Servei de Cirurgia, Departament de Medicina I Cirurgia, Hospital Sant Joan de Reus, Universitat Rovira I Virgili (URV), Institut d'Investigació Sanitària Pere Virgili (IISPV), Avinguda Doctor Josep Laporte, 2, 43204, Reus, Spain.
Grup de Recerca GEMMAIR (AGAUR) - Medicina Aplicada, Departament de Medicina I Cirurgia, URV, IISPV, Mallafré Guasch, 4, 43007, Tarragona, Spain.
Obes Surg. 2022 Oct;32(10):3313-3323. doi: 10.1007/s11695-022-06175-w. Epub 2022 Jul 6.
Given that obesity is a major medical problem associated with non-alcoholic fatty liver disease and the lack of studies on postsurgery weight loss according to hepatic histology, we aimed to analyse weight loss indicators according to non-alcoholic steatohepatitis (NASH) presence one and 2 years postsurgery.
The weight loss pattern of 410 women with severe obesity (SO) was analysed after sleeve gastrectomy (SG, n = 191) and Roux-en-Y gastric bypass (RYGB, n = 219) according to NASH presence at baseline and at 12 and 24 months postsurgery. Weight loss indicators: expected BMI (eBMI), excess BMI loss percentage (%EBMIL), total weight loss percentage (%TWL) and alterable weight loss percentage (%AWL).
Unlike RYGB, after SG, a higher percentage of NASH patients do not reach the eBMI 2 years postsurgery. %TWL and %AWL presented no differences after RYGB despite the presence of NASH. After SG, there is a worse ponderal evolution of all indicators analysed in the presence of NASH. Unlike SG, diabetic patients lose less weight than non-diabetic patients after RYGB. The presence of NASH in diabetics had no impact on weight loss indicators, but in non-diabetics, it had an impact, particularly in the SG group.
The presence of NASH suggests a worse weight loss pattern through all the analysed indicators one and 2 years after SG in women. The presence of T2DM appears to result in less weight loss after RYGB, but only non-diabetic women presenting NASH lose less weight that non-diabetic women in the absence of NASH after SG.
鉴于肥胖是与非酒精性脂肪性肝病相关的主要医学问题，且缺乏根据肝组织学对术后体重减轻的研究，我们旨在分析术后 1 年和 2 年根据非酒精性脂肪性肝炎（NASH）存在情况的体重减轻指标。
分析了 410 例严重肥胖（SO）女性在袖状胃切除术（SG，n=191）和 Roux-en-Y 胃旁路术（RYGB，n=219）后根据基线和术后 12 个月和 24 个月时 NASH 存在情况的体重减轻模式。体重减轻指标：预期 BMI（eBMI）、超重 BMI 减轻百分比（%EBMIL）、总体重减轻百分比（%TWL）和可改变体重减轻百分比（%AWL）。
与 RYGB 不同，SG 后，较高比例的 NASH 患者术后 2 年无法达到 eBMI。尽管存在 NASH，但 RYGB 后 %TWL 和 %AWL 没有差异。SG 后，所有分析指标的体重变化都较差。与 SG 不同，RYGB 后糖尿病患者的体重减轻少于非糖尿病患者。糖尿病患者中 NASH 的存在对体重减轻指标没有影响，但在非糖尿病患者中，NASH 的存在会产生影响，特别是在 SG 组。
NASH 的存在表明，女性 SG 术后 1 年和 2 年时，所有分析指标的体重减轻模式都更差。T2DM 的存在似乎导致 RYGB 后体重减轻减少，但只有非糖尿病女性在 SG 中存在 NASH 时体重减轻少于非糖尿病女性，而 NASH 不存在时。
