Hepatic Lipid in Morbid Obesity

Abstract

Twenty-three massively obese patients (mean excess of ideal body weight of 137 per cent) underwent end-to-end jejunoileal bypass because of dietary treatment failure and complications of obesity. Histologic assessment was done on liver biopsies taken at operation and an average of 13 months later. Chemical measurement showed a mean (± S.D.) increase in total lipids from 110.7 ± 62.8 to 221.7 ± 180.2 mg per gram, and in triglycerides from 79.9 ± 63.3 to 177.2 ± 151.2 mg per gram (p<0.05). Phospholipid, free cholesterol and cholesterol esters were not significantly increased. Thus, controlled histologic estimates can provide a rough guide of lipid mass present in a given biopsy specimen within the range of 50 per cent. For purposes of experimental study, this degree of sensitivity and precision may be inadequate. Secondly, hepatic lipid accumulation does not correlate with degree of obesity. Thirdly, jejunoileal bypass for obesity is accompanied during the period of weight loss by a threefold increase (p<0.02) in the excess hepatic lipid, as triglyceride, normally present in the obese. (N Engl J Med 290:296–299, 1974)