Volume 149, Issue 2, Pages 379-388 (August 2015) Bariatric Surgery Reduces Features of Nonalcoholic Steatohepatitis in Morbidly Obese Patients  Guillaume Lassailly, Robert Caiazzo, David Buob, Marie Pigeyre, Hélène Verkindt, Julien Labreuche, Violeta Raverdy, Emmanuelle Leteurtre, Sébastien Dharancy, Alexandre Louvet, Monique Romon, Alain Duhamel, François Pattou, Philippe Mathurin  Gastroenterology  Volume 149, Issue 2, Pages 379-388 (August 2015) DOI: 10.1053/j.gastro.2015.04.014 Copyright © 2015 AGA Institute Terms and Conditions

Figure 1 Flow chart. Gastroenterology 2015 149, 379-388DOI: (10.1053/j.gastro.2015.04.014) Copyright © 2015 AGA Institute Terms and Conditions

Figure 2 (A) Distribution of NASH inflammatory activity grade (severity) before and 1 year after surgery, according to the Brunt score. Data are reported for 82 patients with paired liver biopsies before and 1 year after surgery. (Before surgery: Brunt 1: n = 52; Brunt 2: n = 21; Brunt 3: n = 9. After surgery: Brunt 0: n = 70; Brunt 1: n = 8; Brunt 2: n = 3; Brunt 3: n = 1). P value for comparison of Brunt score before and after surgery <.0001 (Wilcoxon signed rank test). (B) Distribution of NAS before and 1 year after surgery. Data are reported for 82 patients with paired liver biopsies before and 1 year after surgery. (Before surgery, NAS 3: n = 6; NAS 4: n = 25; NAS 5: n = 32; NAS 6: n = 12; NAS 7: n = 7. After surgery, NAS 0: n = 15; NAS 1: n = 37; NAS 2: n = 12; NAS 3: n = 6; NAS 4: n = 6; NAS 5: n = 5; NAS 6: n = 1; NAS 7: n = 0). P value for comparison of NAS score before and after surgery <.0001 (Wilcoxon signed rank test). Gastroenterology 2015 149, 379-388DOI: (10.1053/j.gastro.2015.04.014) Copyright © 2015 AGA Institute Terms and Conditions

Figure 3 Change of histologic features 1 year after bariatric surgery. (A) Percentage of improvement in hepatocellular ballooning and in lobular inflammation 1 year after bariatric surgery. (B) Median of NAS and steatosis at baseline and at 1 year after surgery. ∗Wilcoxon signed rank test. Gastroenterology 2015 149, 379-388DOI: (10.1053/j.gastro.2015.04.014) Copyright © 2015 AGA Institute Terms and Conditions

Figure 4 Distribution of fibrosis stage before and 1 year after surgery: Metavir score. Wilcoxon signed rank paired t test: P < .003. Fibrosis evolution (fibrosis staged with Metavir score) (n = 80∗/82) with paired liver biopsies before and 1 year after surgery. Before surgery F0: n = 22; F1: n = 32; F2: n = 17; F3: n = 6; F4: n = 3. After surgery F0: n = 35; F1: n = 26; F2: n = 11; F3: n = 6; F4: n = 2). ∗For 1 patient, Kleiner score was staged, but Metavir scale staging was missing and another patient could not have fibrosis evaluation due to sample size. Gastroenterology 2015 149, 379-388DOI: (10.1053/j.gastro.2015.04.014) Copyright © 2015 AGA Institute Terms and Conditions

Supplementary Figure Gastroenterology 2015 149, 379-388DOI: (10.1053/j.gastro.2015.04.014) Copyright © 2015 AGA Institute Terms and Conditions

Supplementary Table Gastroenterology 2015 149, 379-388DOI: (10.1053/j.gastro.2015.04.014) Copyright © 2015 AGA Institute Terms and Conditions