title: Improvement in nonalcoholic fatty liver disease and metabolic syndrome in adolescents undergoing bariatric surgery.
abstract: BACKGROUND
  Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in children. It is linked to obesity and the metabolic syndrome (MS), predisposing to future cirrhosis. The objective of this study was to demonstrate the effects that weight loss achieved with laparoscopic adjustable gastric band (LAGB) has on the metabolic parameters and NAFLD scores of obese adolescents with evidence of fatty liver disease.
  
  
  METHODS
  Adolescents undergoing LAGB were evaluated for NAFLD with evidence of fatty liver on preoperative sonogram, serum biochemistry, or both between 2005 and 2011. Primary endpoint was change in NAFLD scores after LAGB and secondary endpoint change in MS criteria.
  
  
  RESULTS
  Fifty-six out of 155 adolescents had evidence of fatty liver disease at presentation. The group consisted of 17 (30%) male and 39 (70%) females, mean age 16.1 years (range 14-17.8 yr). Preoperative body mass index (BMI) was 48.8 kg/m(2) (±7) dropping to 37.9 kg/m(2) (±8.3) at 12 months and 36.8 kg/m(2) (±8.2) at 24 months. Fifteen (27%) patients met the criteria for MS. When comparing 1-year postsurgery to presurgery, the NAFLD score decreased by an average of .68 (SD = 1.03, P<.01). The 2-year NAFLD score decreased by a mean of .38 (SD = .99, P = .01). The reoperation rate for band/port related complications was 10.7% at 2 years with no mortality. MS rates improved from 27% to 2% at 2 years (P< .01).
  
  
  CONCLUSIONS
  LAGB is a safe and effective operation for obese adolescents with NAFLD. There was significant improvement in NAFLD scores and resolution of MS.
authors.affiliation: NYU Langone Medical Center, Department of Bariatric Surgery, New York, New York. Electronic address: Johnloy79@yahoo.co.uk.
authors.forename: John J
authors.initials: JJ
authors.lastname: Loy
authors.affiliation: NYU Langone Medical Center, Department of Bariatric Surgery, New York, New York.
authors.forename: Heekoung A
authors.initials: HA
authors.lastname: Youn
authors.affiliation: NYU Langone Medical Center, Department of Bariatric Surgery, New York, New York.
authors.forename: Bradley
authors.initials: B
authors.lastname: Schwack
authors.affiliation: NYU Langone Medical Center, Department of Bariatric Surgery, New York, New York.
authors.forename: Marina
authors.initials: M
authors.lastname: Kurian
authors.affiliation: NYU Langone Medical Center, Department of Bariatric Surgery, New York, New York.
authors.forename: Christine
authors.initials: C
authors.lastname: Ren Fielding
authors.affiliation: NYU Langone Medical Center, Department of Bariatric Surgery, New York, New York.
authors.forename: George A
authors.initials: GA
authors.lastname: Fielding
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D005260:Female; D015391:Gastroplasty; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000209:etiology / Q000601:surgery*; D065626:Non-alcoholic Fatty Liver Disease / Q000209:etiology / Q000601:surgery*; D009765:Obesity / Q000150:complications / Q000601:surgery*; D015431:Weight Loss
keywords: Bariatric; Fatty liver; Metabolic; Obesity; Pediatric