Baseline Presence of NAFLD Predicts Weight Loss after Gastric Bypass Surgery for Morbid Obesity

Karl Peter Rheinwalt; Uta Drebber; Robert Schierwagen; Sabine Klein; Ulf Peter Neumann; Tom Florian Ulmer; Andreas Plamper; Andreas Kroh; Sandra Schipper; Margarete Odenthal; Frank Erhard Uschner; Philipp Lingohr; Jonel Trebicka; Maximilian Joseph Brol

doi:10.3390/jcm9113430

Baseline Presence of NAFLD Predicts Weight Loss after Gastric Bypass Surgery for Morbid Obesity

Karl Peter Rheinwalt, Uta Drebber, Robert Schierwagen, Sabine Klein, Ulf Peter Neumann, Tom Florian Ulmer, Andreas Plamper, Andreas Kroh, Sandra Schipper, Margarete Odenthal, Frank Erhard Uschner, Philipp Lingohr, Jonel Trebicka^*, Maximilian Joseph Brol

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Background. Bariatric surgery is a widely used treatment for morbid obesity. Prediction of postoperative weight loss currently relies on prediction models, which mostly overestimate patients' weight loss. Data about the influence of Non-alcoholic fatty liver disease (NAFLD) on early postoperative weight loss are scarce. Methods. This prospective, single-center cohort study included 143 patients receiving laparoscopic gastric bypass surgery (One Anastomosis-Mini Gastric Bypass (OAGB-MGB) or Roux-en-Y Gastric Bypass (RYGB)). Liver biopsies were acquired at surgery. NAFLD activity score (NAS) assigned patients to "No NAFLD", "NAFL" or "NASH". Follow up data were collected at 3, 6 and 12 months. Results. In total, 49.7% of patients had NASH, while 41.3% had NAFL. Compared with the No NAFLD group, NAFL and NASH showed higher body-mass-index (BMI) at follow-up (6 months: 31.0 kg/m(2) vs. 36.8 kg/m(2) and 36.1 kg/m(2), 12 months: 27.0 kg/m(2) vs. 34.4 and 32.8 kg/m(2)) and lower percentage of total body weight loss (%TBWL): (6 months: 27.1% vs. 23.3% and 24.4%; 12 months: 38.5% vs. 30.1 and 32.6%). Linear regression of NAS points significantly predicts percentage of excessive weight loss (%EWL) after 6 months (Cologne-weight-loss-prediction-score). Conclusions. Histopathological presence of NAFLD might lead to inferior postoperative weight reduction after gastric bypass surgery. The mechanisms underlying this observation should be further studied.

Original language	English
Article number	3430
Number of pages	12
Journal	Journal of Clinical Medicine
Volume	9
Issue number	11
DOIs	https://doi.org/10.3390/jcm9113430
Publication status	Published - Nov 2020

Keywords

Roux-en-Y gastric bypass
one anastomosis gastric bypass
mini gastric bypass
NAFLD
NASH
weight loss
SIMPLE NONINVASIVE INDEX
BARIATRIC SURGERY
SIGNIFICANT FIBROSIS
SLEEVE GASTRECTOMY
SCORING SYSTEM
VALIDATION

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Cite this

Rheinwalt, K. P., Drebber, U., Schierwagen, R., Klein, S., Neumann, U. P., Ulmer, T. F., Plamper, A., Kroh, A., Schipper, S., Odenthal, M., Uschner, F. E., Lingohr, P., Trebicka, J., & Brol, M. J. (2020). Baseline Presence of NAFLD Predicts Weight Loss after Gastric Bypass Surgery for Morbid Obesity. Journal of Clinical Medicine, 9(11), Article 3430. https://doi.org/10.3390/jcm9113430

@article{ce36c6f2641b46e495cbd55122ff5c7e,

title = "Baseline Presence of NAFLD Predicts Weight Loss after Gastric Bypass Surgery for Morbid Obesity",

abstract = "Background. Bariatric surgery is a widely used treatment for morbid obesity. Prediction of postoperative weight loss currently relies on prediction models, which mostly overestimate patients' weight loss. Data about the influence of Non-alcoholic fatty liver disease (NAFLD) on early postoperative weight loss are scarce. Methods. This prospective, single-center cohort study included 143 patients receiving laparoscopic gastric bypass surgery (One Anastomosis-Mini Gastric Bypass (OAGB-MGB) or Roux-en-Y Gastric Bypass (RYGB)). Liver biopsies were acquired at surgery. NAFLD activity score (NAS) assigned patients to {"}No NAFLD{"}, {"}NAFL{"} or {"}NASH{"}. Follow up data were collected at 3, 6 and 12 months. Results. In total, 49.7% of patients had NASH, while 41.3% had NAFL. Compared with the No NAFLD group, NAFL and NASH showed higher body-mass-index (BMI) at follow-up (6 months: 31.0 kg/m(2) vs. 36.8 kg/m(2) and 36.1 kg/m(2), 12 months: 27.0 kg/m(2) vs. 34.4 and 32.8 kg/m(2)) and lower percentage of total body weight loss (%TBWL): (6 months: 27.1% vs. 23.3% and 24.4%; 12 months: 38.5% vs. 30.1 and 32.6%). Linear regression of NAS points significantly predicts percentage of excessive weight loss (%EWL) after 6 months (Cologne-weight-loss-prediction-score). Conclusions. Histopathological presence of NAFLD might lead to inferior postoperative weight reduction after gastric bypass surgery. The mechanisms underlying this observation should be further studied.",

keywords = "Roux-en-Y gastric bypass, one anastomosis gastric bypass, mini gastric bypass, NAFLD, NASH, weight loss, SIMPLE NONINVASIVE INDEX, BARIATRIC SURGERY, SIGNIFICANT FIBROSIS, SLEEVE GASTRECTOMY, SCORING SYSTEM, VALIDATION",

author = "Rheinwalt, {Karl Peter} and Uta Drebber and Robert Schierwagen and Sabine Klein and Neumann, {Ulf Peter} and Ulmer, {Tom Florian} and Andreas Plamper and Andreas Kroh and Sandra Schipper and Margarete Odenthal and Uschner, {Frank Erhard} and Philipp Lingohr and Jonel Trebicka and Brol, {Maximilian Joseph}",

note = "Publisher Copyright: {\textcopyright} 2020 by the authors. Licensee MDPI, Basel, Switzerland.",

year = "2020",

month = nov,

doi = "10.3390/jcm9113430",

language = "English",

volume = "9",

journal = "Journal of Clinical Medicine",

issn = "2077-0383",

publisher = "Multidisciplinary Digital Publishing Institute (MDPI)",

number = "11",

}

TY - JOUR

T1 - Baseline Presence of NAFLD Predicts Weight Loss after Gastric Bypass Surgery for Morbid Obesity

AU - Rheinwalt, Karl Peter

AU - Drebber, Uta

AU - Schierwagen, Robert

AU - Klein, Sabine

AU - Neumann, Ulf Peter

AU - Ulmer, Tom Florian

AU - Plamper, Andreas

AU - Kroh, Andreas

AU - Schipper, Sandra

AU - Odenthal, Margarete

AU - Uschner, Frank Erhard

AU - Lingohr, Philipp

AU - Trebicka, Jonel

AU - Brol, Maximilian Joseph

PY - 2020/11

Y1 - 2020/11

N2 - Background. Bariatric surgery is a widely used treatment for morbid obesity. Prediction of postoperative weight loss currently relies on prediction models, which mostly overestimate patients' weight loss. Data about the influence of Non-alcoholic fatty liver disease (NAFLD) on early postoperative weight loss are scarce. Methods. This prospective, single-center cohort study included 143 patients receiving laparoscopic gastric bypass surgery (One Anastomosis-Mini Gastric Bypass (OAGB-MGB) or Roux-en-Y Gastric Bypass (RYGB)). Liver biopsies were acquired at surgery. NAFLD activity score (NAS) assigned patients to "No NAFLD", "NAFL" or "NASH". Follow up data were collected at 3, 6 and 12 months. Results. In total, 49.7% of patients had NASH, while 41.3% had NAFL. Compared with the No NAFLD group, NAFL and NASH showed higher body-mass-index (BMI) at follow-up (6 months: 31.0 kg/m(2) vs. 36.8 kg/m(2) and 36.1 kg/m(2), 12 months: 27.0 kg/m(2) vs. 34.4 and 32.8 kg/m(2)) and lower percentage of total body weight loss (%TBWL): (6 months: 27.1% vs. 23.3% and 24.4%; 12 months: 38.5% vs. 30.1 and 32.6%). Linear regression of NAS points significantly predicts percentage of excessive weight loss (%EWL) after 6 months (Cologne-weight-loss-prediction-score). Conclusions. Histopathological presence of NAFLD might lead to inferior postoperative weight reduction after gastric bypass surgery. The mechanisms underlying this observation should be further studied.

AB - Background. Bariatric surgery is a widely used treatment for morbid obesity. Prediction of postoperative weight loss currently relies on prediction models, which mostly overestimate patients' weight loss. Data about the influence of Non-alcoholic fatty liver disease (NAFLD) on early postoperative weight loss are scarce. Methods. This prospective, single-center cohort study included 143 patients receiving laparoscopic gastric bypass surgery (One Anastomosis-Mini Gastric Bypass (OAGB-MGB) or Roux-en-Y Gastric Bypass (RYGB)). Liver biopsies were acquired at surgery. NAFLD activity score (NAS) assigned patients to "No NAFLD", "NAFL" or "NASH". Follow up data were collected at 3, 6 and 12 months. Results. In total, 49.7% of patients had NASH, while 41.3% had NAFL. Compared with the No NAFLD group, NAFL and NASH showed higher body-mass-index (BMI) at follow-up (6 months: 31.0 kg/m(2) vs. 36.8 kg/m(2) and 36.1 kg/m(2), 12 months: 27.0 kg/m(2) vs. 34.4 and 32.8 kg/m(2)) and lower percentage of total body weight loss (%TBWL): (6 months: 27.1% vs. 23.3% and 24.4%; 12 months: 38.5% vs. 30.1 and 32.6%). Linear regression of NAS points significantly predicts percentage of excessive weight loss (%EWL) after 6 months (Cologne-weight-loss-prediction-score). Conclusions. Histopathological presence of NAFLD might lead to inferior postoperative weight reduction after gastric bypass surgery. The mechanisms underlying this observation should be further studied.

KW - Roux-en-Y gastric bypass

KW - one anastomosis gastric bypass

KW - mini gastric bypass

KW - NAFLD

KW - NASH

KW - weight loss

KW - SIMPLE NONINVASIVE INDEX

KW - BARIATRIC SURGERY

KW - SIGNIFICANT FIBROSIS

KW - SLEEVE GASTRECTOMY

KW - SCORING SYSTEM

KW - VALIDATION

U2 - 10.3390/jcm9113430

DO - 10.3390/jcm9113430

M3 - Article

C2 - 33114543

SN - 2077-0383

VL - 9

JO - Journal of Clinical Medicine

JF - Journal of Clinical Medicine

IS - 11

M1 - 3430

ER -