Weight Loss After Bariatric Surgery Predicts an Improvement in the Non-alcoholic Fatty Liver Disease (NAFLD) Fibrosis Score

Purpose Non-alcoholic fatty liver disease (NAFLD) is present in up to 90% of bariatric surgery patients. Previous literature has demonstrated an improvement in liver steatosis and fibrosis in post-bariatric surgery patients. Our study aims to investigate if bariatric surgery results in an improvement in NAFLD fibrosis scores, and if this correlates with weight loss. Methods A retrospective study was conducted on all patients who underwent bariatric surgery from 2010 to 2016 in our institution. Patients who had a redo bariatric surgery or concomitant gastric pathologies were excluded. Indications for bariatric surgery followed the Asia-Pacific Metabolic and Bariatric Surgery Society guidelines. Results There were 192 patients in this study, with the majority being females (n=120, 63%). Mean age was 42.7 +/- 10.2years old. Pre-operative mean weight and body mass index (BMI) were 113 +/- 27.9kg and 41.6 +/- 7.98kg/m(2) respectively. The mean pre-operative NAFLD fibrosis score was -1.27. Six-month and 1-year follow-up post-surgery demonstrated a decrease in mean weight to 90.6 and 85.9kg and a decrease in mean BMI to 33.8 and 31.6kg/m(2). Mean NAFLD scores improved from -1.27 to -1.56 to -2.00. The correlation between weight loss and NAFLD fibrosis score improvement was statistically significant at the first post-operative year (r-coefficient=0.36, p value <= 0.001). Conclusion Bariatric surgery results in weight reduction as well as an improvement in the NAFLD fibrosis score. The degree of weight loss predicts the extent of improvement in NAFLD fibrosis scores. More long-term studies need to be conducted to assess if this effect is permanent.