Bariatric surgery for nonalcoholic fatty liver disease in adolescents with severe obesity

Abstract

Nonalcoholic fatty liver disease (NAFLD) is defined as excess liver fat infiltration (greater than 5% on liver biopsy), in the absence of excessive alcohol intake or viral, autoimmune, or drug-induced liver disease, and is found in approximately 70% of adults with severe obesity (body mass index (BMI)≥35 kg/m2) [ [1] Ray K. NAFLD-the next global epidemic. Nat Rev Gastroenterol Hepatol. 2013; 10: 621 Crossref PubMed Scopus (67) Google Scholar ]. While steatosis may be a relatively benign finding in and of itself, it may advance to Nonalcoholic Steatohepatitis (NASH), cirrhosis, and hepatocarcinoma. NASH is observed in 30% of individuals with NAFLD and is characterized by the presence, on liver biopsy, of necroinflammation with variable amounts of fibrosis in addition to steatosis [ [2] Brunt E.M. Kleiner D.E. Wilson L.A. Belt P. Neuschwander-Tetri B.A. Network NCR. Nonalcoholic fatty liver disease (NAFLD) activity score and the histopathologic diagnosis in NAFLD: distinct clinicopathologic meanings. Hepatology. 2011; 53: 810-820 Crossref PubMed Scopus (757) Google Scholar ]. An important concept links metabolic diseases, such as type 2 diabetes, to the risk of progression of NAFLD to NASH; i.e., individuals with NAFLD that have metabolic diseases are at particularly high risk for progression to NASH [ 3 Anstee Q.M. Targher G. Day C.P. Progression of NAFLD to diabetes mellitus, cardiovascular disease or cirrhosis. Nat Rev Gastroenterol Hepatol. 2013; 10: 330-344 Crossref PubMed Scopus (1046) Google Scholar , 4 Campos G.M. Bambha K. Vittinghoff E. et al. A clinical scoring system for predicting nonalcoholic steatohepatitis in morbidly obese patients. Hepatology. 2008; 47: 1916-1923 Crossref PubMed Scopus (134) Google Scholar ]. Improvement in nonalcoholic fatty liver disease and metabolic syndrome in adolescents undergoing bariatric surgerySurgery for Obesity and Related DiseasesVol. 11Issue 2PreviewNonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in children. It is linked to obesity and the metabolic syndrome (MS), predisposing to future cirrhosis. The objective of this study was to demonstrate the effects that weight loss achieved with laparoscopic adjustable gastric band (LAGB) has on the metabolic parameters and NAFLD scores of obese adolescents with evidence of fatty liver disease. Full-Text PDF