Liver disease significantly higher in white females who undergo Bariatric surgery, new study reports
SAN FRANCISCO, June 30, 2006 – A new study shows that white females are 17 times more likely to have non-alcoholic fatty liver disease than African-American females who undergo bariatric surgery. The study was presented at the 23rd Annual Meeting of the American Society for Bariatric Surgery (ASBS). 31-12-2006
 Obesity increases the risk of developing non-alcoholic fatty liver disease, an accumulation of fat in the liver and the most common liver disease in the U.S. According to the Centers for Disease Control and Prevention (CDC), about 29 million Americans have the disease.
Researchers analyzed 552 patients who had bariatric surgery during a two-year period, of which nearly three-quarters had liver disease and several other obesity-related conditions. Of those with liver disease, 70 percent were white women compared to only 4 percent who were African-American women. The remaining patients were male.
The study showed that while Type 2 diabetes, hypertension, body weight, body mass index (BMI), sleep apnea and dyslipidemia correlated with the presence of liver disease, it did not predict its severity.
“Gender and ethnicity appear to be a better predictor of the severity of liver disease in patients with morbid obesity than anything else and the reasons for this are unclear and merit further study,” said Neil Hutcher, MD, lead researcher and ASBS president at Commonwealth Surgeons of Richmond, Virginia. “Liver disease is a big problem in people with morbid obesity and soon obesity could overtake alcohol as a leading cause of liver transplants.”
The liver disease ranged in severity from steatosis (simple fatty tissue in the liver), to fibrosis (formation of scar-like tissue on the liver), to the most serious condition of cirrhosis (a lethal collection of fat and scar tissue within the liver that impairs the organ’s ability to function). The researchers recommended that an intraoperative liver biopsy be done to adequately stage non-alcoholic fatty liver disease.
Additional data showed that 16.5% (67 out of 406 patients) had fibrosis, and 5.9% (24) had bridging fibrosis and some degree of cirrhosis. None of the patients in the study had a history of excess alcohol consumption or viral hepatitis.
As with any surgery, the risks and benefits should be carefully considered by the surgeon, the patient and the patient’s family. According to the ASBS, the average mortality rate in an ASBS Center of Excellence is 0.3 percent after 90 days based on an analysis of 33,000 patients. A 2004 study published in the Journal of the American Medical Association (JAMA)* showed 0.1% mortality for laparoscopic adjustable gastric band (LAGB) patients, 0.5% mortality for gastric bypass patients and 1% mortality for biliopancreatic diversion (BPD) and duodenal switch (DS) patients.
In 2005, the ASBS reported that an estimated 170,000 people in the U.S. had bariatric surgery. About 15 million or 1 in 50, adults in the U.S. have morbid obesity, which is associated with numerous other diseases and conditions including Type 2 diabetes, heart disease, sleep apnea, hypertension, asthma, cancer joint problems and infertility. The direct and indirect costs to the healthcare system associated with obesity are about $117 billion annually.
The ASBS is the largest organization for bariatric surgeons in the world. It is a non-profit organization that works to advance the art and science of bariatric surgery and is committed to educating medical professionals and the lay public about bariatric surgery as an option for the treatment of morbid obesity, as well as the associated risks and benefits. It encourages its members to investigate and discover new advances in bariatric surgery, while maintaining a steady exchange of experiences and ideas that may lead to improved surgical outcomes for morbidly obese patients. For more information about the ASBS visit www.asbs.org.
*Buchwald H, Avidor Y, Braunwald E, Jensen M, Pories W, Fahrbach K, Schoelles, Bariatric surgery: A systematic review and meta-analysis. JAMA, 2004,292:1724-57.
Source: www.asbs.org.
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