{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T09:13:10Z","timestamp":1768468390526,"version":"3.49.0"},"reference-count":37,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2024,9,23]],"date-time":"2024-09-23T00:00:00Z","timestamp":1727049600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"FormMed HealthCare AG, Frankfurt, Germany"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: Metabolic dysfunction-associated steatotic liver disease (MASLD) is closely associated with obesity and insulin resistance (IR). Identifying characteristics that predict a higher risk of fibrosis using noninvasive methods is particularly important. Methods: We performed a secondary analysis of data from an RCT of 48 patients after one anastomosis gastric bypass (OAGB) surgery, supplemented with specifically formulated probiotics and micronutrients or control treatment for 12 weeks. Patients were categorized using alanine aminotransferase (ALAT; &gt;35 U\/L for women, &gt;50 U\/L for men), higher NAFLD fibrosis score (NFS) &gt; \u22121.455), and IR (HOMA-IR &gt; 2.0). This trial was registered at Clinicaltrials.gov (ID: NCT03585413). Results: Abnormal ALAT was associated with high triglycerides, blood pressure (BP), glucose, and fatty liver index (FLI). NFS &gt; \u22121.455 was linked to higher age, body mass, waist circumference, and FLI, and lower albumin and platelet count. HOMA-IR &gt; 2.0 was associated with higher BP and triglycerides, lower HDL-cholesterol, higher serum transaminases, and higher probabilities of steatosis and fibrosis. Twelve weeks postoperatively, patients with NFS &gt; \u22121.455 showed greater reductions in body mass, systolic BP, serum insulin, and HbA1c, whereas those with NFS \u2264 \u22121.455 showed improvements in FLI and lipid metabolism but had high glucose concentrations. Patients with HOMA-IR \u2264 2.0 also had high glucose concentrations. Conclusions: The evaluation of common biomarker scores for fibrosis and IR may help clinicians to recognize severe NAFLD and improve the outcomes of OAGB surgery.<\/jats:p>","DOI":"10.3390\/nu16183210","type":"journal-article","created":{"date-parts":[[2024,9,23]],"date-time":"2024-09-23T09:15:07Z","timestamp":1727082907000},"page":"3210","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Prognostic Characteristics of Metabolic Dysfunction-Associated Steatotic Liver in Patients with Obesity Who Undergo One Anastomosis Gastric Bypass Surgery: A Secondary Analysis of Randomized Controlled Trial Data"],"prefix":"10.3390","volume":"16","author":[{"given":"Silke","family":"Crommen","sequence":"first","affiliation":[{"name":"Institute of Nutritional and Food Sciences, Nutritional Physiology, University of Bonn, 53113 Bonn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9375-874X","authenticated-orcid":false,"given":"Karl Peter","family":"Rheinwalt","sequence":"additional","affiliation":[{"name":"Department of Bariatric, Metabolic and Plastic Surgery, Cellitinnen-Krankenhaus St. Franziskus Cologne, 50825 Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0699-3149","authenticated-orcid":false,"given":"Andreas","family":"Plamper","sequence":"additional","affiliation":[{"name":"Department of Bariatric, Metabolic and Plastic Surgery, Cellitinnen-Krankenhaus St. Franziskus Cologne, 50825 Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1995-427X","authenticated-orcid":false,"given":"Daniela","family":"R\u00f6sler","sequence":"additional","affiliation":[{"name":"Bonn Education Association for Dietetics r.A., 50935 Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonie","family":"Weinhold","sequence":"additional","affiliation":[{"name":"Institute of Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, 53127 Bonn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine","family":"Metzner","sequence":"additional","affiliation":[{"name":"Bonn Education Association for Dietetics r.A., 50935 Cologne, Germany"},{"name":"Medical Clinic III\u2014Department of Gastroenterology, Metabolic Disorders and Internal Intensive Care, University Hospital RWTH Aachen, 52074 Aachen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4092-8981","authenticated-orcid":false,"given":"Sarah","family":"Egert","sequence":"additional","affiliation":[{"name":"Institute of Nutritional and Food Sciences, Nutritional Physiology, University of Bonn, 53113 Bonn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1186\/s13098-020-00570-y","article-title":"NAFLD as a continuum: From obesity to metabolic syndrome and diabetes","volume":"12","author":"Valerio","year":"2020","journal-title":"Diabetol. Metab. Syndr."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1038","DOI":"10.1016\/j.metabol.2015.12.012","article-title":"The multiple-hit pathogenesis of non-alcoholic fatty liver disease (NAFLD)","volume":"65","author":"Buzzetti","year":"2016","journal-title":"Metabolism"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Kitade, H., Chen, G., Ni, Y., and Ota, T. (2017). Nonalcoholic Fatty Liver Disease and Insulin Resistance: New Insights and Potential New Treatments. Nutrients, 9.","DOI":"10.3390\/nu9040387"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1780","DOI":"10.1016\/j.soard.2017.07.032","article-title":"Benefit-risk of intraoperative liver biopsy during bariatric surgery: Review and perspectives","volume":"13","author":"Barbois","year":"2017","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"71","DOI":"10.5152\/dir.2018.17525","article-title":"Predictors of bleeding complications following percutaneous image-guided liver biopsy: A scoping review","volume":"25","author":"Midia","year":"2019","journal-title":"Diagn. Interv. Radiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"101363","DOI":"10.1016\/j.diabet.2022.101363","article-title":"Prevalence and predictors of non-alcoholic steatohepatitis in subjects with morbid obesity and with or without type 2 diabetes","volume":"48","author":"Lembo","year":"2022","journal-title":"Diabetes Metab."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"11","DOI":"10.4291\/wjgp.v8.i2.11","article-title":"Nonalcoholic fatty liver disease: Diagnostic biomarkers","volume":"8","author":"Hadizadeh","year":"2017","journal-title":"World J. Gastrointest. Pathophysiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1540","DOI":"10.1007\/s11695-012-0677-1","article-title":"Impact of weight-loss surgery and diabetes status on serum ALT levels","volume":"22","author":"Xourafas","year":"2012","journal-title":"Obes. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1002\/hep.21496","article-title":"The NAFLD fibrosis score: A noninvasive system that identifies liver fibrosis in patients with NAFLD","volume":"45","author":"Angulo","year":"2007","journal-title":"Hepatology"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1007\/s10620-021-07317-3","article-title":"Bariatric Surgery in NAFLD","volume":"67","author":"Chauhan","year":"2022","journal-title":"Dig. Dis. Sci."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1040","DOI":"10.1016\/j.cgh.2018.10.017","article-title":"Complete Resolution of Nonalcoholic Fatty Liver Disease After Bariatric Surgery: A Systematic Review and Meta-analysis","volume":"17","author":"Lee","year":"2019","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1290","DOI":"10.1053\/j.gastro.2020.06.006","article-title":"Bariatric Surgery Provides Long-term Resolution of Nonalcoholic Steatohepatitis and Regression of Fibrosis","volume":"159","author":"Lassailly","year":"2020","journal-title":"Gastroenterology"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1346","DOI":"10.1055\/a-1880-2283","article-title":"Aktualisierte S2k-Leitlinie nicht-alkoholische Fettlebererkrankung der Deutschen Gesellschaft f\u00fcr Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS)\u2013April 2022\u2013AWMF-Registernummer: 021\u2013025","volume":"60","author":"Roeb","year":"2022","journal-title":"Z. Gastroenterol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1093\/jn\/nxab392","article-title":"A Specifically Tailored Multistrain Probiotic and Micronutrient Mixture Affects Nonalcoholic Fatty Liver Disease-Related Markers in Patients with Obesity after Mini Gastric Bypass Surgery","volume":"152","author":"Crommen","year":"2022","journal-title":"J. Nutr."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Bedogni, G., Bellentani, S., Miglioli, L., Masutti, F., Passalacqua, M., Castiglione, A., and Tiribelli, C. (2006). The Fatty Liver Index: A simple and accurate predictor of hepatic steatosis in the general population. BMC Gastroenterol., 6.","DOI":"10.1186\/1471-230X-6-33"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1156","DOI":"10.1007\/s00464-016-5085-5","article-title":"Comparison of mini-gastric bypass with sleeve gastrectomy in a mainly super-obese patient group: First results","volume":"31","author":"Plamper","year":"2017","journal-title":"Surg. Endosc."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1007\/s11695-007-9367-9","article-title":"Laparoscopic mini-gastric bypass: Experience with tailored bypass limb according to body weight","volume":"18","author":"Lee","year":"2008","journal-title":"Obes. Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1007\/BF00280883","article-title":"Homeostasis model assessment: Insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man","volume":"28","author":"Matthews","year":"1985","journal-title":"Diabetologia"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"921","DOI":"10.1007\/s00392-020-01709-7","article-title":"NAFLD and cardiovascular diseases: A clinical review","volume":"110","author":"Kasper","year":"2021","journal-title":"Clin. Res. Cardiol."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Pennisi, G., Infantino, G., Celsa, C., Di Maria, G., Enea, M., Vaccaro, M., Cannella, R., Ciccioli, C., La Mantia, C., and Mantovani, A. (2024). Clinical outcomes of MAFLD versus NAFLD: A meta-analysis of observational studies. Liver Int., 1\u201311.","DOI":"10.1111\/liv.16075"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1542","DOI":"10.1016\/j.jhep.2023.06.003","article-title":"A multisociety Delphi consensus statement on new fatty liver disease nomenclature","volume":"79","author":"Rinella","year":"2023","journal-title":"J. Hepatol."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"(2016). EASL-EASD-EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease. J. Hepatol., 64, 1388\u20131402.","DOI":"10.1016\/j.jhep.2015.11.004"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1363","DOI":"10.1002\/hep.22109","article-title":"Serum activity of alanine aminotransferase (ALT) as an indicator of health and disease","volume":"47","author":"Kim","year":"2008","journal-title":"Hepatology"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"427","DOI":"10.15403\/jgld-293","article-title":"Characterization of Patients with Biopsy-Proven Non-Alcoholic Fatty Liver Disease and Normal Aminotransferase Levels","volume":"28","author":"Ulasoglu","year":"2019","journal-title":"J. Gastrointestin. Liver Dis."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1002\/hep.23784","article-title":"Clinical, laboratory and histological associations in adults with nonalcoholic fatty liver disease","volume":"52","author":"Clark","year":"2010","journal-title":"Hepatology"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1016\/j.cca.2018.10.033","article-title":"The longitudinal increments of serum alanine aminotransferase increased the incidence risk of metabolic syndrome: A large cohort population in China","volume":"488","author":"Sun","year":"2019","journal-title":"Clin. Chim. Acta"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1563","DOI":"10.1111\/liv.13185","article-title":"Nonalcoholic fatty liver disease: Cause or consequence of type 2 diabetes?","volume":"36","author":"Valenti","year":"2016","journal-title":"Liver Int."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1001\/jama.287.3.356","article-title":"Prevalence of the metabolic syndrome among US adults: Findings from the third National Health and Nutrition Examination Survey","volume":"287","author":"Ford","year":"2002","journal-title":"JAMA"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Vishram, J.K.K., Borglykke, A., Andreasen, A.H., Jeppesen, J., Ibsen, H., J\u00f8rgensen, T., Palmieri, L., Giampaoli, S., Donfrancesco, C., and Kee, F. (2014). Impact of age and gender on the prevalence and prognostic importance of the metabolic syndrome and its components in Europeans. The MORGAM Prospective Cohort Project. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0107294"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.cgh.2020.04.067","article-title":"Women Have a Lower Risk of Nonalcoholic Fatty Liver Disease but a Higher Risk of Progression vs Men: A Systematic Review and Meta-analysis","volume":"19","author":"Balakrishnan","year":"2021","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"100835","DOI":"10.1016\/j.jhepr.2023.100835","article-title":"Non-alcoholic fatty liver disease in women\u2014Current knowledge and emerging concepts","volume":"5","author":"Eng","year":"2023","journal-title":"JHEP Rep."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1342","DOI":"10.1007\/s11695-017-3012-z","article-title":"Bariatric Surgery as an Efficient Treatment for Non-Alcoholic Fatty Liver Disease in a Prospective Study with 1-Year Follow-up : BariScan Study","volume":"28","author":"Nickel","year":"2018","journal-title":"Obes. Surg."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"3814","DOI":"10.1007\/s11695-023-06865-z","article-title":"Impact of Nonalcoholic Fatty Liver Disease (NAFLD) on Weight Loss After Bariatric Surgery","volume":"33","author":"Haddad","year":"2023","journal-title":"Obes. Surg."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1574","DOI":"10.2337\/dc21-2441","article-title":"Diabetes Remission in the Alliance of Randomized Trials of Medicine Versus Metabolic Surgery in Type 2 Diabetes (ARMMS-T2D)","volume":"45","author":"Kirwan","year":"2022","journal-title":"Diabetes Care"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1577","DOI":"10.1056\/NEJMoa1200111","article-title":"Bariatric surgery versus conventional medical therapy for type 2 diabetes","volume":"366","author":"Mingrone","year":"2012","journal-title":"N. Engl. J. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1567","DOI":"10.1056\/NEJMoa1200225","article-title":"Bariatric surgery versus intensive medical therapy in obese patients with diabetes","volume":"366","author":"Schauer","year":"2012","journal-title":"N. Engl. J. Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1056\/NEJMoa1600869","article-title":"Bariatric Surgery versus Intensive Medical Therapy for Diabetes-5-Year Outcomes","volume":"376","author":"Schauer","year":"2017","journal-title":"N. Engl. J. Med."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/16\/18\/3210\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:02:28Z","timestamp":1760112148000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/16\/18\/3210"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,23]]},"references-count":37,"journal-issue":{"issue":"18","published-online":{"date-parts":[[2024,9]]}},"alternative-id":["nu16183210"],"URL":"https:\/\/doi.org\/10.3390\/nu16183210","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,23]]}}}