HEPATIC LEFT LOBE VOLUME IS A SENSITIVE INDEX OF METABOLIC IMPROVEMENT IN OBESE WOMEN AFTER GASTRIC BANDING

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 liver 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/m2) underwent LAGB and completed an average (± SD) post-surgical follow-up of 24 ± 6 months. Determination of HLLV, subcutaneous and intra-abdominal fat was based on ultrasound. Principal Component statistical Analysis (PCA) applied to pre-operative measurements, highlighted HLLV as a parameter that clustered with serum insulin, intra-abdominal fat, serum glucose and uric acid, along with triglycerides, alkaline phosphatase and HDL cholesterol. After LAGB, the average reduction of BMI was 23%, 12% for subcutaneous fat, 42% for HLLV and 40% for visceral fat. Among body weight, BMI, subcutaneous fat, intra-abdominal fat and HLLV, reduction of the latter was an independent predictor of reduction of serum transaminases and γ-glutamyltransferase, glucose, insulin, and triglycerides. 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.