Clinical

Insulin resistance tied to post-bariatric surgery steatosis

Last Updated: 2006-06-26 10:28:28 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Insulin resistance is independently associated with severe steatosis both before and after bariatric surgery in very obese patients, according to French researchers.

In the May issue of Gastroenterology, Dr. Philippe Mathurin of Hopital Huriez, Lille and colleagues prospectively investigated factors involved in the development of severe steatosis in 185 severely obese patients who were referred for bariatric surgery.

At preoperative biopsy, 27% of the patients showed steatosis of at least 60%. Alanine aminotransferase and insulin resistance indices were independent predictors of such steatosis.

One year after surgery, there was a significant 9.5 drop in BMI. There also were significant reductions in steatosis score and insulin resistance index. However, preoperative insulin resistance index and preoperative steatosis were independent predictors of the persistence of severe steatosis.

Weight loss was also significantly less in patients with a refractory insulin resistance profile.

Altogether 10 patients continued to have severe steatosis. Moderate or severe steatosis was seen more often in patients who continued to have a high insulin resistance index after surgery than in those who showed a reduction (44% versus 20.2%).

Given these findings, the researchers conclude that a refractory insulin resistance profile "may help to identify patients who are poor responders to the beneficial effects of bariatric surgery for obesity-induced liver injury."

Gastroenterology 2006;130:1617-1624.