Comparison of Hepatic Profile in Pre and Postoperative of Bariatric Surgery: Private vs Public Network

Abstract

Background: Obesity is associated to several comorbidities, including nonalcoholic fatty liver disease, which implicates in isolated steatosis to steatohepatitis. The latter may progress to severe manifestations such as liver fibrosis, cirrhosis and hepatocellular carcinoma. Aim: To compare the presence of advanced liver fibrosis before and after bariatric surgery in patients of private and public health system. Methods: Patients from public and privative networks were studied before and after bariatric surgery. The presence or absence of advanced hepatic fibrosis was evaluated by NAFLD Fibrosis Score, a non-invasive method that uses age, BMI, AST/ALT ratio, albumin, platelet count and the presence or absence of hyperglycemia or diabetes. The characteristics of the two groups were compared. The established statistical significance criterion was p<0.05. Results: Were analyzed 40 patients with a mean age of 34.6±9.5 years for private network and 40.6± 10.2 years for public. The study sample, 35% were treated at private health system and 65% in the public ones, 38% male and 62% female. Preoperatively in the private network one (7.1%) patient had advanced liver fibrosis and developed to the absence of liver fibrosis after surgery. In the public eight (30.8%) patients had advanced liver fibrosis preoperatively, and at one year after the proportion fell to six (23%). Conclusion: The non-alcoholic fatty liver disease in its advanced form is more prevalent in obese patients treated in the public network than in the treated at the private network and bariatric surgery may be important therapeutic option in both populations.

The Effect of Roux-en-Y Gastric Bypass on Non-Alcoholic Fatty Liver Disease Fibrosis Assessed by FIB-4 and NFS Scores—An 11.6-Year Follow-Up Study

“…Two recent meta-analyses have reported that RYGB had a positive effect on NAFLD after short- to mid-term follow-up time of 1–60 months, with improvement or resolution of histological steatosis and steatohepatitis in the majority of patients, as well as resolution of fibrosis in 28–51% [ 12 , 13 ]. Importantly, studies assessing resolution of liver fibrosis after RYGB with NFS and/or FIB-4 have found improvement in agreement with studies using biopsies [ 26 , 27 , 28 , 29 ]. The proportion of patients with a low postoperative fibrosis score was similar in our population to that in studies with shorter follow-up times [ 11 , 12 , 29 , 30 , 31 , 32 , 33 ].…”

Influence of Hepatocellular Carcinoma Etiology in the Survival After Resection

“…Resection appears today as the main approach for treatment of HCC, especially in patients with good liver function. This mainly occurs because of the restrictive criteria and the inadequate supply of grafts for transplantation in the world 1 , 11 , 13 , 16 , 19 .…”

The Effect of Laparoscopic Sleeve Gastrectomy on the Course of Non-Alcoholic Fatty Liver Disease in Morbidly Obese Patients during One Year of Follow Up

“…Nascimento et al analyzed changes in NAFLD Fibrosis Score before and after bariatric surgery. The NAFLD Fibrosis Score changed from −0.6845 before the surgery to −1.6898 12 months after the procedure (p < 0.0002), indicating an absence of advanced liver fibrosis in any patient 12 months after the surgery [35] In the above-mentioned study, a weak negative correlation between the decrease in NAFLD Fibrosis Score and weight loss parameters (%EWL (r = −0.251, p < 0.0001) and %TWL (r = −0.280, p < 0.0001)) was observed [37]. In our study, a statistically significant decrease in NAFLD Fibrosis Score was also seen.…”