Positive Results Include Improvement of Both Nonalcoholic Fatty Liver Disease and Metabolic Syndrome

Doctors and clinicians all over the world are taking notice of the increase in younger patients with obesity-related liver disease, as well as metabolic syndrome, which is a group of risk factors increasing a person’s likelihood for additional diseases.  Dr. Christine Ren-Fielding and Dr. George Fielding from the NYU Langone Medical Center researched a group of adolescents who were scheduled to undergo weight loss surgery, and discovered the following: bariatric surgery with laparoscopic adjustable gastric band both improves adolescent patients’ weight, as well as lowers their rates of nonalcoholic fatty liver disease and metabolic syndrome.

Methods of Study

Dr. Christine Ren-Fielding and the team of researchers studied 155 adolescents ranging in age from 14-18. These patients were scheduled to undergo bariatric surgery with the laparoscopic adjustable gastric band (LAGB). 56 out of the 155 individuals had evidence of fatty liver after undergoing preoperative workup including serum liver testing and abdominal sonogram. The results showed fatty liver in the absence of known liver disease, liver altering medications, or alcohol ingestion. In order to test for NAFLD, doctors used the NAFLD fibrosis score, taking into account BMI, age, platelet count, hyperglycemia, albumin, and aspartate transaminase.  The patients were also assessed against International Diabetes Federation (IDF) criteria for metabolic syndrome (MS). The following factors were considered: raised triglycerides, hypertension, low-high density lipoprotein C (HDL-C), or abnormally high-fasting blood glucose. If the adolescents have 2 of the 4 criteria, they are considered to have metabolic syndrome.

Dr. Christine Ren-Fielding’s Positive Results

The results of the study were favorable, which is encouraging news as childhood obesity rates continue to rise. Laparoscopic adjustable gastric band surgery had a positive effect on both the patients’ fibrosis scores and manifestation of metabolic syndrome. The wide range of metabolic factors included in the study (waist/BMI, glucose measure, triglycerides, patients’ blood pressure, and high-density lipoproteins, or HDL) all showed improvement after surgery. The group of individuals tested had a mean preoperative weight of 304.3 lbs. with a BMI of 48.8. One year postoperative mean weight was 235.6 lbs with a BMI of 37.9. At year 2, mean BMI had decreased to 36.8 while excess weight loss (%EWL) had increased to 45%.

Favorable Changes in NAFLD Scores

The decrease in nonalcoholic fatty liver disease scores are directly connected with patients decrease in waist circumference and overall weight loss. These health improvements were significant at 1 and 2 years postoperatively. These findings show that LAGB is a safe and effective weight loss option for adolescents, and that the benefits are wide-ranging. The significant improvements in NAFLD scores and resolution of metabolic syndrome as a result of LAGB surgery can significantly improve quality of life in children and adolescents.

If you or a loved one are interested in learning about the benefits of bariatric surgery, including the work of Dr. Christine Ren-Fielding and Dr. George Fielding, visit the NYU Langone Weight Management Program here.