Aims and objectives
Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in developed countries.
Nowadays it is under investigation the usefulness of safe tools for diagnosis and monitoring this condition in order to avoid liver biopsy.
the aim of this research was to assess the evolution of NAFLD in morbidly obese patients treated with bariatric surgery by comparing analytical and elastography data before and after bariatric surgery.
Methods and materials
For this prospective study we conducted a randomized sampling of morbidly obese patientswhich had undergone bariatric surgery three years before,
obtaining 40 patients.
The inclusion criteria were:
To fulfil the Spanish Society for the Study of Obesity (SEEDO) criteria concerning the indication of bariatric surgery
To have a preoperative clinical-radiological assessment includingblood tests,
ultrasound examination and determination of shear wave velocity of the liver with acoustic radiation force impulse (ARFI)
To undergone a intraoperative biopsy whichshowed features consistent with NAFLD
The exclusion criteria were:
It was verified a significant reduction of liver ARFI values since the average shear wave velocity declined from 1.74±0.9m/s before surgery to 1.26±0.8m/s after surgery (p<0.02). Fig. 1
it was detected liversteatosis with ultrasound in 67,5% (n=27) of patients before the procedure.
Severe steatosis was found in 12.5% of patients before surgery.
only7,5% (n=3) patients had liver steatosis.
These data reflect a significant decrease of liver steatosis after treatment (p<0.0001).Fig. 2
it was determined a significant decrease of BMI,
it has been verified a significantimprovement of morphologic and structural liver parameters as well as ofanalytical profile after bariatric surgery,
reflecting regressionof NAFLD.
Demonstratingthe reversibility of NAFLDrelated to obesity is essential for prognosis and clinical management of these patients.
ARFIelastography has proved to be a useful tool to assess the evolution of this disease after bariatric surgery.
Braunwald E et al.
Bariatric surgery: a systematic review and meta-analysis.
Hepatic steatosis: quantification by proton density fat fraction with MR imaging versus liver biopsy.
Detection of non-alcoholic steatohepatitis in patients with morbid obesity before bariatric surgery: Preliminary evaluation with acoustic radiation force impulse imaging.
Bariatric Surgery and Non-Alcoholic...