Charleen Yeo, Marc Ong, Anton Cheng, Chun Hai Tan. Khoo Teck Puat Hospital, Singapore
Introduction: Non-alcoholic fatty liver disease (NAFLD) is one of the most common liver diseases worldwide, and has been shown to be present in up to 90% of bariatric surgery patients. Bariatric surgery has grown to be an internationally accepted option for the treatment of obesity and type II diabetes mellitus. Previous literature has demonstrated improvement in liver steatosis, inflammation and fibrosis in patients undergoing bariatric surgery. Our study aims to investigate if bariatric surgery results in an improvement in NAFLD fibrosis scores, and if there is a correlation with weight loss.
Materials and Methods: A retrospective study was conducted on all patients who underwent bariatric surgery from 2010 to 2016 in our institution, using a prospectively collected bariatric surgery database. Patients who had a redo bariatric surgery, or other concomitant gastric pathologies requiring surgical intervention were excluded. Indications for bariatric surgery followed the guidelines of the Asia-Pacific Metabolic and Bariatric Surgery Society. Patient demographics, clinical characteristics, operative details, and surgical outcomes were collected. All patients were followed up for at least one year post-operatively. Statistical analysis was performed using SPSS Version 21, with p-value of less than 0.05 considered statistically significant.
Results: There were a total of 304 patients in this study, of which the majority were females (n=178, 59%). Data are represented in mean ± 2 standard deviation unless stated otherwise. Mean age was 40±8 years old. Pre-operative mean weight and body mass index (BMI) was 116±24 kilograms, and 42±3.6 kg/m2 respectively. The mean pre-operative NAFLD fibrosis score was -1.42. 1-year and 2-year follow up post bariatric surgery demonstrated a decrease in mean weight from 116 to 86 to 82 kilograms, and a decrease in in mean BMI from 42 to 31 to 30 kg/m2. There was also an improvement in mean NAFLD scores from -1.42 to -1.99 to -1.84. The correlation between weight loss and the improvement in NAFLD fibrosis scores was statistically significant at both the 1st and 2nd post-operative year, with a r-coefficient of 0.36 and 0.463 respectively, and p-values of <0.001.
Conclusion: Bariatric surgery results in weight reduction as well as an improvement in the NAFLD fibrosis score. The degree of weight loss predicts the extent of improvement in NAFLD fibrosis scores. More long term studies need to be conducted to assess if this effect is permanent.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 93636
Program Number: P161
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster