Bariatric Metabolic Surgery Reduced Liver Enzyme Levels in Patients with Non-Alcohol Fatty Liver Disease.

Abstract

IntroductionApproximately 93.3 million Americans are obese (BMI > 30 kg/m2) and 51% have non-alcoholic fatty liver disease (NAFLD). Progression of NAFLD can lead to non-alcoholic steatohepatitis (NASH), which is the leading cause of liver transplant in the United States. This study analyzed liver enzyme levels following bariatric metabolic surgery in NAFLD patients up to one-year post-surgical intervention.MethodsA retrospective analysis of adults with NAFLD who underwent bariatric metabolic surgery from 2009 to 2016 was conducted. The primary outcomes were transaminase levels following surgery. Secondary outcomes included levels of blood glucose and lipids.ResultsA total of 130 participants consisting of 80% Caucasian females with an average BMI of 47.5 kg/m2 participated in the study. Reductions were noted in ALT (57.6% decrease) and AST (47.7% decrease) at one-year post-surgical intervention. Significant reductions also were noted in levels of blood glucose (22.34%; p < 0.0001), HbA1c (1.11% change; p < 0.0001), LDL (19.75%; p = 0.0046), total cholesterol (10.12%; p = 0.0153), and triglycerides (37.21%; p < 0.0001) with an increase in HDL levels (17.22%; p = 0.0007). Significant correlations were noted at six months between levels of alkaline phosphatase and both ALT (p = 0.0101) and AST (p = 0.0009), as well as an additional correlation trending toward significance between ALT and alkaline phosphatase at one year (p = 0.0547). When separated by obesity class, participants with class II obesity experienced improved outcomes compared to participants with class III obesity.ConclusionsBariatric metabolic surgery was associated with a reduction in liver enzyme levels in NAFLD. These findings suggested that bariatric metabolic surgery is a viable treatment option for participants with NAFLD.