title: The effects of bariatric surgeries on nonalcoholic fatty liver disease.
abstract: Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease and is associated with obesity. Bariatric surgery has been shown to be the most effective method for weight reduction. However, no conclusive data exists on the effects of weight reduction surgery on NAFLD. This study aimed to characterize liver histology, metabolic status, and liver function changes in patients who underwent bariatric surgery, before and after the weight-reduction procedure. This is a phase 1 report of a prospective cohort study of patients who underwent bariatric surgery. Biopsies were obtained at baseline (intraoperatively) and 3 months postoperatively. Clinical characteristics, biochemical profile, and histopathological data [steatosis, NAFLD activity score (NAS), hepatocyte ballooning, lobular inflammation, and degree of fibrosis] were obtained at each time point. Twenty-seven patients were included (9 men and 18 women), and the median age was 35 ± 8 years old. At baseline, 3 patients had dyslipidemia, 4 had diabetes, and 5 patients had hypertension, which did not change at follow-up. The average body mass index decreased from 44.6 ± 7.8 to 34.2 ± 6.3 kg/m2at follow-up (P < 0.001). On histopathology, 12 of the 18 patients with preoperative steatosis (median score 2) had reduced steatosis scores postoperatively (P = 0.025); fibrosis (median score 1) was also reduced in 17 patients (P = 0.012), and NAS was decreased from 4 (3-5) to 2 (1-3) (P = 0.004). The changes in lobular inflammation and hepatocyte ballooning were not statistically significant on follow-up. The phase 1 results of this study described the histopathological changes following weight reduction surgery and suggested that hepatic steatosis, fibrosis, and NAFLD activity score were reduced 3 months after surgery. This clinical trial is financially supported by the National Plan for Science, Technology and Innovation Program grant number (11-MED1910-02).
authors.affiliation: Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.|Department of Pathology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.|Liver Disease Research Centre, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Tamadar
authors.identifier: 0000-0002-6425-6676
authors.initials: T
authors.lastname: Aldoheyan
authors.affiliation: Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia. mhassanain@ksu.edu.sa.|Liver Disease Research Centre, College of Medicine, King Saud University, Riyadh, Saudi Arabia. mhassanain@ksu.edu.sa.|Department of Oncology, McGill University, Montreal, Canada. mhassanain@ksu.edu.sa.|Hubert Department of Global Health, Emory University, Atlanta, USA. mhassanain@ksu.edu.sa.
authors.forename: Mazen
authors.initials: M
authors.lastname: Hassanain
authors.affiliation: Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Amnah
authors.initials: A
authors.lastname: Al-Mulhim
authors.affiliation: Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Atheer
authors.initials: A
authors.lastname: Al-Sabhan
authors.affiliation: Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Shaden
authors.initials: S
authors.lastname: Al-Amro
authors.affiliation: Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Fahad
authors.initials: F
authors.lastname: Bamehriz
authors.affiliation: Department of Pathology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Hisham
authors.initials: H
authors.lastname: Al-Khalidi
mesh_terms: D000328:Adult; D050110:Bariatric Surgery; D001706:Biopsy; D015331:Cohort Studies; D005260:Female; D022781:Hepatocytes / Q000473:pathology; D006801:Humans; D008099:Liver / Q000473:pathology*; D008297:Male; D065626:Non-alcoholic Fatty Liver Disease / Q000473:pathology*; D009767:Obesity, Morbid / Q000601:surgery
keywords: Bariatric; Gastric banding; Gastric bypass; Insulin resistance biliopancreatic diversion with duodenal switch; Nonalcoholic fatty liver disease; Obesity; Sleeve gastrectomy; Steatosis