Key result
Bypass surgery resulted in significantly lower levels of HSCRP compared to non-bypass procedures at 10 years (0.2 vs. 0.8 mg/dL, p=0.009), suggesting better resolution of NASH.
Why the study?
Does bypass bariatric surgery improve resolution of NASH compared to non-bypass surgery in morbidly obese patients?
Cohort
Does bypass bariatric surgery improve resolution of NASH compared to non-bypass surgery in morbidly obese patients?
Absolute Event Rate: 0.2% vs 0.8%
p-value: p=0.009
HSCRP is an independent predictor of NASH and suggests bypass bariatric surgery is more effective than non-bypass procedures for NASH resolution.
Bypass surgery was associated with lower long-term HSCRP; leaves open whether it improves NASH resolution versus non-bypass procedures.
BACKGROUND: Nonalcoholic steatohepatitis (NASH) is closely associated with obesity and is one of the important etiologies of hepatocellular carcinoma (HCC and liver failure. Bariatric surgery is proven to be effective in causing weight loss and improvement of NASH) but there is limited long term data. OBJECTIVES: To identify the predictors of NASH in morbidly obese patients and evaluate long term data of bariatric surgery effects on NASH. METHODS: ) with concurrent liver biopsy form 2003 to 2008 were included. We compared the clinical data between the NASH and non-NASH group and identify predictors of NASH in this cohort of patients. Remission of NASH was evaluated using the predictor of NASH. RESULTS: Prevalence of NASH was 43.8%. At baseline, the NASH and non-NASH groups both had similar age, BMI and sex ratio but the NASH group had significantly worse glycemic control, liver enzymes, triglycerides and uric acid. Highly sensitive-C Reactive Protein (HSCRP) level was identified as the only independent predictor of NASH. Ten years follow up (60.4% loss to follow up) showed good weight loss, resolution of co-morbidities and reduction of HSCRP. Patients with bypass surgery had better weight loss and lower levels of HSCRP. (HSCRP 0.2 ± 0.1 mg/dL vs. 0.8 ± 0.7 mg/dL, p = 0.009). than non-bypass group. CONCLUSION: NASH is common in bariatric patients. HSCRP is the only independent predictor of NASH and can be used as a surrogate marker in predicting long term effect of Bariatric Surgery on resolution of non-alcoholic steatohepatitis Bypass procedure was better in resolution of NASH than non-bypass procedure.
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Tan et al. (2018) conducted a cohort in Nonalcoholic steatohepatitis (NASH) in morbidly obese patients. Bypass surgery vs. Non-bypass surgery was evaluated on HSCRP level (p=0.009). Bypass surgery resulted in significantly lower levels of HSCRP compared to non-bypass procedures at 10 years (0.2 vs. 0.8 mg/dL, p=0.009), suggesting better resolution of NASH.
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