Laura Konings1, Willy Theel2, Carmen Dietvorst3, Jan Apers4, Susan Ter Borg5, Tessa Noordermeer6, Manuel Castro Cabezas7
(1) 1. Department of Internal medicine, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands 2. Department of Internal medicine, division of endocrinology, Erasmus Medical Center, Rotterdam, the Netherlands.
(2) Department of Internal medicine, division of gastroenterology and hepatology, Erasmus Medical Center, Rotterdam, the Netherlands.
(3) 1. Department of Internal medicine, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands 2. Department of Internal medicine, division of dietetics, Erasmus Medical Center, Rotterdam, the Netherlands.
(4) Department of Bariatric surgery, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands
(5) Department of Pathology, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands.
(6) Department of Clinical chemistry, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands.
(7) 1. Department of Internal medicine, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands 2. Department of Internal medicine, division of endocrinology, Erasmus Medical Center, Rotterdam, the Netherlands 3. Julius Clinical, Zeist, The Netherlands.
Introduction
Metabolic dysfunction-associated steatotic liver disease (MASLD) affects many patients with severe obesity. Weight reduction following bariatric surgery has been associated with improvement of MASLD. Vibration-controlled transient elastography (VCTE) is a non-invasive method to estimate liver steatosis (by controlled attenuation parameter, CAP) and fibrosis (by liver stiffness measurement, LSM). The aim of this study was to evaluate changes in liver steatosis and fibrosis after gastric sleeve resection (GS) and gastric bypass (GB).
Methods
The Franciscus Obesity NASH Study is a single center cohort study including patients undergoing bariatric surgery. VCTE was done at baseline and at least one year after surgery. Anthropometric characteristics and laboratory data were also collected.
Results
182 Subjects underwent bariatric surgery. Overall, there was a significant decrease in weight, BMI, CAP and LSM. CAP improvement was associated with BMI decrease, LSM improvement was not associated with BMI reduction or CAP improvement. There were no baseline differences between GB and GS. In the GB group (n=96) CAP decreased from 298 to 201 dB/m, LSM from 8.1 to 5.1 kPa. In the GS group (n=86) CAP decreased from 289 to 221 dB/m, LSM from 7.8 to 5.2 kPa. In both the GB and GS group CAP values normalized, yet the GB group had a greater decrease in CAP of -95+-50 versus -70+-58 dB/m, p=0.001. The improvement in BMI, weight or LSM did not differ between the groups.
Conclusion
Bariatric surgery improves liver steatosis and liver fibrosis. Liver fibrosis improvement was not associated with steatosis improvement or weight reduction.