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Laparoscopic sleeve gastrectomy reverses non-alcoholic fatty liver disease modulating oxidative stress and

Noemí Cabré1, Fedra Luciano-Mateo1, Salvador Fernández-Arroyo1

  • 1Department of Medicine and Surgery, Universitat Rovira i Virgili, Reus, Spain; Unitat de Recerca Biomèdica, Hospital Universitari Sant Joan, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Reus, Spain.

Metabolism: Clinical and Experimental
|July 8, 2019
PubMed
Abstract

Insights

Laparoscopic sleeve gastrectomy (LSG) significantly improves liver health in obese patients by reducing oxidative stress and inflammation. This procedure offers a promising therapeutic option for non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH).

Area of Science:

  • Hepatology
  • Bariatric Surgery
  • Metabolic Syndrome

Background:

  • Obesity is strongly linked to hepatic alterations like non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH).
  • Understanding the molecular mechanisms driving these liver conditions in obesity is crucial for developing effective treatments.
  • Investigating the impact of bariatric surgery on these mechanisms offers a potential therapeutic avenue.

Purpose of the Study:

  • To investigate the molecular mechanisms underlying hepatic alterations in morbidly obese patients.
  • To assess the modulation of hepatic oxidative stress and inflammation markers following laparoscopic sleeve gastrectomy (LSG).
  • To identify potential therapeutic targets for NAFLD and NASH in the context of obesity surgery.

Main Methods:

  • A cohort of 436 obese patients underwent LSG, with liver biopsies obtained intraoperatively.
  • A sub-cohort of 120 patients provided blood samples and liver biopsies at a 1-year follow-up.
  • Key molecular markers of oxidative stress and inflammation in blood and liver tissue were analyzed pre- and post-LSG.

Main Results:

  • LSG led to significant improvements in liver histology, particularly in severe cases of NAFLD, NASH, fibrosis, and cirrhosis.
  • Post-surgery, there were significant reductions in the prevalence of diabetes, dyslipidemia, and hypertension.
  • Key plasma and liver markers of oxidative stress and inflammation, including chemokine C-C motif ligand 2, paraoxonase-1, galectin-3, and sonic hedgehog, showed consistent improvement post-LSG.

Conclusions:

  • LSG significantly improves liver histology and function in morbidly obese patients.
  • The beneficial effects of LSG are mediated through the reduction of oxidative stress and inflammatory processes.
  • LSG is a viable therapeutic option for improving or resolving NAFLD and associated complications.
Keywords:
CytokinesFibrosisGalectin-3Metabolic surgeryOxidation

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