Post-Bariatric Surgery Liver Disease Investigated

Non-alcoholic fatty liver disease after surgery more likely in insulin resistant patients

WEDNESDAY, Aug. 12 (HealthDay News) -- Obese patients with refractory insulin resistance who undergo bariatric surgery are more likely to develop liver complications, according to a study in the August issue of Gastroenterology.

Philipe Mathurin, M.D., of the Universite Lille 2 in France, and colleagues conducted a prospective study 381 obese patients who underwent bariatric surgery between 1994 and 2005. Patients could choose to receive biliointestinal bypass, gastric bypass, or gastric band surgery (or two of three of these depending on year). Follow-up was performed at one and five years after surgery.

At both the one-year and five-year follow-up, the researchers found a significant increase in the incidence of fibrosis among the study group. By five years, there was an increase in fibrosis, although it was mild (≤F1). In contrast, steatosis was less prevalent after five years compared with baseline (37.7 versus 82 percent. Ballooning also significantly decreased in the five years after surgery. Both at the one-year and five-year follow-up, the authors note, those patients with a refractory insulin resistance profile had a higher probability of increased non-alcoholic fatty liver disease score, steatosis, inflammation, and ballooning.

"Our study on severely obese patients provides the first prospective evidence that the evolution of non-alcoholic fatty liver disease after surgery is intimately associated with insulin resistance over both the short and long term," the authors conclude.

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Lisa Cockrell

Lisa Cockrell

Published on August 12, 2009

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