The Glutamate-Serine-Glycine Index as a Biomarker to Monitor the Effects of Bariatric Surgery on Non-alcoholic Fatty Liver Disease

Authors

DOI:

https://doi.org/10.15605/jafes.039.02.20

Keywords:

non-alcoholic fatty liver disease, amino acids, metabolomics

Abstract

Objective. Bariatric surgery effectively treats non-alcoholic fatty liver disease (NAFLD). The glutamate-serine-glycine (GSG) index has emerged as a non-invasive diagnostic marker for NAFLD, but its ability to monitor treatment response remains unclear. This study investigates the GSG index's ability to monitor NAFLD's response to bariatric surgery.

Methodology. Ten NAFLD participants were studied at baseline and 6 months post-bariatric surgery. Blood samples were collected for serum biomarkers and metabolomic profiling. Hepatic steatosis [proton density fat fraction (PDFF)] and fibroinflammation (cT1) were quantified with multiparametric magnetic resonance imaging (mpMRI), and hepatic stiffness with magnetic resonance elastography (MRE). Amino acids and acylcarnitines were measured with mass spectrometry. Statistical analyses included paired Student’s t-test, Wilcoxon-signed rank test, and Pearson’s correlation.

Results. Eight participants provided complete data. At baseline, all had hepatic steatosis (BMI 39.3 ± 5.6 kg/m2, PDFF ≥ 5%). Post-surgery reductions in PDFF (from 12.4 ± 6.7% to 6.2 ± 2.8%, p = 0.013) and cT1 (from 823.3 ± 85.4ms to 757.5 ± 41.6ms, p = 0.039) were significant, along with the GSG index (from 0.272 ± 0.03 to 0.157 ± 0.05, p = 0.001).   

Conclusion. The GSG index can potentially be developed as a marker for monitoring the response of patients with NAFLD to bariatric surgery.

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Author Biographies

Nichole Yue Ting Tan, Duke-NUS Medical School

Medical Student

Elizabeth Shumbayawonda

Program Lead (Chronic Liver Disease)

Lionel Tim-Ee Cheng, Singapore General Hospital

Senior Consultant, Diagnostic Radiology

Albert Su Chong Low, Singapore General Hospital

Senior Consultant, Diagnostic Radiology

Chin Hong Lim, Singapore General Hospital

Senior Consultant, Upper Gastrointestinal and Bariatric Surgery

Alvin Kim Hock Eng, Singapore General Hospital

Senior Consultant, Upper Gastrointestinal and Bariatric Surgery

Weng Hoong Chan, Singapore General Hospital

Senior Consultant, Upper Gastrointestinal and Bariatric Surgery

Phong Ching Lee, Singapore General Hospital

Senior Consultant, Endocrinology

Mei Fang Tay, Singapore General Hospital

Senior Radiographer

Jason Pik Eu Chang, Singapore General Hospital

Head and Senior Consultant, Gastroenterology and Hepatology

Yong Mong Bee, Singapore General Hospital

Head and Senior Consultant, Endocrinology

George Boon Bee Goh, Singapore General Hospital

Senior Consultant, Gastroenterology and Hepatology

Jianhong Ching, Duke-NUS Medical School

Assistant Professor, Cardiovascular and Metabolic Disorders

Kee Voon Chua, Duke-NUS Medical School

Research Assistant

Sharon Hong Yu Han, Duke-NUS Medical School

Research Assistant

Jean-Paul Kovalik, Singapore General Hospital

Associate Consultant, Endocrinology

Hong Chang Tan, Singapore General Hospital

Senior Consultant, Endocrinology

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2024-09-13

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Tan, N. Y. T., Shumbayawonda, E. ., Cheng, L. T.-E. ., Low, A. S. C., Lim, C. H., Eng, A. K. H., … Tan, H. C. (2024). The Glutamate-Serine-Glycine Index as a Biomarker to Monitor the Effects of Bariatric Surgery on Non-alcoholic Fatty Liver Disease . Journal of the ASEAN Federation of Endocrine Societies, 39(2), 54–60. https://doi.org/10.15605/jafes.039.02.20

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