Bariatric surgery may be an effective treatment for non-alcoholic fatty liver disease (NAFLD), according to a new study published in the ‘Journal of the Endocrine Society’.
The study compared three types of bariatric or weight loss surgery: gastric sleeve, gastric banding, and gastric bypass.
“We believe that gastric bypass may be the best surgical option in these patients,” says lead researcher Marta Borges-Canha, from the Centro Hospitalar Universitário de São João, in Porto.
Non-alcoholic fatty liver disease is a condition in which excess fat is stored in the liver, without being caused by excessive alcohol consumption. It generally causes no symptoms and is found more frequently when blood tests indicate elevated liver enzymes.
It is more common in people who have certain conditions, such as obesity and other related conditions, such as type 2 diabetes. Researchers have found that between 40% and 80% of people with type 2 diabetes and between 30% have it. % and 90% of obese people.
When fat accumulates in the liver and causes inflammation and damage, it is known as non-alcoholic steatohepatitis (NASH), which can lead to scarring of the liver, a life-threatening condition called cirrhosis.
“Nonalcoholic fatty liver disease is strongly associated with obesity, and the prevalence of both diseases is increasing markedly,” says Borges-Canha.
“There is a worrying lack of effective treatment options and no medications have been approved for it. The current recommended treatment is weight loss, which can reduce liver fat, inflammation and fibrosis or scarring.”
The new study evaluated the effects of bariatric surgery on liver function and indicators of liver inflammation and scarring. The researchers included 1,995 morbidly obese patients who underwent bariatric surgery between January 2010 and July 2018.
Their average age was 43 years and 85.8% were women. One year after surgery, patients had a significant decrease in liver enzymes.
Other indicators of fatty liver disease, including the Fatty Liver Index (FLI), decreased markedly after one year. It is an algorithm that predicts liver steatosis or fat deposition. It is based on waist circumference, body mass index, and triglyceride levels and an enzyme found in the liver called gamma-glutamyltransferase.
Another measure of fatty liver disease, called the BARD score, also decreased markedly. The BARD score predicts liver scarring.
It is calculated using the ratio of two liver enzymes, the body mass index and the presence of diabetes. Gastric sleeve was associated with a greater reduction in liver enzymes and FLI and BARD compared to the gastric band. However, the gastric sleeve led to a lower reduction in FLI and BARD compared to gastric bypass surgery.