In:
Diabetes, American Diabetes Association, Vol. 67, No. Supplement_1 ( 2018-07-01)
Abstract:
Teen-LABS is a multicenter, prospective observational study of adolescents undergoing bariatric surgery. Predictors of resolution of NAFLD post-surgery are unclear. We evaluated changes in serum ALT levels, an acceptable surrogate when liver biopsy is not feasible, in 219 Teen-LABS subjects 3 years post gastric bypass or vertical sleeve gastrectomy. Three years post-surgery, median BMI declined to 38.4 from 52.6 kg/m2 at baseline (p & lt;0.01). Median ALT (IU/L) decreased between baseline (36.5 ± 2.6 [95% CI: 31.4, 41.7]) and 6 months after surgery (28.9 ± 2.5 [95% CI: 24.4, 33.9] ), and remained stable at 1, 2 and 3 years, all p & lt;0.01 vs. baseline. 58% had abnormal ALT at baseline, which decreased to 10% at 3 years. After adjustment by logistic regression, 6 month improvement in BMI, fasting glucose, HOMA-IR, triglycerides, TG/HDL, and HDL were independently associated with reduced ALT. Improvement in metabolic indices remained significantly associated with decline in ALT, after adjusting for BMI (Table). In conclusion, while weight loss was associated with decreased ALT by 6 months post-surgery, improved fasting glycemia, insulin resistance and dyslipidemia indices were also independently associated with ALT decline. Association between change in predictor variables and decline in ALT from baseline to 6 months.Change in predictor variables over 6 monthsEstimate (SE) adjusted for age, race, sexp-valueEstimate (SE) adjusted for age, race, sex, change in BMIp-valueDecline in BMI0.64 (0.13) & lt;0.01Decline in fasting glucose0.40 (0.07) & lt;0.010.28 (0.08)0.01Decline in HbA1C4.59 (2.28)0.041.57 (2.32)0.50Decline in HOMA-IR1.11 (0.22) & lt;0.010.82 (0.27) & lt;0.01Decline in Triglycerides0.17 (0.02) & lt;0.010.15 (0.02) & lt;0.01Increase in HDL-0.75 (0.15) & lt;0.01-0.52 (0.16) & lt;0.01Decline in TG/HDL ratio5.11 (0.56) & lt;0.014.85 (0.66) & lt;0.01 Disclosure F. Bacha: Research Support; Self; AstraZeneca, JAEB Center For Health Research, National Institutes of Health, Pediatric Diabetes Consortium. R. Gupta: None. T.M. Jenkins: None. M. Brandt: None. T.H. Inge: Consultant; Self; Standard Bariatrics, Independent Medical Expert Consulting Services, UpToDate. D. Kleiner: None. S. Xanthakos: None.
Type of Medium:
Online Resource
ISSN:
0012-1797
,
1939-327X
Language:
English
Publisher:
American Diabetes Association
Publication Date:
2018
detail.hit.zdb_id:
1501252-9
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