The Effects of Bariatric Surgeries on Non-Alcoholic Fatty Liver Disease

Tamader Aldoheyan, Mazen Hassanain, MBBS, FRCSC, FACS, PhD, Atheer Al-Sabhan, Shaden Alamro, Amnah Al-Mulhim, MD. King Saud University

Background: Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease and is known to be associated with obesity. Bariatric surgery has been shown to be the most effective method for weight reduction, however no conclusive data exists on the potential beneficial effects of weight reduction surgery on NAFLD.

Objective: Characterize liver histology, metabolic status and liver function changes of patients undergoing bariatric surgery, prior to and after weight reduction procedures. 

Methods: This is a preliminary report of an IRB-approved prospective cohort study, recruiting patients undergoing bariatric surgery. All patients signed informed consents. Biopsies were obtained at baseline (intraoperatively) and 3 months postoperatively. Clinical characteristics, biochemical profile and histopathological data (steatosis, NAFLD activity score (NAS), hepatocyte ballooning, lobular inflammation and degree of fibrosis) were obtained at each time point.

Results: Fifteen patients were included, 6 were male and the median age was 34 ± 8 years old. At baseline, one patient had dyslipidemia, one had diabetes and 2 patients had hypertension, which did not change at follow-up. The average body mass index went from 44.8 ± 7.8 kg/m2 to 34.6 ± 6.3 kg/m2 at follow-up (p<0.001). On histopathology, 6 out of 9 patients with pre-op steatosis (median score 2 (1-3)) had reduced steatosis scores post-op (p=0.022), fibrosis (median score 1 (1-2)) was also reduced in 7 patients (p=0.003) and NAS score was decreased from 4 (3-5) to 2 (1-3) (p=0.004). The changes in lobular inflammation and hepatocyte ballooning were not statistically significant on follow-up.

Conclusion: Preliminary results of this study describe histopathological changes following weight reduction surgery and suggest that hepatic steatosis, fibrosis and NAFLD activity score are reduced 3 months after surgery. (Registration number: NCT01619215).

Disclosure: The clinical trial is financially supported by NPST (National Plan for Science and Technology).