Baseline Hepamet fibrosis score is associated with type 2 diabetes remission after bariatric surgery

Type 2 diabetes (T2D) and metabolic dysfunction-associated steatotic liver disease (MASLD) share common pathophysiological mechanisms and exert reciprocal influences on each other. Bariatric surgery (BS) is the most effective treatment for the improvement and resolution of both conditions; however, little is known about the role of MASLD in diabetes remission following BS.

We evaluated the Hepamet fibrosis score (HFS), a noninvasive scoring system used to assess the risk of liver fibrosis, for this endpoint, hypothesizing that a preoperative HFS < .12 (low risk for advanced fibrosis) would be associated with a higher likelihood of diabetes remission, as earlier stages of liver disease may have a positive influence on glycemic outcomes.

University hospital (two-center).

In a retrospective observational analysis of a prospectively collected cohort of 145 adults with T2D undergoing BS, we evaluated the association between the preoperative HFS and diabetes remission at 1 year.

Among participants with a HFS < .12, 53 out of 72 (73.6%) achieved diabetes remission, compared to 38 out of 73 (52.1%) with a HFS ≥ .12, indicating a 41% higher probability of diabetes remission in the HFS < .12 group (RR = 1.41 [95% confidence interval, 1.09-1.83]; P = .007), compared to HFS ≥ .12 group. In the multivariate logistic regression analysis, HFS <.12 was independently associated with diabetes remission, after adjusting for diabetes duration, number of glucose-lowering medications, suboptimal glycemic control (HbA1c ≥ 7%), type of surgery, waist circumference, and percentage of total weight loss.

We report for the first time an association between the preoperative HFS and diabetes remission following BS, potentially complementing existing predictors with a simple, accessible, and inexpensive preoperative biomarker.