NAFLD Has No Current Treatment Options, but Gastric Bypass Surgery May Be The Answer.

As originally reported in News Medical, a new study suggests that gastric bypass bariatric surgery may be the most effective treatment for non-alcoholic fatty liver disease (NAFLD). This disorder currently has no approved medicinal treatment options, but patients are recommended to lose weight to reduce the fatty build-up.

Non-Alcoholic Fatty Liver Disease

Non-alcoholic fatty liver disease (NAFLD) is a disease caused by a buildup of fat in the liver, but is not associated with alcohol consumption. It is heavily associated with diseases related to obesity- with 30-90% of people who are obese victim to the disease, and 40-80% of patients with type 2 diabetes. While the condition has no clear distinct symptoms, it can results in inflammation that damages the liver. This liver inflammation can cause a more serious subset of the disease known as non-alcoholic steatohepatitis (NASH) which can permanently damage the liver and cause another life-threatening disorder, cirrhosis. This inhibits the ability for the liver to function properly and can require a liver transplant.

Current Treatment

There are currently no medicines approved for the disease. Patients are currently recommended to lose weight, since the disease is strongly associated with obesity and type 2 diabetes. Losing weight can reduce the fat in the liver,  which can reduce inflammation, fibrosis, and scarring. Dr. Marta Borges-Canha explained, “NAFLD is strongly associated with obesity, and the prevalence of both diseases is notably increasing. There is a concerning lack of effective treatment options for patients with NAFLD.”

Study Suggests Gastric Bypass Surgery

The new study accepted by the Endocrine Society’s annual meeting, ENDO 2020, compares different weight loss surgeries to address the disease- gastric sleeve, gastric band, or gastric bypass surgery. They concluded that a gastric bypass is the best option of the three.

The researchers studied 1995 patients who were morbidly obese and went through the different bariatric surgeries. The sample was mostly female (85.8%) and middle aged, on average 43 years of age. They found that a year following the surgery, the patients had significant results on the different indicators of the diseases progression. This included a notable reduction in liver enzymes; the Fatty Liver Index (FLI)- an index measuring liver steatosis and fat deposition based on BMI, waist circumference, triglyceride levels, and a liver enzyme; and the BARD score, a measure of liver scarring based on liver enzymes, BMI, and whether a patient has diabetes and how severe it is.

The various surgeries had different effects on the different measures. The gastric sleeve was most effective in reducing the buildup of liver enzymes of the three, and more effective at reducing the other measures than the gastric band. However, gastric bypass surgery was most effective at reducing the FLI and BARD index, leading scientists to deem it the most promising option of the three.

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