Change in Transaminases and NASH Clinical Scores in Severely Obese Subjects Enrolled in a Population-Based Bariatric Program: 2-Year Follow-up
Bibliographic record
Abstract
Introduction: Obesity and its cardiometabolic complications are strongly associated with non-alcoholic steatohepatitis (NASH). The effect of weight loss on fatty liver diseases is, however, controversial. We examined the long-term change in transaminases and the risk of NASH according to treatment strategy in a publically funded Adult Bariatric Care center in Edmonton. Methods: Five hundred patients who progressed from the wait-list (WL; n=200) to multi-disciplinary intensive medical management (MM; n=150) and then surgery (SX; banding n=48, bypass n=51 and sleeve gastrectomy n=51), if indicated, were enrolled prospectively and followed for up to 24 months. Transaminases and a previously validated “NASH Clinical Scoring System for Morbid Obesity” were examined. Last-observation-carried-forward was used for imputing missing data. Between group comparisons were analyzed with a two-way ANOVA. Results: At baseline, no between-group differences were found (age 43.7±9.6 yrs, weight 131.9±25.1 kg, BMI 47.9±8.1 kg/m2, 88.2 % female, zz% had diabetes). Absolute weight change was -2.2±9.6 kg in WL patients, -9.2±18.5kg in MM and -21.9±19.7kg in SX patients (p < 0.0001). Within the SX group, mean weight change was -7.0±9.8kg for banding, -21.4±16.0kg for sleeve and -36.6±19.5 kg for bypass (p < 0.0001). Transaminases (ALT and GGT) and NASH clinical score were all significantly reduced in the SX group but not in WL or MM subjects (Figures A to D). Despite the large differences in weight loss obtained with the different surgical procedures, changes in transaminases and NASH clinical score were comparable among all surgical groups (Figure E and F).Figure: WL: Wait listed, MM: Medical management, SX: surgical management. LOCF, NASH Clinical Scoring System for Morbid Obesity, HEPATOLOGY 2008;47:1916-1923 Reporting Mean ±(SEM). † p<0.05 vs. Baseline in the same study arm (Bonferroni).Conclusion: Compared to those subjects receiving medical management, patients undergoing any type of bariatric surgery exhibited a significant reduction in transaminases as well as a reduction in their estimated risk of having NASH. The magnitude of this improvements does not seem to be associated to the type of bariatric surgery nor the amount of weight loss.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".