Bariatric surgery effect on patients with nonalcoholic fatty liver disease and type II diabetes mellitus

Abstract

Aims: To study the effect of sleeve gastrectomy in patients with type II diabetes mellitus and fatty liver disease. Settings and Design: This is a prospective study that was conducted from September 2016 to 2017 in KSUMC Riyadh, Saudi Arabia. Subjects and Methods: We obtained prospectively collected data from two longitudinal cohort studies at our institution. We included adults who were diagnosed with nonalcoholic fatty liver disease (NAFLD) and diabetes, with a body mass index (BMI) of >30 kg/m2, and who underwent sleeve gastrectomy. Statistical Analysis Used: Data were analyzed using JMP® 13.0.0 for data management and reporting. Continuous data were reported as means and standard deviations if normally distributed or as medians and interquartile ranges otherwise. We also used the paired t-test and Chi-square test. Results: Our population included 32 patients (mean age, 39.5 years). The preoperative and postoperative median BMIs were 42.1 and 34.2 kg/m2, respectively (P = 0.0003). The percentages of macrovascular steatosis pre- and postoperatively were 37.5 and 10, respectively (P = 0.0328). The patients who had complete diabetes mellitus (DM) remission postoperatively had a higher median BMI of 42.05 kg/m2 preoperatively and 35.7 kg/m2 postoperatively than that the patients who did not have remission (P = 0.0003). Regarding the age groups, 46.1% of patients aged <40 years at DM onset, and 34.6% of patients aged >40 years who had complete diabetes remission postoperatively, which was not statistically significant. Conclusions: DM remission was statistically significant postoperatively. Remission occurred more in the higher BMI groups. There was no clear relationship between NAFLD and diabetes remission.