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. 2024 Mar;34(3):841-849.
doi: 10.1007/s11695-024-07071-1. Epub 2024 Jan 29.

Mid-term Effects of Bariatric Surgery on Metabolic Dysfunction-Associated Fatty Liver Disease Remission and Predictive Factors: A Prospective Study with a Focus on Non-invasive Diagnosis

Èlia Navarro-Masip  1 , Núria Mestres  2 , Marta Zorzano-Martínez  1   3 , Blanca Salinas-Roca  1   4 , Enric Sánchez  1   5 , Carolina López-Cano  1   3   5 , Fernando Herrerías  2   5 , Mari Cruz de la Fuente  2   5 , Maite Santamaría  2   5 , Josep León-Mengíbar  1   3 , Ana-Gloria Soler  1   3 , Marta Bueno  1   3 , Albert Lecube  6   7   8
Affiliations

Mid-term Effects of Bariatric Surgery on Metabolic Dysfunction-Associated Fatty Liver Disease Remission and Predictive Factors: A Prospective Study with a Focus on Non-invasive Diagnosis

Èlia Navarro-Masip et al. Obes Surg. 2024 Mar.

Abstract

Purpose: Non-alcoholic fatty liver disease (NAFLD), now termed metabolic dysfunction-associated fatty liver disease (MAFLD), is a growing health concern associated with obesity and type 2 diabetes. Bariatric surgery offers potential benefits, but its impact on MAFLD remains incompletely understood, with scarce long-term follow-up prospective studies. Moreover, being liver biopsy the gold standard for liver condition measurement, the need for non-invasive techniques that allow the assessment of MAFLD development after bariatric surgery is imperative. OWLiver® Care and OWLiver® represent two serum lipidomic tests, featuring panels comprising 11 and 20 triglycerides, respectively.

Materials and methods: We conducted a prospective study involving 80 Caucasians to assess the effects of bariatric surgery on MAFLD using non-invasive diagnostics and to identify baseline predictors of MAFLD remission. Serum samples were collected before surgery and at a 3-year follow-up.

Results: After 3 years, the proportion of patients exhibiting a healthy liver escalated from 5.0% at baseline to 26.3%. Conversely, the percentage of steatohepatitis declined from 35.1% to a mere 7.6%. Younger age, female gender, and the absence of type 2 diabetes were associated with MAFLD remission. However, age stood as the only independent variable associated with this favorable liver evolution (R2 = 0.112).

Conclusion: Bariatric surgery demonstrates mid-term benefits in improving MAFLD, with younger age as a baseline predictor of remission. Non-invasive diagnostic methods, like OWLiver®, are valuable tools for monitoring MAFLD evolution. Further research with larger populations and longer follow-up periods is warranted to refine personalized treatment approaches.

Keywords: Bariatric surgery; Liver; MAFLD; NASH; OWLiver; Obesity; Steatohepatitis; Type 2 diabetes.

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