Riassunto analitico
BACKGROUND Obesity prevalence is getting higher every year, and this condition is associated with several co-morbidities, such as metabolic syndrome, cardiovascular and liver disease, sleep disorders, and certain types of cancer. The obesity treatment plan includes different procedures, among them bariatric surgery (BS) is present too. This technique leads to weight loss, reduction of BMI, and an improvement in obesity co-morbidities. Hepatic steatosis is the most common chronic liver disease worldwide, commonly associated with obesity and high risk for cardiometabolic and malignant complications. Therefore, metabolic liver disease could represent a target for BS. AIM OF THE STUDY The aim of this study was to evaluate the hepatic steatosis risk profile changes in subjects with severe obesity undergoing different procedures of BS in a real-world, clinical setting. MATERIALS AND METHODS A single-center, retrospective, observational clinical study was performed enrolling patients undergoing BS and were under follow-up from 2010 to July 2023 at the Unit of Endocrinology of the University Hospital of Modena. The data were collected in months considering two visits: the baseline visit, and the follow-up visit. The Hepatic Steatosis Index (HSI) was used to evaluate the risk of liver steatosis. RESULTS 82 subjects were enrolled (males 18: females 64; ages 47.5 ± 8.3 years). Considering the surgical procedure, 59 patients underwent RYGB (71.9%) and 23 SG (28.1%). In the overall group, we observed weight loss (from 129.3 ± 26.6 to 91,7 ± 19,7), and a reduction in body mass index (BMI) (from 47 ± 7,9 to 33,5 ± 6,1), cholesterol value, LDL, TGG, glycemia, uric acid, GGT, ALT. There is also an improvement in HSI values, which is associated with the improvement in hepatic steatosis; this change is present in mild liver steatosis, but this doesn’t happen in moderate and severe grades. HSI values relate to BMI at the baseline and to the ALT concentration at the follow-up. Considering the two cohorts, results demonstrated an improvement in ALT value which is present only in SG patients, but not in RYGB patients. This result is predictably associated with a direct effect of SG on liver enzymes. CONCLUSION The findings of this study highlight the effects of BS on liver function have been highlighted. This result was supported by the improvement in HSI value, related mostly to the post-surgery period at ALT value.
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Abstract
BACKGROUND Obesity prevalence is getting higher every year, and this condition is associated with several co-morbidities, such as metabolic syndrome, cardiovascular and liver disease, sleep disorders, and certain types of cancer. The obesity treatment plan includes different procedures, among them bariatric surgery (BS) is present too. This technique leads to weight loss, reduction of BMI, and an improvement in obesity co-morbidities. Hepatic steatosis is the most common chronic liver disease worldwide, commonly associated with obesity and high risk for cardiometabolic and malignant complications. Therefore, metabolic liver disease could represent a target for BS.
AIM OF THE STUDY The aim of this study was to evaluate the hepatic steatosis risk profile changes in subjects with severe obesity undergoing different procedures of BS in a real-world, clinical setting.
MATERIALS AND METHODS A single-center, retrospective, observational clinical study was performed enrolling patients undergoing BS and were under follow-up from 2010 to July 2023 at the Unit of Endocrinology of the University Hospital of Modena. The data were collected in months considering two visits: the baseline visit, and the follow-up visit. The Hepatic Steatosis Index (HSI) was used to evaluate the risk of liver steatosis.
RESULTS 82 subjects were enrolled (males 18: females 64; ages 47.5 ± 8.3 years). Considering the surgical procedure, 59 patients underwent RYGB (71.9%) and 23 SG (28.1%). In the overall group, we observed weight loss (from 129.3 ± 26.6 to 91,7 ± 19,7), and a reduction in body mass index (BMI) (from 47 ± 7,9 to 33,5 ± 6,1), cholesterol value, LDL, TGG, glycemia, uric acid, GGT, ALT. There is also an improvement in HSI values, which is associated with the improvement in hepatic steatosis; this change is present in mild liver steatosis, but this doesn’t happen in moderate and severe grades. HSI values relate to BMI at the baseline and to the ALT concentration at the follow-up. Considering the two cohorts, results demonstrated an improvement in ALT value which is present only in SG patients, but not in RYGB patients. This result is predictably associated with a direct effect of SG on liver enzymes.
CONCLUSION The findings of this study highlight the effects of BS on liver function have been highlighted. This result was supported by the improvement in HSI value, related mostly to the post-surgery period at ALT value.
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