Baseline presence of NAFLD predicts weight loss after gastric bypass surgery for morbid obesity

  • 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/m2 vs. 36.8 kg/m2 and 36.1 kg/m2, 12 months: 27.0 kg/m2 vs. 34.4 and 32.8 kg/m2) 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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Author:Karl Peter Rheinwalt, Uta Drebber, Robert SchierwagenORCiDGND, Sabine KleinORCiD, Ulf Peter Neumann, Tom Florian Ulmer, Andreas Plamper, Andreas Kroh, Sandra Schipper, Margarete Odenthal, Frank Erhard UschnerORCiDGND, Philipp LingohrGND, Jonel TrebickaORCiDGND, Maximilian BrolORCiDGND
Parent Title (English):Journal of clinical medicine
Place of publication:Basel
Document Type:Article
Date of Publication (online):2020/10/26
Date of first Publication:2020/10/26
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2020/11/12
Tag:NAFLD; NASH; Roux-en-Y gastric bypass; mini gastric bypass; one anastomosis gastric bypass; weight loss
Page Number:12
Institutes:Medizin / Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung 4.0