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NASH Presence is Associated with a Lower Weight Loss One and 2 Years After Bariatric Surgery in Women with Severe Obesity

Abstract

Purpose

Given that obesity is a major medical problem associated with non-alcoholic fatty liver disease and the lack of studies on postsurgery weight loss according to hepatic histology, we aimed to analyse weight loss indicators according to non-alcoholic steatohepatitis (NASH) presence one and 2 years postsurgery.

Materials and Methods

The weight loss pattern of 410 women with severe obesity (SO) was analysed after sleeve gastrectomy (SG, n = 191) and Roux-en-Y gastric bypass (RYGB, n = 219) according to NASH presence at baseline and at 12 and 24 months postsurgery. Weight loss indicators: expected BMI (eBMI), excess BMI loss percentage (%EBMIL), total weight loss percentage (%TWL) and alterable weight loss percentage (%AWL).

Results

Unlike RYGB, after SG, a higher percentage of NASH patients do not reach the eBMI 2 years postsurgery. %TWL and %AWL presented no differences after RYGB despite the presence of NASH. After SG, there is a worse ponderal evolution of all indicators analysed in the presence of NASH. Unlike SG, diabetic patients lose less weight than non-diabetic patients after RYGB. The presence of NASH in diabetics had no impact on weight loss indicators, but in non-diabetics, it had an impact, particularly in the SG group.

Conclusion

The presence of NASH suggests a worse weight loss pattern through all the analysed indicators one and 2 years after SG in women. The presence of T2DM appears to result in less weight loss after RYGB, but only non-diabetic women presenting NASH lose less weight that non-diabetic women in the absence of NASH after SG.

Graphical abstract

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Funding

This research was funded by Instituto de Salud Carlos III, Spain, grant number PI18/00081 (to Fàtima Sabench and Daniel del Castillo).

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Correspondence to Teresa Auguet.

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Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Moreover, the study was approved by the Institutional Review Board (or Ethics Committee) CEIm (protocol code 23c/2015).

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Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Key Points

- Lower percentage of patients achieved the eBMI 2 years after SG in NASH presence.

- %EBMIL at 12 and 24 months were lower in presence of NASH after RYGB and after SG.

- %TWL and %AWL were not affected by NASH presence after RYGB, but did it after SG.

- After SG, non-T2DM patients presented worse weight loss results in NASH presence.

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Sabench, F., Bertran, L., Vives, M. et al. NASH Presence is Associated with a Lower Weight Loss One and 2 Years After Bariatric Surgery in Women with Severe Obesity. OBES SURG (2022). https://doi.org/10.1007/s11695-022-06175-w

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  • DOI: https://doi.org/10.1007/s11695-022-06175-w

Keywords

  • Obesity
  • Bariatric surgery
  • NAFLD
  • NASH
  • T2DM
  • Weight loss