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. 2022 Nov-Dec;140(6):739-746.
doi: 10.1590/1516-3180.2021.0828.07012022.

Trajectory of NAFLD characteristics after Roux-en-Y gastric bypass: a five-year historical cohort study

Fernanda Kreve  1 , Guilherme Hoverter Callejas  2 , Laísa Simakawa Jimenez  3 , Rodolfo Araújo Marques  4 , Felipe David Mendonça Chaim  5 , Murillo Pimentel Utrini  6 , Martinho Antonio Gestic  7 , Almino Cardoso Ramos  8 , Elinton Adami Chaim  9 , Everton Cazzo  10
Affiliations

Trajectory of NAFLD characteristics after Roux-en-Y gastric bypass: a five-year historical cohort study

Fernanda Kreve et al. Sao Paulo Med J. 2022 Nov-Dec.

Abstract

Background: The long-term effects of bariatric surgery on the course of non-alcoholic fatty hepatopathy (NAFLD) are not fully understood.

Objective: To analyze the evolution of NAFLD characteristics through noninvasive markers after Roux-en-Y gastric bypass (RYGB) over a five-year period.

Design and setting: Historical cohort study; tertiary-level university hospital.

Methods: The evolution of NAFLD-related characteristics was evaluated among 49 individuals who underwent RYGB, with a five-year follow-up. Steatosis was evaluated through the hepatic steatosis index (HSI), steatohepatitis through the clinical score for non-alcoholic steatohepatitis (C-NASH) and fibrosis through the NAFLD fibrosis score (NFS).

Results: 91.8% of the individuals were female. The mean age was 38.3 ± 10 years and average body mass index (BMI), 37.4 ± 2.3 kg/m2. HSI significantly decreased from 47.15 ± 4.27 to 36.03 ± 3.72 at 12 months (P < 0.01), without other significant changes up to 60 months. C-NASH significantly decreased from 0.75 ± 1.25 to 0.29 ± 0.7 at 12 months (P < 0.01), without other significant changes up to 60 months. NFS decreased from 1.14 ± 1.23 to 0.27 ± 0.99 at 12 months (P < 0.01), and then followed a slightly ascending course, with a marked increase by 60 months (0.82 ± 0.89), but still lower than at baseline (P < 0.05). HSI variation strongly correlated with the five-year percentage total weight loss (R = 0.8; P < 0.0001).

Conclusion: RYGB led to significant improvement of steatosis, steatohepatitis and fibrosis after five years. Fibrosis was the most refractory abnormality, with a slightly ascending trend after two years. Steatosis improvement directly correlated with weight loss.

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Conflict of interest statement

Conflict of interest: The authors declare that they did not have any conflict of interest

Figures

Figure 1.
Figure 1.. Evolution of percentage total weight loss (%TWL) and body mass index (BMI) over time.
Figure 2.
Figure 2.. Evolution of hepatic steatosis index (HSI), clinical score for non-alcoholic steatohepatitis (C-NASH) and non-alcoholic fatty liver disease fibrosis score (NFS) over time.
See this image and copyright information in PMC

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