Changes in serum albumin and liver enzymes following three different types of bariatric surgery: six-month follow-up. A retrospective cohort study.

Mohadeseh Hassan Zadeh,Negar Zamaninour,Abdolreza Pazouki,Hastimansooreh Ansar,Ali Kabir,Gholamreza Mohammadi Farsani

doi:10.1590/1516-3180.2021.00065.r1.1504221

Abstract

Few reports have examined the effects of Roux-en-Y gastric bypass (RYGB), one-anastomosis gastric bypass (OAGB) and sleeve gastrectomy (SG) on changes to serum albumin (Alb) and liver enzyme levels. To compare short-term post-surgery changes in serum Alb, aspartate aminotransferase (AST), alanine aminotransferase (ALT) and alkaline phosphatase (ALKP) levels. Body composition changes were also measured and compared among three groups. Retrospective cohort study conducted in Tehran, Iran. 151 OAGB, RYGB and SG patients referred to the obesity clinic of Hazrat-e Rasool General Hospital, Tehran, Iran, were evaluated. Physical characteristics and biochemical parameters were measured pre-surgery and then after three and six months. Through repeated measurements to determine intragroup changes, significant changes in serum AST (P = 0.003) and ALT (P < 0.001) were observed in follow-ups. However, Alb levels did not change (P = 0.413). Body fat, fat-free mass and muscle mass decreased significantly in each group (P < 0.05). In a univariate general linear model for determining intergroup changes, SG showed greater decreases in ALT and AST at three and six months (P < 0.05) and in ALKP at six months (P = 0.037), compared with OAGB. There were no significant differences in Alb levels. Also, RYGB had a greater effect on reducing fat percentage (three months, P = 0.011; six months, P = 0.059) and fat mass (three months, P = 0.042) than OAGB. SG and RYGB may be superior to OAGB in reducing liver enzymes and body fat, respectively. However, Alb levels showed no significant differences.

Highlights

The worldwide prevalence of obesity has tripled in the past four decades,[1] which may have led to higher incidence of some major health problems, such as type 2 diabetes (T2DM), high blood pressure, cardiovascular disease (CVD), degenerative arthritis and sleep apnea.[2]
The mean age was highest among the Roux-en-Y gastric bypass (RYGB) patients (43.04 ± 8.31 years) (P = 0.017)
This study focused on changes in serum Alb levels and liver enzymes in 151 patients who had undergone RYGB, OAGBMGB or sleeve gastrectomy (SG)

Summary

Introduction

The worldwide prevalence of obesity has tripled in the past four decades,[1] which may have led to higher incidence of some major health problems, such as type 2 diabetes (T2DM), high blood pressure, cardiovascular disease (CVD), degenerative arthritis and sleep apnea.[2]. No similar domestic study had compared the three types of surgery regarding Alb levels. Few reports have examined the effects of Roux-en-Y gastric bypass (RYGB), one-anastomosis gastric bypass (OAGB) and sleeve gastrectomy (SG) on changes to serum albumin (Alb) and liver enzyme levels. OBJECTIVE: To compare short-term post-surgery changes in serum Alb, aspartate aminotransferase (AST ), alanine aminotransferase (ALT) and alkaline phosphatase (ALKP) levels. Body composition changes were measured and compared among three groups. RESULTS: Through repeated measurements to determine intragroup changes, significant changes in serum AST (P = 0.003) and ALT (P < 0.001) were observed in follow-ups. In a univariate general linear model for determining intergroup changes, SG showed greater decreases in ALT and AST at three and six months (P < 0.05) and in ALKP at six months (P = 0.037), compared with OAGB.

Methods

Results

Discussion

Conclusion