Background and Objective: Morbid obesity is a growing global health concern, affecting more than 400 million individuals worldwide. In cases where dietary interventions, lifestyle modifications, and pharmacotherapy fail, bariatric surgery (such as sleeve gastrectomy [SG] and gastric bypass [GB] surgeries) remains the most effective therapeutic option. In addition to inducing weight loss, these surgical procedures ameliorate comorbidities such as diabetes, hypertension, and fatty liver disease (FLD). The present study aimed to evaluate liver enzyme alterations and non-alcoholic FLD (NAFLD) improvement rates six months following SG and GB surgeries.
Methods: This retrospective cohort study was conducted on 120 patients (62.2% female) with morbid obesity (mean age = 35.2±11.13 years) who underwent bariatric surgeries at Falsafi Hospital in Gorgan, Golestan Province, Iran during 2021-23. Patients with a body mass index (BMI) greater than 40 kg/m², or greater than 35 kg/m² with underlying comorbidities, were included. Exclusion criteria consisted of excessive alcohol use, a history of hepatic surgery, and early pregnancy post-surgery. Liver enzyme levels (alanine aminotransferase [ALT], aspartate aminotransferase [AST], and alkaline phosphatase [ALP]), as well as serum albumin (ALB) levels, were measured at baseline and 6 months post-surgery.
Results: A total of 95 patients presented with FLD. After 6 months, the fatty liver grade decreased in 57 patients, increased in 4, and remained unchanged in 34 (P<0.05). Specifically, reductions of 35%, 45%, and 82% were observed in grades I, II, and III, respectively. ALT, AST, and ALP decreased by 6.1 U/L, 12.8 U/L, and 9.58 U/L, respectively (P<0.05). ALB levels showed no statistically significant change. Type 2 diabetes, hypertension, advanced age, or a higher BMI had no significant effect on the reduction of liver enzymes.
Conclusion: Bariatric surgery improved FLD and significantly reduced liver enzymes (ALT, AST, and ALP).