PD342 - IMPACT OF ROUX-EN-Y GASTRIC BYPASS ON FIBROSIS-4 SCORE IN OBESE PATIENTS

PD342

IMPACT OF ROUX-EN-Y GASTRIC BYPASS ON FIBROSIS-4 SCORE IN OBESE PATIENTS

D. Ramakrishnan^1,*, Y. Dupertuis¹, M. Plenc¹, L. Wilmart¹, N. Goossens¹, L. Spahr¹, J.-L. Frossard¹, M. Jung¹, L. Genton Graf¹

¹Hopitaux Universitaire de Genève, Geneva, Switzerland

 

Rationale: Metabolic-Associated Steatotic Liver Disease (MASLD) is closely linked to obesity and metabolic dysfunction, making weight reduction central to its management. The fibrosis-4 (FIB-4) score¹ is a widely used screening tool for significant fibrosis in MASLD, but the extent to which weight loss (WL) after Roux-en-Y gastric bypass (RYGB) affects reductions in FIB-4 remains unclear.

Methods: Patients aged 35–65 years who underwent RYGB since 2022 with one year of follow-up were included. Preoperative and 12-month postoperative assessments included anthropometric measurements and blood tests. FIB-4 scores were calculated using age, AST, ALT, and platelet count. Pre- and postoperative continuous variables were compared using a paired t-test. A multivariable linear regression was performed to assess the association between % WL and % change in FIB-4 at 12 months, adjusted for gender, age, baseline BMI, and baseline FIB-4 category (<1.3 vs ≥1.3).

Results: We included 43 patients (65% female; mean age 47.3 ± 7.7 years). Five patients (12%) had a baseline FIB-4 score ≥1.3. WL was 30.7±6.8% and FIB-4 increased by 9.7±23.4%

 

	Pre-op	12 months post-op	Mean Difference	p*
BMI (kg/m2)	41.5±4.4	28.7±4.4	-12.6	< 0.001
FIB-4 score	0.7±0.5	0.9±0.4	+0.1	0.003

*paired t test

 

Multivariable linear regression showed that baseline FIB-4 ≥1.3 was associated with greater reductions in FIB-4 at 12 months (Coeff= −35.7%, p = 0.003), while a higher BMI was associated with a greater increase in FIB-4 score (Coeff= 1.55, p = 0.049). WL, age and gender were not significantly associated with FIB-4 change. The model explained 24% of the variability in FIB-4 change (R² = 0.24, p = 0.061).

Conclusion: WL was not associated with FIB-4 change at 12 months post-RYGB. Larger studies, particularly in patients with FIB-4 >1.3 and using complementary measures (e.g. transient elastography), are needed to clarify its impact on MASLD risk.

References: ¹ EASL MASLD CPG 2024 J Hepatol 2024

Disclosure of Interest: None declared