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Background <p>Metabolically-dysfunction-associated steatotic liver disease (MASLD) is a prevalent comorbidity of obesity, with metabolic bariatric surgery (MBS) suggested as the only definitive treatment. Concerns have been raised about altered weight loss patterns in patients with MASLD undergoing MBS; therefore, we aimed to evaluate the influence of MASLD on postoperative weight loss patterns after Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG).</p> Method <p>Data from 347 patients who underwent MBS between 2020 and 2024 were retrospectively reviewed. Patients were followed at 1, 6, and 12 months postoperatively. Weight, body mass index (BMI), excess weight loss (EWL), and total weight loss (TWL) were compared both by the presence of MASLD and by the different ultrasound-determined grades of MASLD.</p> Result <p>After 12 months postoperatively, weight and BMI were lower in the no MASLD groups than in the MASLD group (74.61 vs. 77.04 for weight and 28.49 vs. 29.21 for BMI in the RYGB group, and 71.03 vs. 74.92 for weight and 27.41 vs. 29.05 for BMI in the SG group). However, after adjusting for age, sex, history of diabetes, baseline BMI, and baseline weight, as well as the alimentary and biliopancreatic limbs in RYGB, multivariate analysis of repeated measures ANOVA revealed that the overall pattern of the MASLD group was statistically similar to that of the no MASLD group.</p> Conclusion <p>Preoperative MASLD does not appear to influence weight loss outcomes after RYGB or SG significantly. Larger prospective studies are required to clarify the predictive value of MASLD on postoperative weight loss patterns after MBS.</p> Graphical Abstract <p></p>

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The Weight of the Matter: Preoperative Metabolic Dysfunction-Associated Steatotic Liver Disease and its Limited Impact on Bariatric Outcomes

  • 期刊论文

  • 发表日期：

    2026年4月13日

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  • Motahare Moosavi,
  • Tooraj Zandbaf,
  • Keivan Kalali,
  • Hanie Gholami,
  • Amin Dalili,
  • Mohammad Javad Ghamari

摘要

Background

Metabolically-dysfunction-associated steatotic liver disease (MASLD) is a prevalent comorbidity of obesity, with metabolic bariatric surgery (MBS) suggested as the only definitive treatment. Concerns have been raised about altered weight loss patterns in patients with MASLD undergoing MBS; therefore, we aimed to evaluate the influence of MASLD on postoperative weight loss patterns after Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG).

Method

Data from 347 patients who underwent MBS between 2020 and 2024 were retrospectively reviewed. Patients were followed at 1, 6, and 12 months postoperatively. Weight, body mass index (BMI), excess weight loss (EWL), and total weight loss (TWL) were compared both by the presence of MASLD and by the different ultrasound-determined grades of MASLD.

Result

After 12 months postoperatively, weight and BMI were lower in the no MASLD groups than in the MASLD group (74.61 vs. 77.04 for weight and 28.49 vs. 29.21 for BMI in the RYGB group, and 71.03 vs. 74.92 for weight and 27.41 vs. 29.05 for BMI in the SG group). However, after adjusting for age, sex, history of diabetes, baseline BMI, and baseline weight, as well as the alimentary and biliopancreatic limbs in RYGB, multivariate analysis of repeated measures ANOVA revealed that the overall pattern of the MASLD group was statistically similar to that of the no MASLD group.

Conclusion

Preoperative MASLD does not appear to influence weight loss outcomes after RYGB or SG significantly. Larger prospective studies are required to clarify the predictive value of MASLD on postoperative weight loss patterns after MBS.

Graphical Abstract