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减重手术对代谢相关脂肪性肝病缓解的中期效果及预测因素:一项以非侵入性诊断为重点的前瞻性研究。

Mid-term Effects of Bariatric Surgery on Metabolic Dysfunction-Associated Fatty Liver Disease Remission and Predictive Factors: A Prospective Study with a Focus on Non-invasive Diagnosis.

机构信息

Obesity, Diabetes and Metabolism (ODIM) Research Group, Institut de Recerca Biomèdica de Lleida, Avinguda Rovira Roure 80, 25198, Lleida, Catalonia, Spain.

General and Digestive Surgery Department, Arnau de Vilanova University Hospital, Avinguda Rovira Roure 80, 25198, Lleida, Catalonia, Spain.

出版信息

Obes Surg. 2024 Mar;34(3):841-849. doi: 10.1007/s11695-024-07071-1. Epub 2024 Jan 29.

DOI:10.1007/s11695-024-07071-1
PMID:38285299
Abstract

PURPOSE

Non-alcoholic fatty liver disease (NAFLD), now termed metabolic dysfunction-associated fatty liver disease (MAFLD), is a growing health concern associated with obesity and type 2 diabetes. Bariatric surgery offers potential benefits, but its impact on MAFLD remains incompletely understood, with scarce long-term follow-up prospective studies. Moreover, being liver biopsy the gold standard for liver condition measurement, the need for non-invasive techniques that allow the assessment of MAFLD development after bariatric surgery is imperative. OWLiver® Care and OWLiver® represent two serum lipidomic tests, featuring panels comprising 11 and 20 triglycerides, respectively.

MATERIALS AND METHODS

We conducted a prospective study involving 80 Caucasians to assess the effects of bariatric surgery on MAFLD using non-invasive diagnostics and to identify baseline predictors of MAFLD remission. Serum samples were collected before surgery and at a 3-year follow-up.

RESULTS

After 3 years, the proportion of patients exhibiting a healthy liver escalated from 5.0% at baseline to 26.3%. Conversely, the percentage of steatohepatitis declined from 35.1% to a mere 7.6%. Younger age, female gender, and the absence of type 2 diabetes were associated with MAFLD remission. However, age stood as the only independent variable associated with this favorable liver evolution (R = 0.112).

CONCLUSION

Bariatric surgery demonstrates mid-term benefits in improving MAFLD, with younger age as a baseline predictor of remission. Non-invasive diagnostic methods, like OWLiver®, are valuable tools for monitoring MAFLD evolution. Further research with larger populations and longer follow-up periods is warranted to refine personalized treatment approaches.

摘要

目的

非酒精性脂肪性肝病(NAFLD),现称为代谢相关脂肪性肝病(MAFLD),是一种与肥胖和 2 型糖尿病相关的日益严重的健康问题。减重手术具有潜在的益处,但对 MAFLD 的影响仍不完全了解,缺乏长期随访的前瞻性研究。此外,由于肝活检是衡量肝脏状况的金标准,因此需要非侵入性技术来评估减重手术后 MAFLD 的发展,这是至关重要的。OWLiver® Care 和 OWLiver® 是两种血清脂质组学测试,分别具有包含 11 种和 20 种甘油三酯的面板。

材料和方法

我们进行了一项前瞻性研究,涉及 80 名白种人,使用非侵入性诊断方法评估减重手术对 MAFLD 的影响,并确定 MAFLD 缓解的基线预测因素。在手术前和 3 年随访时采集血清样本。

结果

3 年后,表现出健康肝脏的患者比例从基线时的 5.0%上升到 26.3%。相反,肝炎的比例从 35.1%下降到仅 7.6%。年龄较小、女性和没有 2 型糖尿病与 MAFLD 缓解相关。然而,年龄是唯一与这种有利的肝脏演变相关的独立变量(R = 0.112)。

结论

减重手术在改善 MAFLD 方面具有中期益处,年龄较小是缓解的基线预测因素。OWLiver® 等非侵入性诊断方法是监测 MAFLD 演变的有用工具。需要进一步研究更大的人群和更长的随访时间,以完善个性化的治疗方法。

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