Pathology of nonalcoholic fatty liver disease improves after bariatric surgery

Bariatric surgery improved nonalcoholic fatty liver disease (NAFLD) in obese patients, according to a study presented at Digestive Disease Week.


Bariatric surgery improved nonalcoholic fatty liver disease (NAFLD) in obese patients, according to a study presented at Digestive Disease Week.

Researchers had a pathologist review liver biopsies of 152 patients who underwent bariatric surgery between 1998 and 2013 (82% women, mean pre-op body-mass index 52 kg/m2). For each patient, a biopsy taken during the bariatric procedure was compared to one taken during a subsequent abdominal operation, which was on average 29 months after the index procedure. The study was presented as an abstract at the meeting.

The post-op biopsies showed that steatosis resolved in 70% of the 118 patients who had it initially. Chronic portal inflammation resolved in 32% of cases (32 of 99 patients) and steatohepatitis resolved in 88% (44 of 50 patients). Fibrosis of any grade resolved in 21% of cases and improved in another 23%. Most significantly, the researchers noted, Grade 2 or 3 (bridging) fibrosis resolved or improved in 65% of the patients who had it (Grade 2: 16 of 52 cases resolved, 16 improved; Grade 3: 1 of 10 cases resolved, 7 improved).

“What we found surprised us,” the study's lead author said at a press conference. “These findings suggest that bariatric surgery should be considered as the treatment of choice for NAFLD patients with a body mass index greater than 35 and obesity-related comorbidities or patients with a body mass index of greater than 40.”

The findings may be particularly relevant to patients who haven't had success with traditional interventions such as medications and dieting, he added.