Surgery for Obesity and Related Diseases
Wednesday, November 6, 2019 3:45 PM - 5:15 PMA139 Gastric bypass and sleeve gastrectomy for hepatic steatosis in type 2 diabetes – a randomized controlled trial
Section snippets
Background
Bariatric surgery may improve hepatic steatosis in patients with type-2 diabetes. We aimed to compare the effect of Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) on liver fat fraction (LFF), fatty liver index (FLI) and liver enzymes 5 weeks and 1 year after surgery.
Methods
Patients with type-2 diabetes and severe obesity were included in the triple blinded randomized Obesity surgery in Tønsberg (Oseberg) trial, and randomly allocated to RYGB or SG. LFF was estimated with the modified Dixon method calculating the percentage of liver-fat using magnetic resonance imaging (MRI). Low grade (G1) hepatic steatosis was defined in patients with values below the 25th percentile of LFF at baseline. Surrogate markers for hepatic steatosis included FLI and liver enzymes
Results
A total of 82 patients (60% female) with mean (SD) age 47.9 (9.6) years, BMI 41.6 (4.8) kg/m2, duration of diabetes 6.2 (5.3) years, HbA1c 67 (20) mmol/mol, LFF of 19.8 (11.9) %, were included in the analyses. At 5-week and 1-year, 74% vs 79% and 100% vs 93% (ns), achieved low-grade (G1) hepatic steatosis in the RYGB and SG group, respectively (Figure). FLI, ALAT and GGT decreased in both groups, and ALAT were significantly higher (p=0.040) in the RYGB group at 1 year (Table).
Conclusions
Patients who underwent RYGB and SG had a similar short- and medium-term decrease in liver fat fraction, but the RYGB group had a higher serum level of ALAT at 1 year.