Improvement of non-alcoholic steatohepatitis as measured by elastography in obese diabetic and non-diabetic patients undergoing bariatric surgery, after one-year follow-up

Simon Frapolli Victor Jose; Garcia Ana Sanchez; Pelaez Esther Garvi; Marin Raquel Sancho; Salas Isabel Arranz; Casado Gema Gomez; Humanes Rocio Soler; Bandera Jose Pinazo; Madueno Francisco Tinahones; Sanchez Lourdes Garrido

doi:10.1530/endoabs.99.EP439

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Endocrine Abstracts (2024) 99 EP439 | DOI: 10.1530/endoabs.99.EP439

ECE2024 Eposter Presentations Diabetes, Obesity, Metabolism and Nutrition (383 abstracts)

Improvement of non-alcoholic steatohepatitis as measured by elastography in obese diabetic and non-diabetic patients undergoing bariatric surgery, after one-year follow-up

Víctor José Simón Frapolli ^1,2,3 , Ana Sánchez García ^1,3 , Esther Garvi Peláez ^1,3 , Raquel Sancho Marín ³ , Isabel Arranz Salas ^3,4 , Gema Gómez Casado ^1,3 , Rocío Soler Humanes ^3,5 , José Pinazo Bandera ^3,6 , Francisco Tinahones Madueño ^1,3 & Lourdes Garrido Sánchez ^1,3

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Author affiliations

¹Hospital Universitario Virgen de la Victoria, Endocrinology and Nutrition; ²; ³BIONAND, Málaga, Spain; ⁴Hospital Universitario Virgen de la Victoria, Pathological Anatomy, Málaga, Spain; ⁵Hospital Universitario Virgen de la Victoria, General Surgery, Málaga, Spain; ⁶Hospital Universitario Virgen de la Victoria, Digestive System, Málaga, Spain

Introduction: Bariatric surgery (BS) is an effective strategy for the remission of non-alcoholic steatohepatitis (NASH) in morbidly obese (MO) patients, producing an improvement in comorbidities and better glycaemic control in patients with DM2. Liver biopsy remains the definitive test to classify a patient with NASH/NASH, however, the use of non-invasive techniques such as fibroscan would avoid the limitations and risks that biopsy can cause in this type of patient. Therefore, in this study we determined the improvement of NASH by fibroscan in patients with OM undergoing BC and classified according to diabetes (DM2).

Material and Methods: We included 38 patients with OM classified according to the presence of DM2, who underwent BC and were followed up 1 year after BC. Fibroscan was performed before surgery and one year after BC. Anthropometric and biochemical variables and liver fibrosis scores were measured.

Results: Of the 38 patients included, 22 (non-DM2), and 16 (DM2), only 7 patients remained DM2 at 1 year after BC, which meant a remission of 56.3%. BMI before and 1 year after BC were similar in the two cohorts studied. Fibroscan was also similar in both groups before surgery, reflecting a significant improvement, especially in non-diabetics, but also in diabetics after surgery.

Conclusions: According to this study, liver improvement is equal in both groups of patients after one year. It shows that elastography is a valid technique to assess NASH remission in OM patients undergoing bariatric surgery. Therefore, it is important to use fibroscan to evaluate those patients with NAFLD with liver fibrosis and to prioritise their surgical intervention over those without obesity-associated comorbidities.

Acknowledgements: This work was supported in part by a grant from the Consejería de Salud y Familias de la Junta de Andalucía (PI-0108-2022) and a FUNSECO grant (2023). CIBEROBN is an initiative of the ISCIII and FEDER funds.