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Journal of Obesity
Volume 2011 (2011), Article ID 765473, 7 pages
http://dx.doi.org/10.1155/2011/765473
Clinical Study

Influence of Sleeve Gastrectomy on NASH and Type 2 Diabetes Mellitus

1Department of General and Visceral Surgery, Albert-Ludwigs-University, Hugstetter Straße 55, 79106 Freiburg, Germany
2Department of Surgery, Champain de Chalons, 2 Rue Charles Simon, 51308 Vitry-le-France, Frankreich, France
3Department of Physiology, Silesian Medical University, Jordana 19, 41-800 Zabrze, Poland
4Department of Laparoscopic Surgery, International Medical Center, P.O. Box 2173, Jeddah 21451, Saudi Arabia

Received 31 August 2010; Accepted 26 October 2010

Academic Editor: Francesco Saverio Papadia

Copyright © 2011 W. K. Karcz et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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 < . 0 5 , <.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 < . 0 0 0 1 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.