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Front Physiol. 2016 Aug 19;7:344. doi: 10.3389/fphys.2016.00344. eCollection 2016.

Roux-En Y Gastric Bypass Results in Long-Term Remission of Hepatocyte Apoptosis and Hepatic Histological Features of Non-alcoholic Steatohepatitis.

Author information

1
Institut Nationale de la Santé et de Recherche Médicale, U1065, C3M, Team 8 "Hepatic Complications in obesity"Nice, France; Institut Nationale de la Santé et de Recherche Médicale, C3M, Université Côte d'AzurNice, France; Digestive Centre, Archet Hospital Nice, Centre Hospitalier Universitaire de NiceNice, France.
2
Institut Nationale de la Santé et de Recherche Médicale, U1065, C3M, Team 8 "Hepatic Complications in obesity"Nice, France; Institut Nationale de la Santé et de Recherche Médicale, C3M, Université Côte d'AzurNice, France; Biological Centre, Pasteur Hospital, Centre Hospitalier Universitaire de NiceNice, France.
3
Institut Nationale de la Santé et de Recherche Médicale, U1065, C3M, Team 8 "Hepatic Complications in obesity"Nice, France; Institut Nationale de la Santé et de Recherche Médicale, C3M, Université Côte d'AzurNice, France.
4
Institut Nationale de la Santé et de Recherche Médicale, U1065, C3M, Team 8 "Hepatic Complications in obesity" Nice, France.

Abstract

The long-term effects of bariatric surgery on non-alcoholic steatohepatitis (NASH), focusing on liver injury and hepatocyte apoptosis, are not well-established. We here performed a longitudinal study with paired liver biopsies of nine morbidly obese women (median BMI: 42 [38.7; 45.1] kg/m(2)) with NASH with a median follow-up of 55 [44; 75] months after laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery. LRYGB surgery was associated with significant weight loss (median BMI loss -13.7 [-16.4; -9.5] kg/m(2)), improved hepatic steatosis in all patients (55.5% with total resolution), and resolution of hepatic inflammation and hepatocyte ballooning in 100 and 88.8% of cases, respectively. Alanine aminotransferase levels dropped to normal values while hepatic activated cleaved caspase-3 levels strongly decreased after a median follow-up of 55 months. Hepatocyte apoptosis, as evaluated by serum caspase-generated keratin-18 fragment, improved within the first year following LRYGB and these improvements persisted for at least 55 months. LRYGB in morbidly obese patients with NASH is thus associated with a long-lasting beneficial impact on hepatic steatohepatitis and hepatocyte death.

KEYWORDS:

NAFLD; NASH; bariatric surgery; liver; obesity; steatosis

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