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Original Research

Program: Section on Obesity and Innovations in Obesity Prevention, Assessment, and Treatment Forum

P2.J184: Long-term Outcomes of Metabolic Dysfunction-Associated Steatotic Liver Disease and Insulin Resistance following Sleeve Gastrectomy in Children

Saturday, September 28, 2024
4:30 PM – 5:30 PM EDT
Location: Poster Hall: Hyatt Regency Orlando, Plaza International Ballroom
Poster Presentations
Background: Sleeve gastrectomy (SG) has been shown to cause sustained weight loss and improve chronic comorbidities in children and adolescents. Our objective was to assess long-term outcomes of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and insulin resistance following SG in children.

Methods: Medical records of 136 children who underwent SG at a single academic center between 2014 and 2022 were reviewed. Aspartate transaminase (AST), alanine transaminase (ALT), and fasting insulin (FI) values were used as proxies for MASLD and insulin resistance. Preoperative laboratory data were compared to values obtained at 3, 6, 12 and 24 months post-operatively.

Results: The cohort was 59.6% female 53.7% Hispanic, with a median age of 17.3 years [interquartile range (IQR):15.8-18.2). Median preoperative AST was 27 units(U)/liter(L (IQR:20.0-37.0, n=113), and was significantly decreased at 3 (median:18.0, IQR:14.0-25.0, n=79, P< 0.0001), 6 (median:17.0, IQR:14.0-21.0, n=75, P< 0.0001), 12 (median:17.0, IQR:12.5-23.0, n=69, P< 0.0001), and 24 months (median:19.5, IQR:15.0-24.2, n=42, P< 0.001) postoperatively (Fig. 1A). Median preoperative ALT was 38 U/L (IQR:26.0-66.0, n=113), and was significantly decreased at 3 (median:24.0, IQR:15.0-40.0, n=79, P< 0.0001), 6 (median:19.5, IQR:15.0-31.0, n=74, P< 0.0001), 12 (median:19.0, IQR:15.0-27.2, n=70, P< 0.0001), and 24 months (median:20.0, IQR:14.0-28.5, n=45, P< 0.0001) postoperatively (Fig. 1B). Median preoperative FI was 35.5 milli-International Units/L (mIU/L) (IQR:20.1-59.2, n=76), and was significantly decreased at 3 (median:16.0, IQR:11.2-24.6, n=53, P< 0.0001), 6 (median:15.0, IQR:11.0-23.7, n=43, P< 0.0001), 12 (median:13.3, IQR:9.0-24.4, n=43, P< 0.0001), and 24 months (median:16.0, IQR:9.0-29.0, n=23, P< 0.001) after surgery ((Fig. 1C).

Conclusion: SG results in significant and durable long-term improvement in MASLD and insulin resistance as measured via AST, ALT and fasting insulin.