[Morbid obesity, non-alcoholic fatty liver disease, metabolic syndrome and bariatric surgery].
OBJECTIVE
The objectives of the present study are: 1) to assess protein changes in patients diagnosed with morbid obesity (MO) and non-alcoholic fatty liver disease (NAFLD) or steatohepatitis (NASH); 2) to assess the likely reversibility of these entities after bariatric surgery, and 3) to analyze their progression seven years after the gastric bypass.


METHODS
We retrospectively analyzed the data from 190 patients, 150 women (79%) and 40 men (21%) diagnosed with MO and surgically treated at our Hospital (Capella's gastric bypass). Mean age of the patients was 36.5 years (range: 18.5-54.5). Anthropometric values are gathered: body mass index (BMI), waist circumference (WC) and biochemistry: insulin (INS), glucose (GLU), total proteins (TP), albumin (ALB), transferrin (TRF), ferritin (FER), prealbumin (PBA), retinol binding protein (RBP) and C reactive protein (CRP). The HOMA index was calculated before the bypass and at the following follow-up periods after bypass: 6, 12, 60 and 84 months.


RESULTS
Abdominal ultrasound suggesting NAFLD or NASH was found in 34.7% (n = 66; 52 women and 14 men) of MO patients surgically treated. Ninety patients (47.3%; 67 women and 23 men) presented risk factors for metabolic syndrome (MS). All patients with possible liver dysfunction had MS. Before the bypass, we found increased levels of: BMI, WC, CRP, GLU, INS and HOMA index and changes in TP, ALB, PBA, RBP, FER and TRF levels. The first set of parameters start to decrease within 6 months after surgical bypass and at the same time the changes in protein levels start to face off and remain stable at 84 months.


CONCLUSIONS
Weight loss due to bariatric surgery represents an effective method of fighting MO and its associated comorbidities (NAFLD, NASH, hyperinsulinemia, hyperglycemia, dyslipidemia and components of the metabolic syndrome).
Silvestre
V
V
Departamento de Cirugía General y Gastrointestinal, Hospital General de Móstoles,Madrid, España.
Ruano
M
M
García-Lescún
M C G
MC
Aguirregoicoa
E
E
Criado
L
L
Rodríguez
A
A
Marco
A
A
García-Blanch
G
G
D000293:Adolescent; D000328:Adult; D050110:Bariatric Surgery / Q000706:statistics & numerical data*; D015415:Biomarkers; D005234:Fatty Liver / Q000000981:diagnostic imaging / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000453:epidemiology*; D008875:Middle Aged; D009767:Obesity, Morbid / Q000453:epidemiology / Q000601:surgery*; D012074:Remission Induction; D012189:Retrospective Studies; D014463:Ultrasonography
D015415:Biomarkers