title: Nonalcoholic fatty liver disease in Japanese patients with severe obesity who received laparoscopic Roux-en-Y gastric bypass surgery (LRYGB) in comparison to non-Japanese patients.
abstract: BACKGROUND
  The number of patients with morbid obesity is increasing worldwide. However, the prevalence of morbid obesity is still low in Japan, and therefore few systematic investigations of liver dysfunction in this population have so far been carried out. This study aimed to investigate the clinical characteristics in severe obese Japanese patients undergoing laparoscopic Roux-en-Y gastric bypass surgery (LRYGB).
  
  
  METHODS
  Eighty-four patients with severe obesity, including 61 Japanese and 23 non-Japanese patients, were analyzed.
  
  
  RESULTS
  The mean body mass index (BMI) was 43.7 +/- 7.8 kg/m(2), and there was no difference between Japanese and non-Japanese patients. Nonalcoholic fatty liver disease (NAFLD) was observed in 45/59 (76.2%) of the Japanese patients. Although there were no differences in the BMI and body weight, serum ALT was higher in Japanese patients in comparison to non-Japanese patients (P < 0.05). The indices for insulin resistance were significantly higher in the Japanese patients in comparison to non-Japanese patients (P < 0.01). The liver/spleen computed tomography (CT) ratios were lower in Japanese patients (P < 0.05). The laboratory data and BMI significantly improved at 1 year after LRYGB in both groups.
  
  
  CONCLUSIONS
  Racial difference may exist difference may exist in NAFLD in patients with severe obesity. When the BMI is similar, liver dysfunction among Japanese patients with severe obesity tends to be higher than in non-Japanese patients. Japanese patients with severe obesity must therefore reduce their body weight to a greater degree in comparison to non-Japanese patients with the same BMI. LRYGB can achieve effective weight control and lower ALT levels in Japanese patients with severe obesity.
authors.affiliation: Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, Maebashi, 371-8511, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Kakizaki
authors.forename: Daichi
authors.initials: D
authors.lastname: Takizawa
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Yamazaki
authors.forename: Yuka
authors.initials: Y
authors.lastname: Nakajima
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ichikawa
authors.forename: Ken
authors.initials: K
authors.lastname: Sato
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Takagi
authors.forename: Masatomo
authors.initials: M
authors.lastname: Mori
authors.forename: Kazunori
authors.initials: K
authors.lastname: Kasama
mesh_terms: D000328:Adult; D044466:Asian People; D001707:Biopsy, Needle; D015992:Body Mass Index; D001938:Brazil / Q000208:ethnology; D005234:Fatty Liver / Q000175:diagnosis / Q000208:ethnology* / Q000209:etiology; D005260:Female; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D010535:Laparoscopy / Q000379:methods*; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D009767:Obesity, Morbid / Q000150:complications / Q000453:epidemiology / Q000601:surgery*; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D044465:White People