Endocrine Abstracts

Introduction: Metabolic dysfunction-associated fatty liver disease (MAFLD) is present in a high percentage of obese patients undergoing bariatric surgery (BS), being an effective strategy for the remission of MAFLD. A significant proportion of patients still have steatohepatitis even after considerable weight loss and metabolic improvements. Liver biopsy remains the definitive test to classify a patient with steatohepatitis, but it is an invasive test. The use of non-invasive techniques such as Fibroscan would avoid the limitations and risks that biopsy can cause in this group of patients.

Objective: To evaluate the effect of CB on the improvement of steatohepatitis in patients with morbid obesity (MO), classified according to type 2 diabetes (T2D).

Material and Methods: Patients with morbid obesity and steatohepatitis undergoing CB and classified according to T2D (non-T2D vs T2D). Liver biopsy was performed during BC in order to determine the status of steatohepatitis or fibrosis. Patients underwent Fibroscan before surgery and one year after. Clinical, anthropometric and biochemical variables were measured and liver fibrosis scores (FLI, NFS, APRI, FIB4, Hepamet) were calculated.

Results: Previous BMI (49 kg/m²) and the average weight (135 kg.), as well as the liver biopsy result were similar in the two cohorts studied, diabetics and non-diabetics. Likewise, BMI (33) and average weight (91) were similar one year after surgery in both groups. Fibroscan was equally similar in both groups, prior to the surgical intervention, reflecting a significant improvement, especially in the non-diabetics, but also in the diabetics, after surgery.

Conclusions: The impact of bariatric surgery improving different parameters associated with metabolic syndrome, achieving regression of most serious stages of MAFLD and remission of T2D in a high percentage of patients, makes it as a valid metabolic therapy, especially in cases of severe obesity.