Alexander Heilberger, Falk Rauchfuss, Utz Settmacher, Felix Dondorf, Aladdin Ali Deeb, Hermann Kissler, Laura Schwenk, Johanna Bruns, Michael Ardelt
Department of General, Visceral and Vascular Surgery, University Hospital of Jena, Am Klinikum 1, 07747, Jena, Germany.
Langenbecks Arch Surg. 2025 Jan 8;410(1):29. doi: 10.1007/s00423-024-03569-5.
The prevalence of obesity, along with that of its associated health conditions, including cardiovascular diseases, diabetes mellitus, and liver diseases, such as non-alcoholic fatty liver disease (NAFLD), is increasing annually. Bariatric surgery is indicated for the treatment of obesity if conservative treatment fails. While various liver fibrosis scores have been proposed for assessing liver function, they are typically used prior to bariatric surgery. This study aimed to determine whether fibrosis scores calculated from non-invasive parameters are effective in monitoring liver function after bariatric surgery.
This study analyzed data from 151 patients who underwent sleeve gastrectomy (SG) and were followed up at 3, 6, 9, 12, 24, and 36 months postoperatively. From the routinely collected parameters, liver fibrosis scores (APRI, Fib-4, BARD, Forns index [FORNS], Lok score [LOK], and NAFLD scores) were calculated retrospectively and compared to diabetes status % excess weight loss (%EWL) and % total weight loss (%TWL) over a 3-year follow-up period.
After SG, APRI, FORNS, and NAFLD scores showed significant improvements, whereas Fib-4, BARD, and LOK scores did not improve. Similarly, body mass index, %EWL, %TWL, and diabetes status also improved significantly. Throughout the 3-year follow-up period, only the APRI and NAFLD scores showed significant improvement.
Only APRI and NAFLD scores changed significantly after SG. Thus, these two scores may be used to reflect and monitor liver function in patients who have undergone SG.
肥胖及其相关健康状况（包括心血管疾病、糖尿病以及非酒精性脂肪性肝病（NAFLD）等肝脏疾病）的患病率每年都在上升。如果保守治疗失败，肥胖症手术可用于治疗肥胖。虽然已经提出了各种肝纤维化评分来评估肝功能，但它们通常在肥胖症手术前使用。本研究旨在确定由非侵入性参数计算得出的纤维化评分在监测肥胖症手术后的肝功能方面是否有效。
本研究分析了151例行袖状胃切除术（SG）患者的数据，并在术后3、6、9、12、24和36个月进行随访。从常规收集的参数中，回顾性计算肝纤维化评分（APRI、Fib-4、BARD、Forns指数[FORNS]、Lok评分[LOK]和NAFLD评分），并在3年随访期内与糖尿病状态、%超重减轻（%EWL）和%总体重减轻（%TWL）进行比较。
SG术后，APRI、FORNS和NAFLD评分显示出显著改善，而Fib-4、BARD和LOK评分未改善。同样，体重指数、%EWL、%TWL和糖尿病状态也有显著改善。在整个3年随访期内，只有APRI和NAFLD评分显示出显著改善。
SG术后只有APRI和NAFLD评分有显著变化。因此，这两个评分可用于反映和监测接受SG手术患者的肝功能。
