Percentage of patients with no or low-grade steatosis at 1-year follow-up 94 percent Sleeve gastrectomy 100 percent Roux-en-Y gastric bypass

December 1, 2021

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Source / Disclosures:

Source:

Seeberg KA, et al. Ann Intern Med. 2021; doi: 10.7326 / M21-1962:

Discoveries: The authors do not disclose the relevant financial disclosures.


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Roux-en-Y gastric bypass gastric gastrectomy is equally effective in reducing liver steatosis by almost complete removal of liver fat 1 year after surgery, according to one central study.

“With almost complete liver fat clearance a year after surgery, our study provides new high-quality evidence that the two most common weight loss surgeries, Roux-en-Y gastric bypass and sleeve gastectomy, appear to be very effective in reducing the liver. “Fat content in patients with type 2 diabetes and obesity.” Jens Christopher Hertel, Ph.D. The head of research at the Morbid Obesity Center at the Vestfold Hospital Trust in Tonsberg, Norway, told Healio. “But the effect of these weight loss surgeries on liver scars is more incomprehensible.”

Percentage of patients with or without steatosis at 1 year follow-up 94% TC gastrectomy 100% Roux-en-Y gastric bypass

In a randomized controlled trial, Hertel և colleagues analyzed data from 100 patients with type 2 diabetes from the Norwegian Tertiary Obesity Center (65% women, mean age 48 years, mean BMI 42 kg / m).2:): From January 2013 to February 2018, researchers randomly assigned patients a sleeve gastectomy or Roux-en-Y gastric bypass. The primary results of the type 2 diabetes remission study were previously published. Pre-defined secondary outcomes for the new assay were hepatic steatosis և fibrosis, which were assessed by MRI (liver fatty fraction), elevated liver fibrosis (ELF) test, non-invasive indices, and liver enzymes.

Jens Christopher Hertel

The findings have been published Chronicle of internal medicine.

For up to 1 year after surgery, the researchers found that the fat content of the liver was similarly reduced by salivary gastrectomy (mean -19.7%, 95% CI, -22.5 to -16.9) և Roux-en- After bypassing the stomach Y (average -21.5). %; 95% CI, –24.3 to –18.6). Nearly all of the 94% of patients who underwent sleeve gastectomy և 100% who underwent gastric bypass did not have or had low-grade steatosis within 1 year.

The ELF assessment category remained stable for 77% of patients; however, about 18% experienced a worsening of fibrosis within 1 year, with no difference between groups.

“Both Roux-en-Y gastric bypass and sleeve gastectomy appear to be effective in reducing liver fat,” Hertel told Healio. “Our study also shows that the fat content of the liver decreased dramatically in the first 5 weeks after surgery, which shows that the first 10% of the weight loss gained is most important in fatty liver disease.” “Together, this could have clinical implications for the treatment of fatty liver disease.”

The researchers noted that the study mainly involved white patients with “short-term” control. However, the study is ongoing, with a follow-up of up to 5 years.

“Both procedures stand out as appropriate treatments to reduce the burden of non-alcoholic fatty liver disease,” the researchers wrote. “ELF test results may indicate a slight worsening of liver fibrosis after bariatric surgery, but further studies are warranted for long-term progression or regression of fibrosis.”

For more information:

Jens Christopher Hertel, Ph.D. can be reached at jehert@siv.no.