Resolution of nonalcoholic steatohepatits after gastric bypass surgery

Xiuli Liu, Audrey J. Lazenby, Ronald H. Clements, Nirag Jhala, Gary A. Abrams

Research output: Contribution to journalArticle

96 Citations (Scopus)

Abstract

Background: Nonalcoholic fatty liver disease (NAFLD) has been increasingly recognized as a common chronic liver condition. Previous studies have been variable regarding the histological outcomes after rapid weight loss. The aim of this study was to characterize the histopathologic changes in NASH following laparoscopic Roux-en-Y Gastric Bypass surgery (LRYGBP). Methods: We retrospectively analyzed paired needle liver biopsies taken during and following LRYGBP in 39 patients according to the recent NIH-based NAFLD criteria. Results: The cohort included 33 females and 6 males (range 24-57 years). 23 patients (58.9%) had steatohepatitis, 12 with fatty liver (30.7%), and 4 were normal (10.2%). Follow-up needle liver biopsies were performed at a mean interval of 18 months (range 6-41 months). No significant differences in length or number of portal tracts between the paired biopsies were noted. The mean decrease in weight and BMI was 50.2 kg and 18.2 kg/m2, respectively. The initial prevalence of hepatic pathology: steatosis (89.7%), hepatocellular ballooning (58.9%), and centrilobular/perisinusoidal fibrosis (50%) improved significantly after LRYGBP: steatosis (2.9%), ballooning (0%), and centrilobular fibrosis (25%). Mitigation in the lobular inflammation score (2.23±0.63 vs 1.95±0.56, P=0.01) and stage of fibrosis (1.14±1.05 to 0.72±0.97, P=0.002) were also noted. However, no improvements were detected in portal tract inflammation and fibrosis. Conclusions: Over a mean period of 18 months, histological improvements and resolution of NASH occurs after LRYGBP. Long-term studies are warranted to assess for potential changes in the portal regions or relapse of NASH that could result with weight regain or malnutrition.

Original languageEnglish (US)
Pages (from-to)486-492
Number of pages7
JournalObesity Surgery
Volume17
Issue number4
DOIs
StatePublished - Apr 1 2007

Fingerprint

Gastric Bypass
Fibrosis
Liver
Needle Biopsy
Fatty Liver
Inflammation
Weights and Measures
Malnutrition
Weight Loss
Pathology
Biopsy
Recurrence
Non-alcoholic Fatty Liver Disease

Keywords

  • Centrilobular perisinusoidal fibrosis
  • Gastroplasty
  • Laparoscopic
  • Liver function test
  • Morbid obesity
  • Nonalcoholic fatty liver disease
  • Nonalcoholic steatohepatitis
  • Overall fibrosis
  • Portal fibrosis
  • Roux-en-Y gastric bypass

ASJC Scopus subject areas

  • Surgery
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics

Cite this

Resolution of nonalcoholic steatohepatits after gastric bypass surgery. / Liu, Xiuli; Lazenby, Audrey J.; Clements, Ronald H.; Jhala, Nirag; Abrams, Gary A.

In: Obesity Surgery, Vol. 17, No. 4, 01.04.2007, p. 486-492.

Research output: Contribution to journalArticle

Liu, Xiuli ; Lazenby, Audrey J. ; Clements, Ronald H. ; Jhala, Nirag ; Abrams, Gary A. / Resolution of nonalcoholic steatohepatits after gastric bypass surgery. In: Obesity Surgery. 2007 ; Vol. 17, No. 4. pp. 486-492.
@article{f489d3a1a3824bdab72d94d4c1ecbf35,
title = "Resolution of nonalcoholic steatohepatits after gastric bypass surgery",
abstract = "Background: Nonalcoholic fatty liver disease (NAFLD) has been increasingly recognized as a common chronic liver condition. Previous studies have been variable regarding the histological outcomes after rapid weight loss. The aim of this study was to characterize the histopathologic changes in NASH following laparoscopic Roux-en-Y Gastric Bypass surgery (LRYGBP). Methods: We retrospectively analyzed paired needle liver biopsies taken during and following LRYGBP in 39 patients according to the recent NIH-based NAFLD criteria. Results: The cohort included 33 females and 6 males (range 24-57 years). 23 patients (58.9{\%}) had steatohepatitis, 12 with fatty liver (30.7{\%}), and 4 were normal (10.2{\%}). Follow-up needle liver biopsies were performed at a mean interval of 18 months (range 6-41 months). No significant differences in length or number of portal tracts between the paired biopsies were noted. The mean decrease in weight and BMI was 50.2 kg and 18.2 kg/m2, respectively. The initial prevalence of hepatic pathology: steatosis (89.7{\%}), hepatocellular ballooning (58.9{\%}), and centrilobular/perisinusoidal fibrosis (50{\%}) improved significantly after LRYGBP: steatosis (2.9{\%}), ballooning (0{\%}), and centrilobular fibrosis (25{\%}). Mitigation in the lobular inflammation score (2.23±0.63 vs 1.95±0.56, P=0.01) and stage of fibrosis (1.14±1.05 to 0.72±0.97, P=0.002) were also noted. However, no improvements were detected in portal tract inflammation and fibrosis. Conclusions: Over a mean period of 18 months, histological improvements and resolution of NASH occurs after LRYGBP. Long-term studies are warranted to assess for potential changes in the portal regions or relapse of NASH that could result with weight regain or malnutrition.",
keywords = "Centrilobular perisinusoidal fibrosis, Gastroplasty, Laparoscopic, Liver function test, Morbid obesity, Nonalcoholic fatty liver disease, Nonalcoholic steatohepatitis, Overall fibrosis, Portal fibrosis, Roux-en-Y gastric bypass",
author = "Xiuli Liu and Lazenby, {Audrey J.} and Clements, {Ronald H.} and Nirag Jhala and Abrams, {Gary A.}",
year = "2007",
month = "4",
day = "1",
doi = "10.1007/s11695-007-9086-2",
language = "English (US)",
volume = "17",
pages = "486--492",
journal = "Obesity Surgery",
issn = "0960-8923",
publisher = "Springer New York",
number = "4",

}

TY - JOUR

T1 - Resolution of nonalcoholic steatohepatits after gastric bypass surgery

AU - Liu, Xiuli

AU - Lazenby, Audrey J.

AU - Clements, Ronald H.

AU - Jhala, Nirag

AU - Abrams, Gary A.

PY - 2007/4/1

Y1 - 2007/4/1

N2 - Background: Nonalcoholic fatty liver disease (NAFLD) has been increasingly recognized as a common chronic liver condition. Previous studies have been variable regarding the histological outcomes after rapid weight loss. The aim of this study was to characterize the histopathologic changes in NASH following laparoscopic Roux-en-Y Gastric Bypass surgery (LRYGBP). Methods: We retrospectively analyzed paired needle liver biopsies taken during and following LRYGBP in 39 patients according to the recent NIH-based NAFLD criteria. Results: The cohort included 33 females and 6 males (range 24-57 years). 23 patients (58.9%) had steatohepatitis, 12 with fatty liver (30.7%), and 4 were normal (10.2%). Follow-up needle liver biopsies were performed at a mean interval of 18 months (range 6-41 months). No significant differences in length or number of portal tracts between the paired biopsies were noted. The mean decrease in weight and BMI was 50.2 kg and 18.2 kg/m2, respectively. The initial prevalence of hepatic pathology: steatosis (89.7%), hepatocellular ballooning (58.9%), and centrilobular/perisinusoidal fibrosis (50%) improved significantly after LRYGBP: steatosis (2.9%), ballooning (0%), and centrilobular fibrosis (25%). Mitigation in the lobular inflammation score (2.23±0.63 vs 1.95±0.56, P=0.01) and stage of fibrosis (1.14±1.05 to 0.72±0.97, P=0.002) were also noted. However, no improvements were detected in portal tract inflammation and fibrosis. Conclusions: Over a mean period of 18 months, histological improvements and resolution of NASH occurs after LRYGBP. Long-term studies are warranted to assess for potential changes in the portal regions or relapse of NASH that could result with weight regain or malnutrition.

AB - Background: Nonalcoholic fatty liver disease (NAFLD) has been increasingly recognized as a common chronic liver condition. Previous studies have been variable regarding the histological outcomes after rapid weight loss. The aim of this study was to characterize the histopathologic changes in NASH following laparoscopic Roux-en-Y Gastric Bypass surgery (LRYGBP). Methods: We retrospectively analyzed paired needle liver biopsies taken during and following LRYGBP in 39 patients according to the recent NIH-based NAFLD criteria. Results: The cohort included 33 females and 6 males (range 24-57 years). 23 patients (58.9%) had steatohepatitis, 12 with fatty liver (30.7%), and 4 were normal (10.2%). Follow-up needle liver biopsies were performed at a mean interval of 18 months (range 6-41 months). No significant differences in length or number of portal tracts between the paired biopsies were noted. The mean decrease in weight and BMI was 50.2 kg and 18.2 kg/m2, respectively. The initial prevalence of hepatic pathology: steatosis (89.7%), hepatocellular ballooning (58.9%), and centrilobular/perisinusoidal fibrosis (50%) improved significantly after LRYGBP: steatosis (2.9%), ballooning (0%), and centrilobular fibrosis (25%). Mitigation in the lobular inflammation score (2.23±0.63 vs 1.95±0.56, P=0.01) and stage of fibrosis (1.14±1.05 to 0.72±0.97, P=0.002) were also noted. However, no improvements were detected in portal tract inflammation and fibrosis. Conclusions: Over a mean period of 18 months, histological improvements and resolution of NASH occurs after LRYGBP. Long-term studies are warranted to assess for potential changes in the portal regions or relapse of NASH that could result with weight regain or malnutrition.

KW - Centrilobular perisinusoidal fibrosis

KW - Gastroplasty

KW - Laparoscopic

KW - Liver function test

KW - Morbid obesity

KW - Nonalcoholic fatty liver disease

KW - Nonalcoholic steatohepatitis

KW - Overall fibrosis

KW - Portal fibrosis

KW - Roux-en-Y gastric bypass

UR - http://www.scopus.com/inward/record.url?scp=34249791215&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34249791215&partnerID=8YFLogxK

U2 - 10.1007/s11695-007-9086-2

DO - 10.1007/s11695-007-9086-2

M3 - Article

C2 - 17608261

AN - SCOPUS:34249791215

VL - 17

SP - 486

EP - 492

JO - Obesity Surgery

JF - Obesity Surgery

SN - 0960-8923

IS - 4

ER -