Baseline Presence of NAFLD Predicts Weight Loss After Gastric Bypass Surgery for Morbid Obesity

Overview

Journal J Clin Med

Specialty General Medicine

Date 2020 Oct 29

PMID 33114543

Citations 9

Authors

Karl Peter Rheinwalt

Uta Drebber

Robert Schierwagen

Sabine Klein

Ulf Peter Neumann

Tom Florian Ulmer

Andreas Plamper

Andreas Kroh

Sandra Schipper

Margarete Odenthal

Frank Erhard Uschner

Philipp Lingohr

Jonel Trebicka

Maximilian Joseph Brol

Affiliations

Soon will be listed here.

Abstract

Background: Bariatric surgery is a widely used treatment for morbid obesity. Prediction of postoperative weight loss currently relies on prediction models, which mostly overestimate patients' weight loss. Data about the influence of Non-alcoholic fatty liver disease (NAFLD) on early postoperative weight loss are scarce.

Methods: This prospective, single-center cohort study included 143 patients receiving laparoscopic gastric bypass surgery (One Anastomosis-Mini Gastric Bypass (OAGB-MGB) or Roux-en-Y Gastric Bypass (RYGB)). Liver biopsies were acquired at surgery. NAFLD activity score (NAS) assigned patients to "No NAFLD", "NAFL" or "NASH". Follow up data were collected at 3, 6 and 12 months.

Results: In total, 49.7% of patients had NASH, while 41.3% had NAFL. Compared with the No NAFLD group, NAFL and NASH showed higher body-mass-index (BMI) at follow-up (6 months: 31.0 kg/m vs. 36.8 kg/m and 36.1 kg/m, 12 months: 27.0 kg/m vs. 34.4 and 32.8 kg/m) and lower percentage of total body weight loss (%TBWL): (6 months: 27.1% vs. 23.3% and 24.4%; 12 months: 38.5% vs. 30.1 and 32.6%). Linear regression of NAS points significantly predicts percentage of excessive weight loss (%EWL) after 6 months (Cologne-weight-loss-prediction-score).

Conclusions: Histopathological presence of NAFLD might lead to inferior postoperative weight reduction after gastric bypass surgery. The mechanisms underlying this observation should be further studied.

Citing Articles

Weight Loss After Sleeve Gastrectomy According to Metabolic Dysfunction-Associated Steatotic Liver Disease Stage in Patients with Obesity: A Liver Biopsy-Based Prospective Study.

Martinez-Montoro J, Arranz-Salas I, Gutierrez-Repiso C, Sanchez-Garcia A, Ocana-Wilhelmi L, Pinazo-Bandera J Nutrients. 2024; 16(22).

PMID: 39599643 PMC: 11597773. DOI: 10.3390/nu16223857.

Metabolic-Associated Fatty Liver Disease and Weight Loss After Bariatric Surgery: A Systematic Review and Meta-Analysis.

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Effectiveness and predictors of weight loss response to phentermine plus lifestyle modifications among youth in a paediatric weight management clinical setting.

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The Effect of Non-Alcoholic Fatty Liver Disease on Weight Loss and Resolution of Obesity-Related Disorders After Bariatric Surgery.

Abdalla T, Giannou A, Abdalla A, Izbicki J, Dupree A, Mann O World J Surg. 2023; 47(12):3281-3288.

PMID: 37747548 PMC: 10694115. DOI: 10.1007/s00268-023-07153-8.

Microvesicular Steatosis in Individuals with Obesity: a Histological Marker of Non-alcoholic Fatty Liver Disease Severity.

Germano C, Mega P, Mattosinho T, Dias L, Gestic M, Utrini M Obes Surg. 2023; 33(3):813-820.

PMID: 36694089 DOI: 10.1007/s11695-023-06467-9.

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