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Effect of weight loss induced by laparoscopic sleeve gastrectomy on liver histology and serum adipokine levels
Author(s) -
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 ElDin,
Atallah Mohamed,
GabAllah Ghada M K,
Salman Mohamed Abdalla
Publication year - 2020
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.15029
Subject(s) - medicine , steatohepatitis , adiponectin , gastroenterology , resistin , adipokine , fatty liver , steatosis , weight loss , leptin , sleeve gastrectomy , histopathology , liver function , alanine transaminase , liver function tests , homeostatic model assessment , endocrinology , insulin resistance , pathology , insulin , obesity , disease , gastric bypass
Abstract 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.