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The effect of surgically induced weight loss on nonalcoholic fatty liver disease in morbidly obese Indians: "NASHOST" prospective observational trial.
Surg Obes Relat Dis 2015 Nov-Dec; 11(6):1315-22SO

Abstract

BACKGROUND

Surgically induced weight loss improves nonalcoholic fatty liver disease (NAFLD) in morbidly obese Caucasian patients. Similar data are lacking from India.

OBJECTIVE

To compare the histologic features of NAFLD in morbidly obese Indian patients before and 6 months after bariatric surgery. Histologic changes were also separately assessed according to the type of bariatric intervention.

SETTING

Teaching institution, India; private practice.

METHODS

All patients undergoing bariatric surgery from July 2012 to July 2013 underwent a routine liver biopsy at the time of bariatric surgery. If the biopsy specimen indicated NAFLD, patients were asked to undergo a second biopsy after 6 months. Baseline anthropometry, clinical data, biochemistry, and pathology were recorded and repeated at follow-up.

RESULTS

Eighty-eight of 134 index biopsy specimens indicated NAFLD. Thirty patients had paired liver biopsies. Steatosis was present in all, 14 had lobular inflammation, 10 had ballooning degeneration, and 14 had fibrosis. Mean time between the biopsies was 7.1 months (range 6-8 months). At the second biopsy, steatosis had resolution in 19 and improvement in 11, lobular inflammation had resolution in 12 and improvement in 2, ballooning had resolution in 9 and improvement in 1 and fibrosis had resolution in 11 and improvement in 3 (P<0.05 for all). Improvement was greater among those who underwent a sleeve gastrectomy in comparison to a Roux-en-Y gastric bypass, although this difference was not statistically significant. None had worsening of liver histologic results.

CONCLUSIONS

Surgically induced weight loss significantly and rapidly improves liver histology in morbidly obese Indians with NAFLD.

Authors+Show Affiliations

Department of Bariatric Surgery, GEM Hospital and Research Centre, Tamil Nadu, India. Electronic address: praveenraj@me.com.Department of Bariatric Surgery, GEM Hospital and Research Centre, Tamil Nadu, India.Department of Bariatric Surgery, GEM Hospital and Research Centre, Tamil Nadu, India.Department of Bariatric Surgery, GEM Hospital and Research Centre, Tamil Nadu, India.Department of Hepatology, GEM Hospital and Research Centre, Tamil Nadu, India.Department of Pathology, GEM Hospital and Research Centre, Tamil Nadu, India.Department of Bariatric Surgery, GEM Hospital and Research Centre, Tamil Nadu, India.

Pub Type(s)

Clinical Trial
Journal Article
Observational Study

Language

eng

PubMed ID

26003897

Citation

Praveen Raj, P, et al. "The Effect of Surgically Induced Weight Loss On Nonalcoholic Fatty Liver Disease in Morbidly Obese Indians: "NASHOST" Prospective Observational Trial." Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, vol. 11, no. 6, 2015, pp. 1315-22.
Praveen Raj P, Gomes RM, Kumar S, et al. The effect of surgically induced weight loss on nonalcoholic fatty liver disease in morbidly obese Indians: "NASHOST" prospective observational trial. Surg Obes Relat Dis. 2015;11(6):1315-22.
Praveen Raj, P., Gomes, R. M., Kumar, S., Senthilnathan, P., Karthikeyan, P., Shankar, A., & Palanivelu, C. (2015). The effect of surgically induced weight loss on nonalcoholic fatty liver disease in morbidly obese Indians: "NASHOST" prospective observational trial. Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, 11(6), pp. 1315-22. doi:10.1016/j.soard.2015.02.006.
Praveen Raj P, et al. The Effect of Surgically Induced Weight Loss On Nonalcoholic Fatty Liver Disease in Morbidly Obese Indians: "NASHOST" Prospective Observational Trial. Surg Obes Relat Dis. 2015;11(6):1315-22. PubMed PMID: 26003897.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effect of surgically induced weight loss on nonalcoholic fatty liver disease in morbidly obese Indians: "NASHOST" prospective observational trial. AU - Praveen Raj,P, AU - Gomes,Rachel M, AU - Kumar,Saravana, AU - Senthilnathan,Palanisamy, AU - Karthikeyan,Purushothaman, AU - Shankar,Annapoorni, AU - Palanivelu,Chinnusamy, Y1 - 2015/02/11/ PY - 2014/12/01/received PY - 2015/01/21/revised PY - 2015/02/03/accepted PY - 2015/5/25/entrez PY - 2015/5/25/pubmed PY - 2016/10/7/medline KW - Bariatric surgery KW - Cirrhosis KW - Metabolic syndrome KW - Morbid obesity KW - Nonalcoholic liver disease KW - Nonalcoholic steatohepatitis SP - 1315 EP - 22 JF - Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery JO - Surg Obes Relat Dis VL - 11 IS - 6 N2 - BACKGROUND: Surgically induced weight loss improves nonalcoholic fatty liver disease (NAFLD) in morbidly obese Caucasian patients. Similar data are lacking from India. OBJECTIVE: To compare the histologic features of NAFLD in morbidly obese Indian patients before and 6 months after bariatric surgery. Histologic changes were also separately assessed according to the type of bariatric intervention. SETTING: Teaching institution, India; private practice. METHODS: All patients undergoing bariatric surgery from July 2012 to July 2013 underwent a routine liver biopsy at the time of bariatric surgery. If the biopsy specimen indicated NAFLD, patients were asked to undergo a second biopsy after 6 months. Baseline anthropometry, clinical data, biochemistry, and pathology were recorded and repeated at follow-up. RESULTS: Eighty-eight of 134 index biopsy specimens indicated NAFLD. Thirty patients had paired liver biopsies. Steatosis was present in all, 14 had lobular inflammation, 10 had ballooning degeneration, and 14 had fibrosis. Mean time between the biopsies was 7.1 months (range 6-8 months). At the second biopsy, steatosis had resolution in 19 and improvement in 11, lobular inflammation had resolution in 12 and improvement in 2, ballooning had resolution in 9 and improvement in 1 and fibrosis had resolution in 11 and improvement in 3 (P<0.05 for all). Improvement was greater among those who underwent a sleeve gastrectomy in comparison to a Roux-en-Y gastric bypass, although this difference was not statistically significant. None had worsening of liver histologic results. CONCLUSIONS: Surgically induced weight loss significantly and rapidly improves liver histology in morbidly obese Indians with NAFLD. SN - 1878-7533 UR - https://www.unboundmedicine.com/medline/citation/26003897/The_effect_of_surgically_induced_weight_loss_on_nonalcoholic_fatty_liver_disease_in_morbidly_obese_Indians:_"NASHOST"_prospective_observational_trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1550-7289(15)00036-2 DB - PRIME DP - Unbound Medicine ER -