The short-term effects of laparoscopic sleeve gastrectomy on nonalcoholic fatty liver disease and glycolipid metabolism in severely obese patients

doi:10.3877/cma.j.issn.2095-9605.2020.03.003

Abstract

Abstract:

Objective

To investigate the effect of laparoscopic sleeve gastrectomy (LSG) on the glucose and lipid metabolism in patients with severe obesity and non-alcoholic fatty liver disease (NAFLD).

Methods

To retrospectively analyze the clinical data of 78 severely obese patients with non-alcoholic fatty liver disease, followed up for more than 1 year after operation. The change of body weight, glucose and lipid metabolism, liver function (aspartate aminotransferase, ALT; alanine aminotransferase, AST), average liver CT value and liver volume were compared.

Results

The body weight, body mass index (BMI), waist circumference, and hip circumference of the patient decreased significantly compared with that before operation (P<0.01); fasting blood glucose, fasting insulin, glycosylated hemoglobin, and insulin resistance index were significantly improved (P<0.01); Cholesterol, triglyceride and low density lipoprotein were significantly improved (P<0.01); Liver function (ALT, AST) were significantly improved compared with that before operation (P<0.01). The average liver CT value (39.84±4.25) one year after operation was significantly higher than that before operation (22.34±6.64). The liver volume decreased from (1983.61±821.7) cm³ before operation to (1549.32±752.01) cm³ after operation, and the difference was statistically significant (P<0.01). Waist circumference and BMI were positively correlated with insulin resistance and liver volume, and negatively with liver CT value.

Conclusions

LSG can not only effectively reduce the weight of obese patients, improve glucose and lipid metabolism, but also has a significant effect on the treatment of NAFLD. For patients with severe obesity and NAFLD, LSG surgery is an effective treatment.

Key words: Obesity, Nonalcoholic fatty liver disease, Laparoscopic sleeve gastrectomy, Glucolipid metabolism

Wei Chen, Henggui Luo, Xiangwen Zhao, Yuefeng Mao, Bing Tang, Shaojie Li, Xiaoling Zhang, Xianglin Chen, Li Wang. The short-term effects of laparoscopic sleeve gastrectomy on nonalcoholic fatty liver disease and glycolipid metabolism in severely obese patients[J]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2020, 06(03): 153-158.

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References 31

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指标	体重（kg）	BMI（kg/m²）	臀围（cm）	腰围（cm）
术前	118.55±35.59	40.86±8.22	114.61±11.91	128.92±10.67
术后1年	82.24±22.49	28.39±4.07	95.20±11.91	86.86±9.54
t值	7.61	12.00	10.18	25.95
P值	<0.01	<0.01	<0.01	<0.01

指标	体重（kg）	BMI（kg/m²）	臀围（cm）	腰围（cm）
术前	118.55±35.59	40.86±8.22	114.61±11.91	128.92±10.67
术后1年	82.24±22.49	28.39±4.07	95.20±11.91	86.86±9.54
t值	7.61	12.00	10.18	25.95
P值	<0.01	<0.01	<0.01	<0.01

指标	术前	术后1年	t值	P值
FBG （mmol/L）	8.90±7.05	5.20±0.76	4.60	<0.01
FINS（mU/L）	38.66±15.40	27.31±5.73	6.10	<0.01
HbA1 c（%）	7.30± 1.20	5.20± 1.05	15.4	<0.01
HOMA-IR	28.34±9.98	4.52±5.40	18.53	<0.01
TC（mmol /L）	6.58±0.28	4.21±0.75	26.15	<0.01
TG（mmol /L）	2.44±0.76	1.51±0.60	1.67	<0.01
HDL-C（mmol /L）	0.84±0.31	1.45±0.86	9.12	<0.01
LDL-C（mmol /L）	3.56±1.66	2.3±0.67	6.21	<0.01

指标	术前	术后1年	t值	P值
FBG （mmol/L）	8.90±7.05	5.20±0.76	4.60	<0.01
FINS（mU/L）	38.66±15.40	27.31±5.73	6.10	<0.01
HbA1 c（%）	7.30± 1.20	5.20± 1.05	15.4	<0.01
HOMA-IR	28.34±9.98	4.52±5.40	18.53	<0.01
TC（mmol /L）	6.58±0.28	4.21±0.75	26.15	<0.01
TG（mmol /L）	2.44±0.76	1.51±0.60	1.67	<0.01
HDL-C（mmol /L）	0.84±0.31	1.45±0.86	9.12	<0.01
LDL-C（mmol /L）	3.56±1.66	2.3±0.67	6.21	<0.01

?	术前	术后1年	t值	P值
谷草转氨酶ALT（IU/L）	59.82±14.56	32.45±5.29	15.60	<0.01
谷丙转氨酶AST（IU/L）	42.98±8.16	26.98±5.84	14.08	<0.01
肝平均CT值（Hu）	20.34±7.64	39.84±4.25	19.70	<0.01
肝体积（cm³）	1983.61±821.7	1549.32±752.01	3.44	<0.01

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