title: Improvement of nonalcoholic fatty liver disease after bariatric surgery in morbidly obese Chinese patients.
abstract: BACKGROUND
  Obesity is a risk factor for nonalcoholic fatty liver disease (NAFLD), which appears to improve after weight loss induced by bariatric surgery in Western countries. The present study aims to determine the alterations of clinical measurements and liver histology of NAFLD after bariatric surgery in morbidly obese Chinese patients.
  
  
  METHODS
  Between November 2006 and December 2007, 21 morbidly obese patients receiving intra-operative liver biopsy and follow-up liver biopsy 1 year after laparoscopic Roux-en-Y gastric bypass were enrolled. NAFLD activity score (NAS) and fibrosis stage were histologically evaluated.
  
  
  RESULTS
  The mean body mass index fell from 43.8 ± 7.5 to 28.3 ± 4.6 kg/m(2) (P < 0.01). Biochemical improvement was found in serum levels of alanine aminotransferase (P < 0.01) and γ-glutamyltransferase (P < 0.01), but not aspartate aminotransferase (P = 0.66). Histological improvement was noted in NAS (P < 0.01) and individual components, including steatosis (P < 0.01), ballooning degeneration (P < 0.01), and lobular inflammation (P = 0.02). Pre-operatively, 4 (19.0%), 11 (52.4%), and 6 (28.6%) patients were found to have NAS >/=5, 3 or 4, and </=2, respectively. All patients had NAS </=2 after surgery. Fibrosis stage also showed significant improvement (P < 0.01).
  
  
  CONCLUSIONS
  Bariatric surgery can achieve a dramatic improvement of NAFLD both biochemically and histologically in morbidly obese Chinese patients.
authors.affiliation: Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.
authors.forename: Chi-Ming
authors.initials: CM
authors.lastname: Tai
authors.forename: Chih-Kun
authors.initials: CK
authors.lastname: Huang
authors.forename: Jau-Chung
authors.initials: JC
authors.lastname: Hwang
authors.forename: Hung
authors.initials: H
authors.lastname: Chiang
authors.forename: Chi-Yang
authors.initials: CY
authors.lastname: Chang
authors.forename: Ching-Tai
authors.initials: CT
authors.lastname: Lee
authors.forename: Ming-Lung
authors.initials: ML
authors.lastname: Yu
authors.forename: Jaw-Town
authors.initials: JT
authors.lastname: Lin
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D044466:Asian People / Q000706:statistics & numerical data; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D015992:Body Mass Index; D002681:China / Q000453:epidemiology; D015897:Comorbidity; D005234:Fatty Liver / Q000453:epidemiology / Q000473:pathology*; D005260:Female; D015390:Gastric Bypass / Q000379:methods; D006801:Humans; D010535:Laparoscopy; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000473:pathology; D008297:Male; D065626:Non-alcoholic Fatty Liver Disease; D009767:Obesity, Morbid / Q000453:epidemiology / Q000601:surgery*; D012307:Risk Factors; D016896:Treatment Outcome; D015431:Weight Loss; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D015415:Biomarkers; D005723:gamma-Glutamyltransferase; D000410:Alanine Transaminase