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Abbassi Z, Orci L, Meyer J, et al. Impact of Nonalcoholic Steatohepatitis on the Outcome of Patients Undergoing Roux-en-Y Gastric Bypass Surgery: a Propensity Score-Matched Analysis. Obes Surg. 2021;doi: 10.1007/s11695-021-05642-0.
Abbassi, Z., Orci, L., Meyer, J., Sgardello, S. D., Goossens, N., Rubbia-Brandt, L., Spahr, L., Buchs, N. C., Mönig, S. P., Toso, C., Hagen, M. E., & Jung, M. K. (2021). Impact of Nonalcoholic Steatohepatitis on the Outcome of Patients Undergoing Roux-en-Y Gastric Bypass Surgery: a Propensity Score-Matched Analysis. Obesity surgery, . https://doi.org/10.1007/s11695-021-05642-0
Abbassi, Ziad, et al. "Impact of Nonalcoholic Steatohepatitis on the Outcome of Patients Undergoing Roux-en-Y Gastric Bypass Surgery: a Propensity Score-Matched Analysis." Obesity surgery vol. (2021). doi: https://doi.org/10.1007/s11695-021-05642-0
Abbassi Z, Orci L, Meyer J, Sgardello SD, Goossens N, Rubbia-Brandt L, Spahr L, Buchs NC, Mönig SP, Toso C, Hagen ME, Jung MK. Impact of Nonalcoholic Steatohepatitis on the Outcome of Patients Undergoing Roux-en-Y Gastric Bypass Surgery: a Propensity Score-Matched Analysis. Obes Surg. 2021 Sep 21; doi: 10.1007/s11695-021-05642-0. Epub 2021 Sep 21. PMID: 34546514.
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Obes Surg. 2021 Sep 21; doi: 10.1007/s11695-021-05642-0. Epub 2021 Sep 21.

Impact of Nonalcoholic Steatohepatitis on the Outcome of Patients Undergoing Roux-en-Y Gastric Bypass Surgery: a Propensity Score-Matched Analysis.

Obesity surgery

Ziad Abbassi, Lorenzo Orci, Jeremy Meyer, Sebastian Douglas Sgardello, Nicolas Goossens, Laura Rubbia-Brandt, Laurent Spahr, Nicolas Christian Buchs, Stefan Paul Mönig, Christian Toso, Monika Elisabeth Hagen, Minoa Karin Jung

Affiliations

  1. Division of Visceral Surgery, Department of Surgery, Geneva University Hospitals and Faculty of Medicine, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 14, Switzerland.
  2. Division of Gastroenterology and Hepatology, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
  3. Department of Pathology and Immunology, University of Geneva, Geneva, Switzerland.
  4. Division of Clinical Pathology, Geneva University Hospitals, Geneva, Switzerland.
  5. Division of Visceral Surgery, Department of Surgery, Geneva University Hospitals and Faculty of Medicine, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 14, Switzerland. [email protected].

PMID: 34546514 DOI: 10.1007/s11695-021-05642-0

Abstract

PURPOSE: It is currently unknown whether NASH (nonalcoholic steatohepatitis), as compared to simple steatosis, is associated with impaired postoperative weight loss and metabolic outcomes after RYGB surgery. To compare the effectiveness of Roux-en-Y gastric bypass (RYGB) on patients with NASH versus those with simple nonalcoholic fatty liver (NAFL).

MATERIALS AND METHODS: We retrospectively retrieved data from 515 patients undergoing RYGB surgery with concomitant liver biopsy. Clinical follow-up and metabolic assessment were performed prior to surgery and 12 months after surgery. We used multivariate analysis of variance (MANOVA) and propensity score matching and we assessed for changes in markers of hepatocellular injury and metabolic outcomes.

RESULTS: There were 421 patients with simple NAFL, and 94 with NASH. Baseline alanine and aspartate aminotransferases were significantly higher in patients with NASH (p < 0.01). Twelve months after the RYGB surgery, as determined by both MANOVA and propensity score matching, patients with NASH exhibited a significantly greater reduction in alanine aminotransferase (ß-coefficient - 12 iU/l [- 22 to - 1.83], 95% CI, adjusted p = 0.021) compared to their NAFL counterparts (31 matched patients in each group with no loss to follow-up at 12 months). Excess weight loss was similar in both groups (ß-coefficient 4.54% [- 3.12 to 12.21], 95% CI, adjusted p = 0.244). Change in BMI was comparable in both groups (- 14 (- 16.6 to - 12.5) versus - 14.3 (- 17.3 to - 11.9), p = 0.784).

CONCLUSION: After RYGB surgery, patients with NASH experience a greater reduction in markers for hepatocellular injury and similar weight loss compared to patients with simple steatosis.

© 2021. The Author(s).

Keywords: Bariatric surgery; Non-alcoholic fatty liver disease; Non-alcoholic steatohepatitis; Outcome; Propensity score matching; Roux-en-Y gastric bypass

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