[Pre- and postoperative transaminase changes within the scope of gastric banding in morbid obesity].
20-30% of obese patients without concomitant liver disease show elevated liver tests (ALAT, ASAT, GGT) which are known to normalize after weight reduction. Little is known about the impact of gastric banding on elevated liver enzymes. We investigated the role of gastric banding on weight reduction and liver enzymes in a cohort of patients with morbid obesity. 198 obese patients (166 female, 32 male: median age 37 [19-65] years) with BMI 46 kg/m2 were assessed prior to gastric banding and 6/12 months postoperative for BMI, ALAT, ASAT, GGT respectively. Specific liver diseases were excluded. 37 patients (18.7%) had elevated liver enzymes (ALAT 14.1%, ASAT 9.6%, GGT 6.6%) preoperatively. ALAT and ASAT returned to normal in all patients postoperatively (p < 0.01). In 14 patients with significant ALAT-elevation (i.e. > 10% above normal) we found a correlation between postoperative fall of ALAT and reduction of BMI within 12 month (r = 0.4998; p < 0.05).


CONCLUSIONS
18.7% of morbid obese patients (BMI 46 kg/m2) have elevated liver enzymes prior to laparoscopic gastric banding. The normalisation of elevated liver enzymes correlates to the extent of weight reduction after gastric banding. Our data show reversible liver enzyme abnormalities, correlating to the degree of obesity.
Albert
S
S
Fachbereich für Gastroenterologie, Departement Innere Medizin, Kantonsspital St. Gallen.
Borovicka
J
J
Thurnheer
M
M
Lange
J
J
Meyenberger
C
C
D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood*; D001219:Aspartate Aminotransferases / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty; D006801:Humans; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000201:enzymology*; D011183:Postoperative Complications / Q000201:enzymology*; D011446:Prospective Studies; D005723:gamma-Glutamyltransferase / Q000097:blood*
D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase