Liver volume and visceral obesity in women with hepatic steatosis undergoing gastric banding.
OBJECTIVE
To investigate the relationships between visceral obesity and hepatic steatosis in obese patients undergoing adjustable silicone gastric banding with the LAP-BAND.


METHODS
Six premenopausal, morbidly obese women with an ultrasonographic diagnosis of liver steatosis were evaluated before surgery and 8 and 24 weeks after surgery. Liver volume and body fat distribution were simultaneously analyzed by total-body multislices magnetic resonance imaging.


RESULTS
Before surgery, the only variable found to be correlated with liver volume was visceral adipose tissue volume (r = 0.91; p < 0.01). Weight loss was 9.9 +/- 3.8 kg in the period from 0 to 8 weeks (p < 0.01) and 7.1 +/- 4.9 kg in the the period from 8 to 24 weeks (p < 0.05). Total fat showed a statistically significant reduction of 6.2 +/- 4.0 liters in the 0- to 8-week period and a further significant reduction of 7.7 +/- 3.9 liters in the 8- to 24-week period. Visceral adipose tissue showed a statistically significant reduction of 1.0 +/- 0.9 liters in the 0- to 8-week period (p < 0.05) but only a further, not significant reduction of 0.6 +/- 0.7 liters in the 8- to 24-week period. The relative reduction of visceral fat in the 0-to 8-week period was higher than the relative reduction of total fat. Liver volume also showed a statistically significant reduction of 0.24 +/- 0.26 liters in the first phase of weight loss (p < 0.05), corresponding to a relative reduction of 12.3 +/- 10.6%. During the 8- to 24-week period, liver volume was substantially stable.


CONCLUSIONS
Hepatomegaly was associated with visceral obesity in morbidly obese women with liver steatosis. In the phase of rapid weight loss after gastric surgery, a preferential mobilization of visceral fat, compared with total adipose tissue, occurred. This preferential visceral fat loss was associated with a significant reduction in liver volume.
Busetto
Luca
L
Department of Medical and Surgical Sciences, University of Padova, Italy. luca.busetto@unipd.it
Tregnaghi
Alberto
A
De Marchi
Francesco
F
Segato
Gianni
G
Foletto
Mirto
M
Sergi
Giuseppe
G
Favretti
Franco
F
Lise
Mario
M
Enzi
Giuliano
G
D000410:Alanine Transaminase / Q000097:blood; D001823:Body Composition; D015992:Body Mass Index; D001835:Body Weight; D005234:Fatty Liver / Q000150:complications* / Q000000981:diagnostic imaging; D005260:Female; D015391:Gastroplasty; D006801:Humans; D008099:Liver / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D009767:Obesity, Morbid / Q000150:complications / Q000473:pathology / Q000601:surgery*; D017697:Premenopause; D014463:Ultrasonography; D014781:Viscera; D015431:Weight Loss
D000410:Alanine Transaminase