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Article

Bariatric Surgery Affects Plasma Levels of Alanine Aminotransferase Independent of Weight Loss: A Registry-Based Study

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Department of Developmental Biology and Cancer Research, Institute for Medical Research Israel-Canada, The Hebrew University of Jerusalem-Hadassah Medical School, Jerusalem 91120, Israel
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Department of Surgery, Hadassah-Hebrew University Medical Center, Mount Scopus, Jerusalem 91240, Israel
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Bariatric Surgery Unit, Division of General Surgery, Tel Aviv Sourasky Medical Center, Tel-Aviv 64239, Israel
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Israel Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel
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Department of Surgery, Tel HaShomer Medical Center, Ramat Gan 52621, Israel
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Braun School of Public Health and Community Medicine, The Hebrew University of Jerusalem-Hadassah Medical School, Jerusalem 91120, Israel
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Israel Center for Disease Control, Ministry of Health, Ramat Gan 52621, Israel
*
Author to whom correspondence should be addressed.
Academic Editors: Giuseppe Nisi and Kei Nakajima
J. Clin. Med. 2021, 10(12), 2724; https://doi.org/10.3390/jcm10122724
Received: 13 April 2021 / Revised: 14 June 2021 / Accepted: 16 June 2021 / Published: 20 June 2021
(This article belongs to the Section Endocrinology & Metabolism)
Patients that undergo bariatric surgery experience weight loss and a reduction in the plasma levels of the hepatic enzymes alanine aminotransferase (ALT) and aspartate aminotransferase (AST). We used the Israeli national bariatric registry, which includes demographic, clinical, and biochemical data on 19,403 patients, of which 1335 patients had two-year follow-up data on ALT, AST, A1C, and BMI, to test the dependence of the reduction in the levels of ALT and AST on weight loss. The data were analyzed using regression models, retrospective matching, and time course analyses. Changes in liver enzymes did not correlate with change in BMI, and linear regression models did not demonstrate that the change in ALT and AST values were dependent on pre-operative levels of BMI or the extent of weight loss. ALT and AST levels were reduced two years after surgery compared with a cohort of retrospectively matched patients for ethnicity, sex, age, BMI, and A1C. Finally, patients who regained weight displayed a reduction in levels of liver enzymes. Our results suggest that bariatric surgery affects AST and ALT levels via weight loss dependent and independent mechanisms. Mechanistic studies that will identify the nature of this effect and the clinical relevance of ALT and AST levels to the post-bariatric liver function are warranted. View Full-Text
Keywords: bariatric surgery; A1C; ALT; AST; registry; obesity; OAGB; RYGB; sleeve gastrectomy bariatric surgery; A1C; ALT; AST; registry; obesity; OAGB; RYGB; sleeve gastrectomy
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MDPI and ACS Style

Azulai, S.; Grinbaum, R.; Beglaibter, N.; Eldar, S.M.; Rubin, M.; Carmi, S.; Ben-Haroush Schyr, R.; Romano-Zelekha, O.; Ben-Zvi, D. Bariatric Surgery Affects Plasma Levels of Alanine Aminotransferase Independent of Weight Loss: A Registry-Based Study. J. Clin. Med. 2021, 10, 2724. https://doi.org/10.3390/jcm10122724

AMA Style

Azulai S, Grinbaum R, Beglaibter N, Eldar SM, Rubin M, Carmi S, Ben-Haroush Schyr R, Romano-Zelekha O, Ben-Zvi D. Bariatric Surgery Affects Plasma Levels of Alanine Aminotransferase Independent of Weight Loss: A Registry-Based Study. Journal of Clinical Medicine. 2021; 10(12):2724. https://doi.org/10.3390/jcm10122724

Chicago/Turabian Style

Azulai, Shira, Ronit Grinbaum, Nahum Beglaibter, Shai M. Eldar, Moshe Rubin, Shai Carmi, Rachel Ben-Haroush Schyr, Orly Romano-Zelekha, and Danny Ben-Zvi. 2021. "Bariatric Surgery Affects Plasma Levels of Alanine Aminotransferase Independent of Weight Loss: A Registry-Based Study" Journal of Clinical Medicine 10, no. 12: 2724. https://doi.org/10.3390/jcm10122724

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