Bariatric surgery improves metabolic and nonalcoholic fatty liver disease markers in metabolically healthy patients with morbid obesity at 5 years |
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| Institution: | 1. Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain;2. Cardiovascular Risk and Nutrition Research Group (CARIN-ULEC), Institut Hospital del Mar d''Investigacions Mèdiques, Barcelona Biomedical Research Park, Barcelona, Spain;3. Department of Endocrinology and Nutrition, Hospital del Mar, Barcelona, Spain;4. Centro de Investigaciones Biomédicas en Red de Obesidad y Nutrición, Madrid, Spain;5. Unit of Gastrointestinal Surgery, Hospital del Mar, Institut de Recerca Institut Hospital del Mar d''Investigacions Mèdiques, Barcelona, Spain;6. Consorci Sanitari de l’Alt Penedès i Garraf, Vilafranca del Penedès, Spain;1. Department of General Surgery, The Affiliated Hospital of Xuzhou Medical University, Xuzhou Jiangsu, P. R. China;2. Institute of Digestive Diseases, Xuzhou Medical University, Xuzhou Jiangsu, P. R. China;1. Department of General Surgery, Temple University Hospital, Philadelphia, Pennsylvania;2. Department of Minimally Invasive and Bariatric Surgery, Temple University Hospital, Philadelphia, Pennsylvania;3. Department of Clinical Sciences, Temple University Hospital, Philadelphia, Pennsylvania;4. Department of Medical Genetics and Molecular Biochemistry, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania;1. Department of Gastroenterology, Health Research Institute (IDIS), University Hospital of Santiago de Compostela, Santiago de Compostela, Spain;2. Department of Endocrinology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain;1. Department of General Surgery and the Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, Florida;2. Department of Internal Medicine, Cleveland Clinic Florida, Weston, Florida;1. Diabetes Complications Research Centre, UCD Conway Institute, School of Medicine, University College Dublin, Dublin, Ireland;2. Weight Management Service, St. Columcille''s Hospital, Dublin, Ireland;3. Department of Surgery, St Vincent''s University Hospital, Dublin, Ireland;4. Surgery and Surgical Specialities, School of Medicine, University College Dublin, Dublin, Ireland;5. Applied Health Science, Indiana University Bloomington, School of Public Health, Bloomington, Indiana |
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| Abstract: | BackgroundNo studies have evaluated the effect of metabolic and bariatric surgery (MBS) on nonalcoholic fatty liver disease (NAFLD) and cardiometabolic markers in metabolically healthy patients with morbid obesity (MHMO) at midterm.ObjectivesTo assess the effect of MBS on NAFLD and cardiometabolic markers in MHMO patients and ascertain whether metabolically unhealthy patients with morbid obesity (MUMO) remain metabolically healthy at 5 years after MBS.SettingUniversity hospital.MethodsA total of 191 patients with a body mass index >40 kg/m2 and at least 5 years of follow-up were retrospectively analyzed. Lost to follow-up were 37.6% (151 of 401 patients). Patients were classified as MHMO if 1 or 0 of the cardiometabolic markers were present using the Wildman criteria. The degree of liver fibrosis was assessed using the NAFLD fibrosis score (NFS).ResultsForty-one patients (21.5%) fulfilled the criteria for MHMO. They showed significant improvements in blood pressure (from 135.1 ± 22.1 and 84.2 ± 14.3 mm Hg to 117.7 ± 19.2 and 73.0 ± 10.9 mm Hg), plasma glucose (from 91.0 ± 5.6 mg/dL to 87.2 ± 5.2 mg/dL), homeostatic model assessment for insulin resistance (from 2.2 ± .9 to 1.0 ± .8), triglycerides (from 88.0 range, 79.5–103.5] mg/dL to 61.0 range, 2.0–76.5] mg/dL), alanine aminotransferase, gamma-glutamyl transpeptidase NFS (from −1.0 ± 1.0 to −1.9 ± 1.2), and high-density lipoprotein cholesterol (from 56.9 ± 10.5 mg/dL to 77.9 ± 17.4 mg/dL) at 5 years after surgery. A total of 108 MUMO patients (84.4%) who became metabolically healthy after 1 year stayed healthy at 5 years.ConclusionsMBS induced a midterm improvement in cardiometabolic and NAFLD markers in MHMO patients. Seventy-six percent of MUMO patients became metabolically healthy at 5 years after MBS. |
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| Keywords: | Bariatric surgery Morbid obesity Metabolic syndrome Nonalcoholic fatty liver disease Nonalcoholic steatohepatitis Metabolically healthy but obese Metabolically unhealthy obese |
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