%0 Journal Article
%T Post-Bariatric Surgery Liver Injury Assessment Using Circulating Caspase-Cleaved Keratin 18
%A Wiktoria Suchy
%A Adriana Stelmach
%A Maria Szymonowicz
%A Krzysztof Safranow
%J Bulletin of Pioneering Researches of Medical and Clinical Science
%@ 3006-2659
%D 2023
%V 3
%N 2
%R 10.51847/EUsTT6nZua
%P 70-78
%X Bariatric surgery is now recognized as a powerful therapeutic approach for individuals with morbid obesity who also suffer from non-alcoholic fatty liver disease (NAFLD). Despite its metabolic benefits, postoperative progression or new emergence of non-alcoholic steatohepatitis (NASH) and hepatic fibrosis has occasionally been reported. Caspase-cleaved keratin 18 (ccK18), a byproduct of hepatocyte apoptosis, has been identified as a reliable indicator of liver cell death—an essential process in NASH pathogenesis. Therefore, serial ccK18 testing could serve as a practical tool for tracking hepatic recovery in post-bariatric patients. In this study, clinical and biochemical data were obtained from 39 individuals who underwent laparoscopic Roux-en-Y gastric bypass, assessed across six timepoints from baseline to one year post-surgery. Serum ccK18 concentrations were determined, and large-scale profiling of circulating adipokines and cytokines was performed. Half of the participants (20 of 39) exhibited ccK18 values suggestive of advanced liver injury, while 21% had NAFLD fibrosis scores exceeding 0.676, consistent with significant fibrosis. After one year, patients experienced an average body weight reduction of 36.87%. At both six and twelve months after surgery, ccK18 fragment levels declined markedly compared to preoperative measurements (p < 0.001). Yet, nine subjects failed to reach at least a 10% drop in ccK18 over the same period, categorizing them as non-responders. Although standard laboratory indices and mean ccK18 values did not differ significantly, these non-responders exhibited higher baseline levels of leptin and fibrinogen. Sequential ccK18 evaluation effectively tracked NAFLD remission and identified patients with unresolved liver damage after bariatric surgery. Additional investigations are required to clarify the mechanisms underlying poor hepatic recovery and to evaluate the prognostic use of adipokines in this setting.
%U https://bprmcs.com/article/post-bariatric-surgery-liver-injury-assessment-using-circulating-caspase-cleaved-keratin-18-abctlfw74aknr2o