Influence of Sleeve Gastrectomy on NASH and Type 2 Diabetes Mellitus

Background. Nonalcoholic fatty liver disease is present in up to 85% of adipose patients and may proceed to nonalcoholic steatohepatitis (NASH). With insulin resistance and obesity being the main risk factors for NASH, the effect of isolated sleeve gastrectomy (ISG) on these parameters was examined....

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Main Authors: W. K. Karcz, D. Krawczykowski, S. Kuesters, G. Marjanovic, B. Kulemann, H. Grobe, I. Karcz-Socha, U. T. Hopt, W. Bukhari, J. M. Grueneberger
Format: Article
Language:English
Published: Wiley 2011-01-01
Series:Journal of Obesity
Online Access:http://dx.doi.org/10.1155/2011/765473
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author W. K. Karcz
D. Krawczykowski
S. Kuesters
G. Marjanovic
B. Kulemann
H. Grobe
I. Karcz-Socha
U. T. Hopt
W. Bukhari
J. M. Grueneberger
author_facet W. K. Karcz
D. Krawczykowski
S. Kuesters
G. Marjanovic
B. Kulemann
H. Grobe
I. Karcz-Socha
U. T. Hopt
W. Bukhari
J. M. Grueneberger
author_sort W. K. Karcz
collection DOAJ
description Background. Nonalcoholic fatty liver disease is present in up to 85% of adipose patients and may proceed to nonalcoholic steatohepatitis (NASH). With insulin resistance and obesity being the main risk factors for NASH, the effect of isolated sleeve gastrectomy (ISG) on these parameters was examined. Methods. 236 patients underwent ISG with intraoperative liver biopsy from December 2002 to September 2009. Besides demographic data, pre-operative weight/BMI, HbA1c, AST, ALT, triglycerides, HDL and LDL levels were determined. Results. A significant correlation of NASH with higher HbA1c, AST and ALT and lower levels for HDL was observed (P<.05, <.0001, <.0001, <.01, resp.). Overall BMI decreased from 45.0 ± 6.8 to 29.7 ± 6.5 and 31.6 ± 4.4 kg/m2 at 1 and 3 years. An impaired weight loss was demonstrated for patients with NASH and patients with elevated HbA1c (plateau 28.08 kg/m2 versus 29.79 kg/m2 and 32.30 kg/m2 versus 28.79 kg/m2, resp.). Regarding NASH, a significant improvement of AST, ALT, triglyceride and HDL levels was shown (P<.0001 for all). A resolution of elevated HbA1c was observed in 21 of 23 patients. Summary. NASH patients showed a significant loss of body weight and amelioration of NASH status. ISG can be successfully performed in these patients and should be recommended for this subgroup.
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spelling doaj-art-33f82af91b7f45cf90ca8336c36cf78c2025-08-20T03:55:12ZengWileyJournal of Obesity2090-07082090-07162011-01-01201110.1155/2011/765473765473Influence of Sleeve Gastrectomy on NASH and Type 2 Diabetes MellitusW. K. Karcz0D. Krawczykowski1S. Kuesters2G. Marjanovic3B. Kulemann4H. Grobe5I. Karcz-Socha6U. T. Hopt7W. Bukhari8J. M. Grueneberger9Department of General and Visceral Surgery, Albert-Ludwigs-University, Hugstetter Straße 55, 79106 Freiburg, GermanyDepartment of Surgery, Champain de Chalons, 2 Rue Charles Simon, 51308 Vitry-le-France, Frankreich, FranceDepartment of General and Visceral Surgery, Albert-Ludwigs-University, Hugstetter Straße 55, 79106 Freiburg, GermanyDepartment of General and Visceral Surgery, Albert-Ludwigs-University, Hugstetter Straße 55, 79106 Freiburg, GermanyDepartment of General and Visceral Surgery, Albert-Ludwigs-University, Hugstetter Straße 55, 79106 Freiburg, GermanyDepartment of General and Visceral Surgery, Albert-Ludwigs-University, Hugstetter Straße 55, 79106 Freiburg, GermanyDepartment of Physiology, Silesian Medical University, Jordana 19, 41-800 Zabrze, PolandDepartment of General and Visceral Surgery, Albert-Ludwigs-University, Hugstetter Straße 55, 79106 Freiburg, GermanyDepartment of Laparoscopic Surgery, International Medical Center, P.O. Box 2173, Jeddah 21451, Saudi ArabiaDepartment of General and Visceral Surgery, Albert-Ludwigs-University, Hugstetter Straße 55, 79106 Freiburg, GermanyBackground. Nonalcoholic fatty liver disease is present in up to 85% of adipose patients and may proceed to nonalcoholic steatohepatitis (NASH). With insulin resistance and obesity being the main risk factors for NASH, the effect of isolated sleeve gastrectomy (ISG) on these parameters was examined. Methods. 236 patients underwent ISG with intraoperative liver biopsy from December 2002 to September 2009. Besides demographic data, pre-operative weight/BMI, HbA1c, AST, ALT, triglycerides, HDL and LDL levels were determined. Results. A significant correlation of NASH with higher HbA1c, AST and ALT and lower levels for HDL was observed (P<.05, <.0001, <.0001, <.01, resp.). Overall BMI decreased from 45.0 ± 6.8 to 29.7 ± 6.5 and 31.6 ± 4.4 kg/m2 at 1 and 3 years. An impaired weight loss was demonstrated for patients with NASH and patients with elevated HbA1c (plateau 28.08 kg/m2 versus 29.79 kg/m2 and 32.30 kg/m2 versus 28.79 kg/m2, resp.). Regarding NASH, a significant improvement of AST, ALT, triglyceride and HDL levels was shown (P<.0001 for all). A resolution of elevated HbA1c was observed in 21 of 23 patients. Summary. NASH patients showed a significant loss of body weight and amelioration of NASH status. ISG can be successfully performed in these patients and should be recommended for this subgroup.http://dx.doi.org/10.1155/2011/765473
spellingShingle W. K. Karcz
D. Krawczykowski
S. Kuesters
G. Marjanovic
B. Kulemann
H. Grobe
I. Karcz-Socha
U. T. Hopt
W. Bukhari
J. M. Grueneberger
Influence of Sleeve Gastrectomy on NASH and Type 2 Diabetes Mellitus
Journal of Obesity
title Influence of Sleeve Gastrectomy on NASH and Type 2 Diabetes Mellitus
title_full Influence of Sleeve Gastrectomy on NASH and Type 2 Diabetes Mellitus
title_fullStr Influence of Sleeve Gastrectomy on NASH and Type 2 Diabetes Mellitus
title_full_unstemmed Influence of Sleeve Gastrectomy on NASH and Type 2 Diabetes Mellitus
title_short Influence of Sleeve Gastrectomy on NASH and Type 2 Diabetes Mellitus
title_sort influence of sleeve gastrectomy on nash and type 2 diabetes mellitus
url http://dx.doi.org/10.1155/2011/765473
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