LAS VEGAS — Liver fat volume can be reduced by bariatric surgery regardless of procedure type, although some liver enzymes may be affected differently by sleeve gastrectomy or Roux-en-Y gastric bypass, according to findings presented at ObesityWeek.
“Sleeve gastrectomy and Roux-en-Y gastric bypass are currently the most common bariatric surgery procedures performed,” Kathrine Aglen Seeberg, MD, a PhD fellow at the Morbid Obesity Centre and consultant in the department of gastroenterology at Vestfold Hospital Trust in Tønsberg, Norway, said during a presentation. “Despite good results in terms of weight loss for both procedures, it is still not well documented which is the most effective to achieve the favorable metabolic effects.”
Seeberg and colleagues analyzed secondary outcome data on fatty liver disease from the Oseberg study. At endpoints of 5 weeks and 1 year, the researchers assessed liver fat fraction, fatty liver index and levels of the liver enzymes alanine aminotransferase (ALT), aspartate aminotransferase and gamma-glutamyl transferase in a cohort of 82 adults who had a bariatric surgery procedure. The researchers randomly assigned these participants to Roux-en-Y gastric bypass (mean age, 48.7 years; 67% women) or sleeve gastrectomy (mean age, 47.1 years; 54% women).
Among those who had a Roux-en-Y gastric bypass, 74% had a liver fat fraction of 10.7% or lower — which was used as the threshold for low-grade hepatic steatosis — at 5 weeks. The proportion of participants in this group at 1 year was 100%. Meanwhile, 79% of those who had a sleeve gastrectomy had a liver fat fraction of 10.7% of below at 5 weeks and 93% had achieved that level at 1 year.
Seeberg noted that although both groups experienced reductions in fatty liver index, ALT and gamma-glutamyl transferase during the study period, only 1-year ALT levels differed between the groups, with those who had a Roux-en-Y gastric bypass having higher ALT than those who had a sleeve gastrectomy (P = .04).
“We concluded, based on these data, patients who underwent gastric bypass and sleeve gastrectomy had comparable short- and medium-term decrease in liver fat fraction,” Seeberg said. “The bypass group had a higher serum level of ALT at 1 year. Surrogate markers such as [fatty liver index] or liver enzymes are not sufficient alone to evaluate the alteration in hepatic steatosis.” – by Phil Neuffer
Seeberg KA. A139. Presented at: ObesityWeek 2019; Nov. 3-7, 2019; Las Vegas.
Disclosure: Seeberg reports no relevant financial disclosures.