ECE2021 Audio Eposter Presentations Diabetes, Obesity, Metabolism and Nutrition (223 abstracts)
1Hospital Universitario Reina Sofia, Endocrinología, Córdoba, Spain; 2Hospital Reina Sofía, Endocrinología, Spain
Rationale
Obesity is associated with multiple comorbidities including nonalcoholic steatohepatitis (NASH). Despite its association with increased morbidity and mortality, treatment options are limited. Some studies have suggested that glucagon-like peptide-1 receptor agonists (aGLP-1) are associated with NASH resolution. Additionally, the effects of bariatric surgery on NASH-associated liver fibrosis are controversial.
Methods
Clinical and biochemical variables of 399 patients with obesity were recorded. Different treatment-groups were analyzed: aGLP-1 in monotherapy, bariatric surgery (BS) or the combination of both. Intrahepatic fibrosis was assessed by non-invasive liver index Fib-4 before and after 6 months of treatment.
Results
The whole cohort included 62.4% females (mean age 48-y old); 37.3% had T2DM, 82% underwent BS. Mild fibrosis degree (F0-F1) was observed in 68.7% of patients, without differences among treatments groups. Serum transaminases significantly improved in patients with T2DM compared with patients without T2DM that underwent BS (P < 0.05). Patients treated with aGL1 before surgery had increased weight loss 6 months after BS than patients that were not treated with aGLP-1. Improvement of Fib-4 score was observed in 4.3% of patients that received aGLP-1 (3.5% of weight loss); in 2.11% of patients that underwent BS (26% of weight loss); and in 21.7% of patients that received both treatment options (23.5% of weight loss).
Conclusions
aGLP-1 in combination with BS represents a valuable therapeutic option for NASH in patients with obesity. Further studies in patients without T2DM and/or obesity are still required.