The journey of MASLD: Tracking resolution, relapse, and predictive factors after sleeve gastrectomy and one-anastomosis gastric bypass, a propensity score-matched cohort study

Diabetes Res Clin Pract. 2025 Jan:219:111969. doi: 10.1016/j.diabres.2024.111969. Epub 2024 Dec 19.

Abstract

Aims: To assess the rates and predictors of resolution and relapse of metabolic-dysfunction associated steatotic liver disease (MASLD) in individuals undergoing sleeve gastrectomy (SG) or one-anastomosis gastric bypass (OAGB).

Methods: This observational prospective cohort study involved 1618 propensity score-matched participants (81.5% female) with concurrent MASLD and obesity who underwent SG or OAGB between 2013 and 2023.

Results: In the context of a maximum follow-up of four years with a median follow-up of 2.2 years (IQR: 1.0-3.3), the overall rates of MASLD resolution and relapse were 71.1 per 1000 person-month and 8.7 per 1000 person-month, respectively. These rates were comparable between the SG and OAGB groups. Significant resolution predictors were a lower percentage of hepatic steatosis, a higher percentage of 12-month excess weight loss (EWL%), and younger age. In contrast, an increased percentage of liver steatosis, a higher pre-operative (Pre-Op) fat mass percentage (FM%), and older age were significant predictors of relapse.

Conclusion: This study found no significant differences in MASLD resolution and relapse rates between SG and OAGB. Key factors influencing MASLD outcomes included the percentage of hepatic steatosis, 12-month EWL%, Pre-Op FM%, and age.

Keywords: Metabolic-dysfunction associated steatotic liver disease; One-anastomosis gastric bypass; Relapse; Resolution; Sleeve gastrectomy.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Fatty Liver / epidemiology
  • Female
  • Gastrectomy* / methods
  • Gastric Bypass* / methods
  • Humans
  • Male
  • Middle Aged
  • Obesity, Morbid / surgery
  • Propensity Score*
  • Prospective Studies
  • Recurrence*
  • Treatment Outcome
  • Weight Loss / physiology