Rising in level of liver biomarkers after different types of bariatric surgery; is there any concern?

Previous studies indicated that metabolic and bariatric surgery (MBS) is a well-known procedure for considerable and sustainable weight loss. While the studies showed that MBS may unfavorably influence and stimulate hepatic dysfunction by raising the aspartate aminotransferase (AST) and alanine aminotransferase (ALT). It is not yet clear whether the ALT and AST alterations following MBS are transient or it is permanently dangerous for liver function. Thus, we aimed to compare the metabolic effect of three MBS methods on liver function status.

In this retrospective cohort study, we focused on adults who underwent MBS without a history of liver disorders. The trends of liver function enzymes and albumin levels from the baseline to 3, 6, and 12 months postsurgery were explored for all patients with complete data using multiple binary logistic regressions.

The study involved 1378 participants who completed all of the measurements, with 366 (26.56%) undergoing sleeve gastrectomy (SG), 772 (56.02%) undergoing one-anastomosis gastric bypass (OAGB), and 240 (17.41%) undergoing Roux-en-Y gastric bypass (RYGB). While there were no significant differences in the levels of AST, ALT, and albumin between the three surgical methods at baseline, the effect of bariatric procedures on the AST and ALT levels went through completely differed across time. Furthermore, each bariatric technique had a different trend of the levels of AST and ALT. The trend of the levels of AST and ALT of RYGB and OAGB reached a stable level after 12 months of surgery. On the other hand, the stability time of the AST and ALT levels for SG was observed at 6 months, and the reduction was significantly higher than other methods.

Our findings suggest that the increasing trend of the AST and ALT levels and the stimulation of the liver function postoperatively were transient. The changes in the AST and ALT trend also reached a stable level after 12 months postoperative.