ABSTRACTBACKGROUND:The effect of weight loss (WL) on histopathological aspects of non-alcoholic
fatty liver disease (NAFLD) may provide further insights into the dynamics
of hepatic recovery after WL.OBJECTIVE:To analyze the effects of pre-operative WL on insulin resistance- and
NAFLD-related histology in individuals undergoing bariatric surgery (BS)
with or without pre-operative WL.DESIGN AND SETTING:A matched cross-sectional study was conducted at a public university hospital
and a private clinic in Campinas, Brazil.METHODS:An analytical, observational, cross-sectional study was conducted using
prospectively collected databases of individuals who underwent BS and liver
biopsy at either a public tertiary university hospital (with pre-operative
WL) or a private clinic (without pre-operative WL). Random electronic
matching by gender, age, and body mass index (BMI) was performed and two
paired groups of 24 individuals each were selected.RESULTS:Of the 48 participants, 75% were female. The mean age was 37.4 ± 9.6. The
mean BMI was 38.9 ± 2.6 kg/m2. Fibrosis was the most common
histopathological abnormality (91.7%). Glucose was significantly lower in
the WL group (92 ± 19.1 versus 111.8 ± 35.4 mg/dL; P = 0.02). Significantly
lower frequencies of macrovesicular steatosis (58.3% versus 95.8%; P =
0.004), microvesicular steatosis (12.5% versus 87.5%; P < 0.001), and
portal inflammation (50% versus 87.5%; P = 0.011) were observed in the WL
group.CONCLUSION:Pre-operative WL was significantly associated with lower frequencies of
macro- and mi- crovesicular steatosis, portal inflammation, and lower
glycemia, indicating an association between the recent trajectory of body
weight and histological aspects of NAFLD.