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Bariatric Surgery

Hepatic left lobe volume is a sensitive index of metabolic improvement in obese women after gastric banding

International Journal of Obesity volume 36, pages 336–341 (2012)Cite this article

Abstract

BACKGROUND:

Nonalcoholic fatty liver disease is a common finding in obese subjects. Increasing evidence has been provided suggesting that it represents the hepatic component of the metabolic syndrome.

OBJECTIVE:

Aim of this longitudinal study was to evaluate the relationships between several anthropometric measures, including the hepatic left lobe volume (HLLV), and various indicators of the metabolic syndrome in a cohort of severely obese women before and after laparoscopic adjustable gastric banding (LAGB).

STUDY DESIGN AND RESULTS:

Seventy-five obese women (mean age 45±10 years and body mass index (BMI) 42.5±4.8 kg m−2) underwent LAGB and completed an average (±s.d.) post-surgical follow-up of 24±6 months. Determination of HLLV, subcutaneous and intra-abdominal fat (IAF) was based on ultrasound. The principal component statistical analysis applied to pre-operative measurements, highlighted HLLV as a parameter that clustered with serum insulin, IAF, serum glucose and uric acid, along with triglycerides (TGs), alkaline phosphatase and high-density lipoprotein cholesterol. After LAGB, the average reduction of BMI was 23%, 12% for subcutaneous fat (SCF), 42% for HLLV and 40% for visceral fat. Among body weight, BMI, SCF, IAF and HLLV, reduction of the latter was an independent predictor of reduction of serum transaminases and γ-Glutamyltransferase, glucose, insulin and TGs.

CONCLUSIONS:

In severely obese women: (i) HLLV is a sensitive indicator of ectopic fat deposition, clustering with parameters defining the metabolic syndrome; (ii) weight loss achieved by LAGB is associated with a reduction of liver volume as estimated by HLLV; (iii) among various anthropometric parameters measured, reduction of HLLV that follows LAGB represents the best single predictor of improvement of various cardiometabolic risk factors.

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Acknowledgements

This work was supported by: ‘Weight loss, improvement of metabolic profile and reduction of liver volume in obese women after gastric banding’ Johnson and Johnson Ethicon Endo-Surgery 2007, ‘Pathogenetic mechanisms determining the obese phenotype and influencing the response to treatment’ Ministero dell’Università e della Ricerca, Programmi di Ricerca Scientifica 2007, ‘Integrate protocols for the prevention and the treatment of obesity’ Ministero della Salute, Programmi di Ricerca Finalizzata 2006, ‘Obesità: identificazione e sperimentazione di nuove strategie per la prevenzione dell’obesità e delle sue complicanze’ Ministero del Lavoro, della Salute e delle Politiche Sociali, CCM 2008.

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Authors and Affiliations

  1. Department of Endocrinology and Kidney, University Hospital of Pisa, Pisa, Italy

    M Giannetti, G Ceccarini, G Querci, P Fierabracci, G Salvetti, G Galli, I Ricco, S Martinelli, P Vitti, A Pinchera & F Santini

  2. Department of Energy and Systems Engineering, University of Pisa, Pisa, Italy

    P Piaggi & A Landi

  3. Department of Radiology, University Hospital of Pisa, Pisa, Italy

    S Mazzeo

  4. Bariatric Surgery Unit, University Hospital of Pisa, Pisa, Italy

    C Di Salvo & M Anselmino

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  1. M Giannetti
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Correspondence to F Santini.

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Giannetti, M., Piaggi, P., Ceccarini, G. et al. Hepatic left lobe volume is a sensitive index of metabolic improvement in obese women after gastric banding. Int J Obes 36, 336–341 (2012). https://doi.org/10.1038/ijo.2011.243

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