# Impact of pathologically diagnosed metabolic dysfunction-associated steatohepatitis on weight loss outcomes following sleeve gastrectomy

## TL;DR

This study finds that patients with metabolic dysfunction-associated steatohepatitis have worse weight loss outcomes after sleeve gastrectomy surgery.

## Contribution

This study identifies MASH as an independent predictor of reduced weight loss success following sleeve gastrectomy.

## Key findings

- Preoperative MASH is an independent negative predictor of post-operative weight loss outcomes.
- Patients with MASH achieved significantly lower %EWL and took longer to reach weight loss goals.
- MASH patients had a 28.9% lower %EWL compared to non-MASH patients.

## Abstract

The impact of metabolic dysfunction-associated steatohepatitis (MASH) on post-operative weight loss outcomes remains unclear. This study aims to investigate the effects of preoperative concomitant MASH on weight loss outcomes and metabolic improvements following laparoscopic sleeve gastrectomy (LSG).

A retrospective analysis was performed on the clinical data of 226 patients with obesity who underwent LSG and concurrent intraoperative liver biopsy. Univariate analysis, multivariate analysis, and general linear models were employed to evaluate differences in the dynamic trajectories of post-operative weight loss between the groups. Additionally, Kaplan–Meier survival analysis was utilized to compare the time required to achieve successful weight loss outcomes.

Preoperative body mass index (BMI) and the presence of MASH were independent negative predictors of percentage excess weight loss (%EWL) and percentage total weight loss (%TWL) (P < 0.01). The post-operative %EWL difference between the two groups reached up to 28.9%. Compared with non-MASH patients, patients with preoperative MASH had a significantly lower cumulative incidence of achieving 80% EWL within 1 year post-operatively (χ2 = 35.17, P < 0.05, HR = 2.058).

Preoperative MASH is significantly associated with lower post-operative weight loss. Compared to non-MASH patients, patients with MASH experienced a delay in achieving satisfactory weight loss outcomes within the first year after surgery, and this was significantly associated with a lower post-operative %EWL.