Effect of weight loss induced by laparoscopic sleeve gastrectomy on liver histology and serum adipokine levels

• Published in: Journal of gastroenterology and hepatology Vol. 35; no. 10; pp. 1769 - 1773
• Main Authors: Salman, Ahmed Abdallah, Sultan, Ahmed Abd El Aal, Abdallah, Ahmed, Abdelsalam, Ahmed, Mikhail, Hani Maurice Sabri, Tourky, Mohamed, Omar, Mahmoud Gouda, Youssef, Ahmed, Ahmed, Reham Abdelghany, Elkassar, Hesham, Seif El Nasr, Sayed M, Shaaban, Hossam El‐Din, Atallah, Mohamed, GabAllah, Ghada M K, Salman, Mohamed Abdalla
• Format: Journal Article
• Language: English
• Published: Australia Wiley Subscription Services, Inc 01.10.2020
• Subjects: adipokine; Adiponectin; Alanine; Alanine transaminase; Aspartate aminotransferase; Balloon treatment; bariatric surgery; Beta cells; Biochemical markers; Biopsy; Blood levels; Diabetes mellitus; Fatty liver; Fibrosis; Gastrectomy; Gastrointestinal surgery; Histopathology; Homeostasis; Inflammation; Insulin; Laparoscopy; Leptin; Liver diseases; NAFLD; NASH; Patients; Serum levels; Steatosis; Surgery; weight loss; γ-Glutamyltransferase; weight loss; NAFLD; bariatric surgery; NASH; adipokine
• ISSN: 0815-9319; 1440-1746
• DOI: 10.1111/jgh.15029

Background & Aim Bariatric surgery is a valid treatment option for persons with non‐alcoholic fatty liver disease. This study prospectively examined the impact of laparoscopic sleeve gastrectomy (LSG) on liver histopathology, and blood levels of adiponectin, leptin, resistin, and pre‐B cell enhancing factor/Nampt/visfatin. Patients & Methods In 81 patients with non‐alcoholic fatty liver disease who underwent LSG, paired liver biopsies and blood specimens were obtained before and 18 months after LSG. Differences between preoperative and 18 months postoperative data were tested by paired Student's t‐test or Wilcoxon rank test as appropriate. Results At follow up, there was a significant improvement in biochemical markers for glucose homeostasis, including fasting glucose, HbA1c, insulin levels, and homeostatic model assessment index. Postoperative liver function tests, namely serum alanine aminotransferase, aspartate aminotransferase, and gamma‐glutamyl transpeptidase level, showed a significant improvement compared to before weight loss. The number of patients who had definite, borderline, or no non‐alcoholic steatohepatitis was 43 (53%), 27 (33%), and 11 (14%), respectively, at baseline, and 9 (11%), 32 (40%), and 40 (49%) at 18‐month post‐surgery follow up. A significant reduction in steatosis, liver fibrosis, lobular inflammation, and hepatocyte ballooning was observed in the postoperative biopsies (P < 0.001 each). In addition, at the follow‐up assessment, there was a significant increase in serum adiponectin levels and significant decline in serum levels of leptin, resisitin, and pre‐B cell enhancing factor/Nampt/visfatin. Conclusion Weight loss after sleeve gastrectomy was associated with a significant improvement in several metabolic parameters, liver enzyme levels, liver histopathology, and changes in serum adipokine levels towards antidiabetic and anti‐inflammatory profiles.