Endocrine Abstracts

Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD, formerly called non-alcoholic fatty liver disease, NAFLD) is a leading cause of chronic liver disease, affecting 25% adult population worlwide. Its most advanced form is the metabolic dysfunction-associated steatohepatitis, or MASH which may progress to cirrhosis. It has no approved pharmacotherapy yet, and weight reduction is an important therapeutic option. Few studies have evaluated the effect of Endoscopic Sleeve Gastroplasty (ESG) on comorbidities in patients with obesity and MASLD.

Aims: To evaluate the evolution of metabolic comorbidities, weight changes and technique’s safety in patients with obesity and MASLD undergoing ESG.

Material and Methods: We performed retrospective-descriptive analysis in 32 patients with MASLD and Obesity undergoing ESG between 2016-2022. We evaluated the evolution of analytical and anthropometric parameters, and metabolic comorbidities with 1-year follow-up.

Results: 72% of the patients were women, mean age 44 +/- 8.5 years. Mean baseline BMI (body mass index) was 39 +/- 5.47 kg/m², most of them type II obesity (57%). 11 patients (36%) had steatosis grade I, 11 (36%) grade II and 10 (28%) grade III. There were 7 patients with hypertension (HT) (28%), 2 with diabetes (8.7%), 6 with pre-diabetes (26%), 10 with dyslipidemia (47.6%) and 3 with severe Obstructive Sleep Apnoea (OSA) (17%). At 1-year follow-up, there was resolution of HT in 3 patients (P; 0.003), of prediabetes in all cases (P; 0.000), of dyslipidemia in 6 cases (P 0.361) and of OSA in 1 case (P; 0.020). We found a significant decrease in basal glycemia (P; 0.025), glycosylated hemoglobin (P; 0.046) and triglycerides (P; 0.013). There were significant differences in % TWL (total weight loss) mainly at month 6 of treatment: 18.7% TWL (P; 0.004). We observed good correlation between % TWL, age and BMI. 84% of patients completed the endocrinology/nutrition visits. There were no complications in the studied population.

Conclusions: ESG can be considered an effective and safe option in patients with obesity and MASLD, with a positive impact on excess weight and the evolution of associated metabolic comorbidities.