title: Hepatic left lobe volume is a sensitive index of metabolic improvement in obese women after gastric banding.
abstract: BACKGROUND
  Nonalcoholic fatty liver disease is a common finding in obese subjects. Increasing evidence has been provided suggesting that it represents the hepatic component of the metabolic syndrome.
  
  
  OBJECTIVE
  Aim of this longitudinal study was to evaluate the relationships between several anthropometric measures, including the hepatic left lobe volume (HLLV), and various indicators of the metabolic syndrome in a cohort of severely obese women before and after laparoscopic adjustable gastric banding (LAGB).
  
  
  RESULTS
  Seventy-five obese women (mean age 45 ± 10 years and body mass index (BMI) 42.5 ± 4.8 kg m(-2)) underwent LAGB and completed an average (± s.d.) post-surgical follow-up of 24 ± 6 months. Determination of HLLV, subcutaneous and intra-abdominal fat (IAF) was based on ultrasound. The principal component statistical analysis applied to pre-operative measurements, highlighted HLLV as a parameter that clustered with serum insulin, IAF, serum glucose and uric acid, along with triglycerides (TGs), alkaline phosphatase and high-density lipoprotein cholesterol. After LAGB, the average reduction of BMI was 23%, 12% for subcutaneous fat (SCF), 42% for HLLV and 40% for visceral fat. Among body weight, BMI, SCF, IAF and HLLV, reduction of the latter was an independent predictor of reduction of serum transaminases and γ-Glutamyltransferase, glucose, insulin and TGs.
  
  
  CONCLUSIONS
  In severely obese women: (i) HLLV is a sensitive indicator of ectopic fat deposition, clustering with parameters defining the metabolic syndrome; (ii) weight loss achieved by LAGB is associated with a reduction of liver volume as estimated by HLLV; (iii) among various anthropometric parameters measured, reduction of HLLV that follows LAGB represents the best single predictor of improvement of various cardiometabolic risk factors.
authors.affiliation: Department of Endocrinology and Kidney, University Hospital of Pisa, Pisa, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Giannetti
authors.forename: P
authors.initials: P
authors.lastname: Piaggi
authors.forename: G
authors.initials: G
authors.lastname: Ceccarini
authors.forename: S
authors.initials: S
authors.lastname: Mazzeo
authors.forename: G
authors.initials: G
authors.lastname: Querci
authors.forename: P
authors.initials: P
authors.lastname: Fierabracci
authors.forename: G
authors.initials: G
authors.lastname: Salvetti
authors.forename: G
authors.initials: G
authors.lastname: Galli
authors.forename: I
authors.initials: I
authors.lastname: Ricco
authors.forename: S
authors.initials: S
authors.lastname: Martinelli
authors.forename: C
authors.initials: C
authors.lastname: Di Salvo
authors.forename: M
authors.initials: M
authors.lastname: Anselmino
authors.forename: A
authors.initials: A
authors.lastname: Landi
authors.forename: P
authors.initials: P
authors.lastname: Vitti
authors.forename: A
authors.initials: A
authors.lastname: Pinchera
authors.forename: F
authors.initials: F
authors.lastname: Santini
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D005234:Fatty Liver / Q000378:metabolism / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty / Q000379:methods; D006801:Humans; D050152:Intra-Abdominal Fat / Q000473:pathology*; D008099:Liver / Q000378:metabolism / Q000473:pathology*; D008137:Longitudinal Studies; D024821:Metabolic Syndrome / Q000209:etiology / Q000517:prevention & control; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D009767:Obesity, Morbid / Q000150:complications / Q000378:metabolism* / Q000473:pathology* / Q000601:surgery; D009929:Organ Size; D011184:Postoperative Period; D057234:Preoperative Period; D015431:Weight Loss