Liver Fibrosis and IRS1 rs2972146 Are Associated With Weight Loss Response After Metabolic Bariatric Surgery.

Authors

Felice Cinque, Marica Meroni, Sara Badiali, Miriam Longo, Erika Paolini, Elisa Galfrascoli, Giovanna Oberti, Giuseppina Pisano, Gabriele Maffi, Matteo Mureddu, Elena Corbetta, Valentina Scimè, Emma Calzavara, Francesca Alletto, Annalisa Cespiati, Luigi Boni, Anna Ludovica Fracanzani, Paola Dongiovanni, Rosa Lombardi

Published in

Diabetes, obesity & metabolism. Sep 17, 2026. Epub Sep 17, 2026.

Abstract

Weight loss after metabolic bariatric surgery (MBS) is heterogeneous, and the contribution of liver histology and genetic susceptibility to insufficient weight loss (IWL) or weight regain (WR) remains unclear. We assessed the prevalence of IWL and WR after MBS and their association with liver histology and metabolic dysfunction-associated steatotic liver disease (MASLD)-related genetic variants.
We retrospectively included 351 adults undergoing MBS at Policlinico Hospital in Milan, between 2008 and 2023, with intraoperative liver biopsy. IWL was defined at 18 months as < 50% excess weight loss and/or BMI ≥ 35 kg/m², WR as ≥ 10% increase from postoperative weight nadir. PNPLA3, TM6SF2, GCKR, HSD17B13, and IRS1 variants were genotyped.
Out of 351 patients, 109 (31.1%) had IWL and out of 280 patients with available data, 91 (32.5%) developed WR. Hypertension (OR 1.97, 95% CI: 1.06-3.63) and significant liver fibrosis (OR 2.93, 95% CI: 1.07-8.01) were positively independently associated with IWL, whereas the IRS1 rs2972146 variant (OR 0.30, 95% CI: 0.14-0.62), sleeve gastrectomy or gastric bypass (OR 0.20, 95% CI: 0.10-0.39), dietary (OR 0.32, 95% CI: 0.16-0.63) and physical activity adherence (OR 0.38, 95% CI: 0.16-0.89) were inversely associated with IWL. WR was associated with psychiatric comorbidity and inversely associated with preoperative BMI, sleeve gastrectomy/gastric bypass, and dietary adherence.
Weight loss failure affected nearly one third of patients after MBS. Significant liver fibrosis and IRS1 rs2972146 variant may help identify patients at risk of suboptimal postoperative weight loss outcomes.

PMID:
42755140
Bibliographic data and abstract were imported from PubMed on 18 Sep 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.