Effects of sleeve gastrectomy on liver enzymes, non-alcoholic fatty liver disease-related fibrosis and steatosis scores in morbidly obese patients: first year follow-up

Background: Non-alcoholic fatty liver disease (NAFLD) has a high prevalence among patients undergoing laparoscopic sleeve gastrectomy (LSG). Although liver biopsy is the gold standard for assessing histopathologic changes in the liver, it is an invasive procedure. The objective of this study was to evaluate the effect of sleeve gastrectomy on liver enzymes, fibrosis and steatosis scores; ultrasonographic findings; biochemical parameters; and anthropometric measurements in morbidly obese patients with NAFLD. Methods: Ninety-seven obese patients who underwent LSG were included in this study. Sex, age, body mass index (BMI), comorbidities, liver enzymes, ultrasonographic findings and laboratory parameters to calculate fibrosis and steatosis scores were collected before surgery and after 1 year of follow-up. Results: A total of 88.7% of patients had liver steatosis at the pre-surgical ultrasonographic evaluation and this ratio decreased to 46.4% 1 year after surgery. Alanine aminotransferase (ALT), homeostatic model assessment of insulin resistance index (HOMA-IR), aspartate aminotransferase-to-platelet ratio index (APRI) and liver fat score (LFS) were significantly higher in patients with steatosis grade III vs. others. There were improvements in high-density lipoprotein (HDL), triglycerides (TG), glycated hemoglobin (HbA(1c)), glucose, insulin, BMI, liver enzymes and all NAFLD-related fibrosis and steatosis scores. Conclusions: HOMA-IR, ALT, LFS and APRI scores can be used for follow-up procedures in morbidly obese patients with NAFLD who underwent LSG.