AB087. SOH25_AB_091. Metabolic dysfunction-associated steatotic liver disease and fibrosis in the bariatric population: prevalence, predictors and outcomes
Plenary Session

AB087. SOH25_AB_091. Metabolic dysfunction-associated steatotic liver disease and fibrosis in the bariatric population: prevalence, predictors and outcomes

Julie-Therese Clifford, Odhrán Ryan, Emily Carey, Talal Almukhlifi, Cian Davis, Aidan O’Dowling, Waqas Butt, Naomi Fearon, Helen Heneghan

Department of Surgery, St. Vincent’s University Hospital, Dublin, Ireland

Background: The prevalence of non-alcoholic fatty liver disease (NAFLD) continues to escalate rapidly in tandem with the rise in global obesity. Since 2023 this term has been replaced by the term metabolic dysfunction-associated steatotic liver disease (MASLD). The aim of this study is to examine the prevalence of MASLD in the bariatric population? Is there a more useful non-invasive biomarker than can identify at risk patients? Will it affect our treatment pathway for patients diagnosed with MASLD?

Methods: This ongoing study involved 493 intraoperative wedge liver biopsies obtained from patients undergoing bariatric procedures across the St. Vincent’s Hospital Group from 2017–2024. One hundred and thirty-three thus far have been retrospectively analysed by histopathology according and graded in a blinded manner, according to the Clinical Research Network NAFLD Activity Score (NAS) and Kleiner Classification of liver fibrosis.

Results: Of the samples 69.2% were female, 30.8% male, with an average BMI of 51.2 kg/m2. 64% underwent a sleeve gastrectomy, 33.7% underwent a one anastomosis and 2.3% underwent a Roux-en-Y gastric bypass. One hundred and fourteen of 133 (85.7%) samples analysed met the criteria for MASLD diagnosis [hepatic steatosis ≥5%, with a body mass index (BMI) >25 kg/m2]. 23 (18%) had a NAFLD activity score ≥3 with 3 (2.3%) ≥5. Eighty-one (61%) had a NASH CRN ≥1A, with 14.2% having a score ≥3.

Conclusions: Prevalence of MASLD in the bariatric cohort far exceeds international levels of 38%. Research continues to establish a reliable non-invasive test to identify high risk bariatric patients and development of a suitable referral pathway.

Keywords: Metabolic-associated steatotic liver disease (MASLD); bariatrics; liver fibrosis; liver biopsy

Acknowledgments

None.

Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-25-ab087
Cite this abstract as: Clifford JT, Ryan O, Carey E, Almukhlifi T, Davis C, O’Dowling A, Butt W, Fearon N, Heneghan H. AB087. SOH25_AB_091. Metabolic dysfunction-associated steatotic liver disease and fibrosis in the bariatric population: prevalence, predictors and outcomes. Mesentery Peritoneum 2025;9:AB087.

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