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Life sciences · Journal article
Hitit Medical Journal · October 13, 2026
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Objective: Metabolic dysfunction-associated steatotic liver disease (MASLD), previously termed non-alcoholic fatty liver disease, is strongly linked to obesity, insulin resistance, and type 2 diabetes. Bariatric surgery, particularly laparoscopic sleeve gastrectomy (LSG), is an established treatment for severe obesity and may improve hepatic steatosis and broader metabolic dysfunction. However, the interpretation of non-invasive fibrosis markers during rapid postoperative weight loss remains challenging, especially when biochemical improvement does not parallel fibrosis score trajectories. This study aimed to evaluate short-term changes in the fibrosis-4 (FIB-4) index following laparoscopic sleeve gastrectomy and to assess concurrent changes in insulin resistance, liver enzymes, platelet count, and body mass index. We also sought to determine whether early postoperative changes in FIB-4 should be interpreted cautiously during the active weight-loss period.Material and Method: This retrospective single-center study included 91 patients who underwent LSG between 2023 and 2025. Preoperative and postoperative data obtained during a follow-up period of 6–12 months included body weight, body mass index (BMI), liver enzymes, platelet count, fasting glucose, and fasting insulin. FIB-4 and HOMA-IR were calculated from routine laboratory measurements. Ultrasonographic steatosis was graded from 0 to 3. Pre- and postoperative comparisons were performed using non-parametric methods.Results: The cohort had a mean age of 39.19 ± 10.03 years and was predominantly female (80.2%). Significant postoperative reductions were observed in weight (118.92 ± 19.59 kg vs. 93.44 ± 17.70 kg, p