OR15-02 Changes In Liver Fat Content By CT 1 Year After Sleeve Gastrectomy In Adolescents With Severe Obesity

Abstract

Abstract Disclosure: A.P. López López: None. S. Tuli: None. M. Lauze: None. I. Becetti: None. C.C. Pedreira: None. F.A. Huber: None. E. Omeroglu: None. M. Misra: None. V. Singhal: None. M.A. Bredella: None. Introduction: Obesity is associated with non-alcoholic fatty liver disease (NAFLD). Sleeve gastrectomy (SG), the most commonly used metabolic and bariatric surgery, is an effective means of weight loss and has been shown to improve NAFLD in adults but data regarding the efficacy of SG in early stages of NAFLD where steatosis is the only pathology is evolving. We aim to assess the impact of SG on hepatic fat content, one year after SG in youth with severe obesity. Objective: To (i) identify changes in liver fat content using attenuation measurements on non-contrast CT [liver/spleen (L:S) ratio] in youth with obesity before and 12 months after sleeve gastrectomy (SG) compared with non-surgical controls with obesity (NS) and (ii) associations of changes in L:S with changes in body composition. Methods: 52 participants 13-25 years old with obesity were followed for 12 months. 25 subjects had SG (84% female), and 27 were NS (70% female). Non-contrast CT of the abdomen was performed for attenuation measurements of liver and spleen in Hounsfield Units (HU), expressed as L:S ratio. A lower L:S ratio indicates higher liver fat. A single-slice MRI of the abdomen at the level of L4 was performed to assess subcutaneous and visceral adipose tissue (SAT and VAT) cross sectional areas (cm2). Results: Mean age did not differ across groups. Body mass index (BMI) at baseline trended higher in SG vs. NS [44.18 (41.33, 53.72) vs. 42.16 (38.65, 46.96) kg/m2, (p=0.073)], and the mean 1-year decrease in BMI was greater in SG vs. NS (-12.48±0.83 vs. -0.21±0.52 kg/m2, p<0.0001). VAT decreased in SG but increased in NS [-50.77 cm2 (-61.26, -34.09) vs. 13.55 cm2 (-10.27, 34.78), p<0.0001], over 1 year. There was a within group increase in the L:S ratio in SG (0.13± 0.05, p= 0.014) but not NS over 1 year, with a trend for a difference between groups (p=0.055). All SG participants with an L:S ratio <0.9 (threshold for the diagnosis of NAFLD) before surgery had a ratio of >1.0 a year after surgery, consistent with resolution of NAFLD. Within SG, the 1-year change in L:S ratio was negatively associated with 1-year change in visceral fat (ρ=-0.52 p=0.017). Conclusions: Hepatic fat content as assessed by non-contrast CT improved after SG over 1-year in youth with obesity with resolution of NAFLD in all subjects. This was associated with improvements in body composition, especially visceral adiposity. Presentation: Friday, June 16, 2023