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Effects of sleeve gastrectomy and Roux-en-Y gastric bypass on non-alcoholic fatty liver disease in Iranians with morbid obesity

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Background: Morbid obesity increases the risk of various diseases, including non-alcoholic fatty liver disease (NAFLD). Bariatric surgery is one of the most effective tools to achieve significant weight loss and reduce complications in morbidly obese people. The present study was conducted to assess the effects of bariatric surgery on NAFLD-related factors. Methods: This quasi-experimental study was conducted among 40 patients with obesity who underwent sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) between July and November 2020. Biochemical factors and liver steatosis were evaluated by ultrasonography. Results: The results revealed a significant decrease in alanine aminotransferase, triglyceride, and low-density lipoprotein levels in both groups. After RYGB, a significant decline was observed in aspartate aminotransferase, alkaline phosphatase, and total cholesterol (TC) levels. In contrast, after SG, high-density lipoprotein levels were considerably elevated. Ultrasonography results showed a significant reduction in steatosis following RYGB, but not SG. However, no significant differences were observed between the two groups, except in TC levels. Conclusion: This study demonstrated that SG and RYGB had significant and beneficial short-term (6-month) effects on biochemical factors such as lipid profiles, liver enzymes, and blood glucose levels. While RYGB showed a slight advantage over SG in some parameters, the only statistically significant difference between groups was in the TC level. Furthermore, ultrasound findings revealed no statistically significant differences between SG and RYGB, suggesting that both procedures are effective at improving steatosis.

Abstract

Background: Morbid obesity increases the risk of various diseases, including non-alcoholic fatty liver disease (NAFLD). Bariatric surgery is one of the most effective tools to achieve significant weight loss and reduce complications in morbidly obese people. The present study was conducted to assess the effects of bariatric surgery on NAFLD-related factors. Methods: This quasi-experimental study was conducted among 40 patients with obesity who underwent sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) between July and November 2020. Biochemical factors and liver steatosis were evaluated by ultrasonography. Results: The results revealed a significant decrease in alanine aminotransferase, triglyceride, and low-density lipoprotein levels in both groups. After RYGB, a significant decline was observed in aspartate aminotransferase, alkaline phosphatase, and total cholesterol (TC) levels. In contrast, after SG, high-density lipoprotein levels were considerably elevated. Ultrasonography results showed a significant reduction in steatosis following RYGB, but not SG. However, no significant differences were observed between the two groups, except in TC levels. Conclusion: This study demonstrated that SG and RYGB had significant and beneficial short-term (6-month) effects on biochemical factors such as lipid profiles, liver enzymes, and blood glucose levels. While RYGB showed a slight advantage over SG in some parameters, the only statistically significant difference between groups was in the TC level. Furthermore, ultrasound findings revealed no statistically significant differences between SG and RYGB, suggesting that both procedures are effective at improving steatosis.

참고문헌 (45)

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