Insulin resistance and hepatic histological changes after bariatric surgery for severe obesity with NASH

2017 Fiscal Year Final Research Report

• Project/Area Number: 15K10065
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: General surgery
• Research Institution: Iwate Medical University
• Principal Investigator: Sasaki Akira 岩手医科大学, 医学部, 教授 (40275540)
• Co-Investigator(Kenkyū-buntansha): 石垣 泰 岩手医科大学, 医学部, 教授 (50375002)
• Research Collaborator: BABA Shigeaki ; UMEMURA Akira ; NIKAI Haruka
• Project Period (FY): 2015-04-01 – 2018-03-31
• Keywords: 肥満症 / 非アルコール性脂肪性肝疾患 / 非アルコール性脂肪性肝炎 / インスリン抵抗性 / 肥満外科手術

Outline of Final Research Achievements

The aim of the present study was to evaluate the effect of laparoscopic sleeve gastrectomy (LSG) on nonalcoholic steatohepatitis (NASH).Seventy-four patients with severe obesity underwent LSG and concomitant intra-operative liver biopsies from 2008 to 2017. Fifty-one patients fulfilled criteria for NASH and 22 patients underwent repeat percutaneous liver biopsy at 1 year after LSG. Mean excess body weight loss at time of repeat biopsy was 57.0%. Mean NAFLD activity score was decreased from 4.7 to 0.2. At the second biopsy, steatosis resolved in 62%, lobular inflammation resolved in 39%, ballooning resolved in 69%, and fibrosis resolved in 39%. Significant differences were observed in the following variables pre- and post-LSG: HOMA-IR (6.3 vs 1.7), liver volume (2,265 vs 1,598 mL), and visceral adipose tissue (271 vs 148 cm2). Metabolic surgery-induced weight loss should be considered as a treatment of choice for NASH patients with severe obesity.

Free Research Field

消化器外科学、内分泌代謝外科学