Journal
JOURNAL OF CLINICAL MEDICINE
Volume 9, Issue 11, Pages -Publisher
MDPI
DOI: 10.3390/jcm9113430
Keywords
Roux-en-Y gastric bypass; one anastomosis gastric bypass; mini gastric bypass; NAFLD; NASH; weight loss
Categories
Funding
- Deutsche Forschungsgemeinschaft [SFB TRR57]
- EuropeanUnion's Horizon 2020 Research and Innovation Programme (Galaxy) [668031]
- EuropeanUnion's Horizon 2020 Research and Innovation Programme (MICROB-PREDICT) [825694]
- Societal Challenges-Health, Demographic Change and Wellbeing [731875]
- Cellex Foundation (PREDICT)
- H2020 Societal Challenges Programme [668031] Funding Source: H2020 Societal Challenges Programme
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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(2) vs. 36.8 kg/m(2) and 36.1 kg/m(2), 12 months: 27.0 kg/m(2) vs. 34.4 and 32.8 kg/m(2)) 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.
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