In a new study, lean people with NAFLD (non-alcoholic fatty liver disease) appear to have twice the mortality rate of their obese and overweight counterparts. Researchers said that while bariatric surgery helps patients cut down on their weight, it can also significantly improve NAFLD.
The weight loss procedure appears to resolve liver inflammation and reverse an early stage of liver fibrosis which is the liver tissue's thickening and scarring through the lowering of liver fat deposits. Bariatric surgery in people with NAFLD also resulted to the resolution of steatohepatitis and steatosis but the recovery from advanced fibrosis such as bridging or stage 3 fibrosis was more remarkable. It has long been believed that fibrosis was irreversible.
In addition to a higher mortality rate, lean people with NAFLD appear to be more likely a non-Caucasian male with lower chronic condition rates including hypertension and diabetes. Lean people have a BMI (body mass index) below 25.
"About 30 percent of the U.S. population suffers from this disease, which is increasing, and more than half are also severely obese," lead researcher and Tampa General Hospital and USF Health Bariatric Center professor and director Dr. Michel Murr said. "Our findings suggest that providers should consider bariatric surgery as the treatment of choice for nonalcoholic fatty liver disease in severely obese patients."
Researchers analyzed [pdf] the liver biopsies of 152 patients from the time they had their bariatric procedure to around 29 months after that. During the patients' pre-operative biopsies, the researchers identified those with NAFLD cellular manifestations such as liver inflammation and fat deposits. These kinds of liver damage can result to life-threatening illnesses including cirrhosis and liver fibrosis.
Almost 70 percent of the participants had their liver fat deposits resolved after the surgery. 74 percent of the patients had their lobular inflammation resolved. Almost 32 percent improved their chronic portal inflammation and 88 percent had their steatohepatitis resolved. 62 percent of the participants improved or resolved their stage 2 fibrosis while one of the three participants showed improvement in cirrhosis.
Based on the research, weight loss surgery should be recommended to people with a BMI of over 35 and over 40 or obesity reacted co-morbidities.
