Endoscopy 2025; 57(S 02): S157
DOI: 10.1055/s-0045-1805402
Abstracts | ESGE Days 2025
Oral presentation
Endoscopic Treatment of Metabolic Disorders 05/04/2025, 10:30 – 11:30 Room 114

Long-term effects of re-sleeve endoscopic gastroplasty with GLP-1 agonists: weight reduction, liver function improvement, and insulin resistance insights over 24 months

E Gadour
1   King Abdulaziz Hospital, Al Mubarraz, Saudi Arabia
,
A Almuhaidb
2   King Faisal Specialist Hospital ' Research Centre, Riyadh, Saudi Arabia
,
S Al Ghamdi
3   King Abdulaziz University Hospital, Jeddah, Saudi Arabia
,
A Alfadda
4   Riyadh, Riyadh, Saudi Arabia
,
E Eljahdli
3   King Abdulaziz University Hospital, Jeddah, Saudi Arabia
,
E Abufarhaneh
2   King Faisal Specialist Hospital ' Research Centre, Riyadh, Saudi Arabia
,
A C Hoff
5   Angioskope Clinic, São Paulo, Brazil
› Author Affiliations
 

Aims Bariatric procedures are often utilized for obesity. Combining resleeve endoscopic gastroplasty with GLP-1 agonists is a novel approach to achieving long-term weight loss, but its extended efficacy on weight reduction, metabolic health, liver function, and gastrointestinal issues, such as gastroesophageal reflux disease (GERD), requires further evaluation. GLP-1 agonists, such as Semaglutide, have been widely researched for their ability to enhance the outcomes of endoscopic and surgical bariatric procedures by suppressing appetite, promoting satiety, and exerting beneficial metabolic effects. We aim to assess the long-term effects of this combined therapeutic approach on liver function, as evidenced by changes in triglyceride levels and liver enzymes was also examined in this study.

Methods This is a prospective clinical trial that examines the long-term outcomes of the pre and post re-sleeve gastroplasty in combination with the GLP-1 agonists over a 24-month period. All recruited patients who met the inclusion criteria were properly consented and monitored thought the study period of 24 months. Multiple variables were studied including changes in patient weight, liver enzymes, and insulin resistance indicators. Testing for statistically significant differences between means of continuous variables grouped by a categorical variable (procedure type) was performed using the ANOVA test. Testing for statistically significant differences among categorical variables was performed using the Chi-sq test.

Results The study cohort included 48 patients, mostly females (n=41) with a mean age of 36 years, who underwent the resleeve procedure with GLP-1 agonist therapy. The most common comorbidity was steatosis (n=28), followed by diabetes mellitus (n=21). Most patients had 3 sutures. The mean weight decreased consistently throughout the study period, from a decrease of 5.9±1.9 kg at 1 month follow up to 18.4±4.6 kg at 24 months follow up. Meanwhile, GLP and HOMA-IR were mostly unchanged at 24 months. Mean triglyceride, ALT, and AST levels all decreased at 24 months, although a slight increase in mean ALT was noted at 12 months. Similarly, mean Fibroscan scores and BFM decreased at 12 and 24 months. The prevalence of GERD was significantly reduced in the study population, with some patients experiencing full resolution of symptoms. No significant risks of medullary thyroid cancer were identified. Physical exercise and dietary adherence contributed to improved metabolic outcomes [1] [2].

Conclusions Resleeve endoscopic gastroplasty with GLP-1 agonists is a compelling long-term intervention for weight loss, improving metabolic and liver health while significantly reducing GERD prevalence. These findings support the potential of this combined approach in managing obesity and its related comorbidities. However, the minimal changes observed in insulin resistance markers highlight the need for personalized therapeutic strategies to maximize the metabolic benefits and fully address insulin resistance.



Publication History

Article published online:
27 March 2025

© 2025. European Society of Gastrointestinal Endoscopy. All rights reserved.

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