by SWE liver stiffness and FibroTest™, did not change over time. CONCLUSION:Steatosis and steatohepatitis are significantly improved by SG as measured by non-invasive measures.