Study of the Link Between MASH ( Metabolic Dysfunction-Associated Steatohepatitis) and MAMs (Mitochondria-Associated Membranes ) Alteration in Patients Undergoing Bariatric Surgery - MAMBA

• Bariatric surgery (Sleeve Gastrectomy or Gastric Bypass) (Procedure): Patients undergoin bariatric surgery with simultaneous liver biopsy to analyze MAMs alterations in liver and PBMCs. Follow-up assessments at 6 and 12 months.

Primary outcomes

• MAMs alterations in hepatocytes [Baseline (T0)]: Number of MAM contacts in liver cells at baseline (T0)

Secondary outcomes

• MAMs alterations in non-parenchymal liver cells (T0) [Baseline (T0)]: Number of MAM contacts in non-parenchymal liver cells at baseline (T0)
• MAMs alterations in PBMCs (T0, T6, T12 months) [Baseline (T0) , T6, T12 months]: Number of MAM contacts in PBMCs
• Changes in hepatic markers of MASLD post-surgery [T0 to T6, T6 to T12, T0 toT12 (months)]: Changes in measurements, of Vibration Controlled Transient Elastographt (VCTE) after bariatric surgery (∆T0-T6months, ∆T6-T12months and ∆T0-T12months).
• Changes in hepatic markers of MASLD post-surgery (2) [T0 to T6, T6 to T12, T0 toT12 (months)]: Controlled attenuation Parameter (CAP), after bariatric surgery (∆T0-T6months, ∆T6-T12months and ∆T0-T12months).
• Correlation between MASH improvement and MAMs changes [T0-T12 months]: Correlation between MASH improvement and MAMs changes

Sex: All, ages: 18 Years to 99 Years

* Inclusion Criteria * :

  * Female or male adult patients
  * Patient who has benefited from a pluridisciplinary evaluation (medical, surgical, psychiatric), with a favorable opinion for a sleeve gastrectomy or a gastric bypass.
  * Patient with an indication Indication for intraoperative liver biopsy due to suspected MASH
  * Patient who agrees to be included in the study and who signs the informed consent form,
  * Patient affiliated to a healthcare insurance plan.
* Exclusion Criteria * :

  * Patient presenting Hepatitis B as defined as presence of hepatitis B surface antigen (HBsAg).
  * Patient presenting previous or current infection with Hepatitis C
  * Autoimmune hepatitis as defined by anti-nuclear antibody (ANA) of 1:160 or greater and liver histology consistent with autoimmune hepatitis or previous response to immunosuppressive therapy.
  * Patient presenting Autoimmune cholestatic liver disorders as defined by elevation of alkaline phosphatase and anti-mitochondrial antibody of greater than 1:80 or liver histology consistent with primary biliary cirrhosis or elevation of alkaline phosphatase and liver histology consistent with sclerosing cholangitis.
  * Patient presenting Wilson disease as defined by ceruloplasmin below the limits of normal and liver histology consistent with Wilson disease.
  * Patient presenting Alpha-1-antitrypsin deficiency as defined by alpha-1-antitrypsin level less than normal and liver histology consistent with alpha-1-antitrypsin deficiency.
  * Patient presenting Hemochromatosis as defined by presence of 3+ or 4+ stainable iron on liver biopsy and homozygosity for C282Y or compound heterozygosity for C282Y/H63D.
  * Patient presenting Drug-induced liver disease as defined on the basis of typical exposure and history.
  * Patient presenting Bile duct obstruction as shown by imaging studies.
  * History of ingestion of medications known to produce steatosis, such as corticosteroids, high-dose estrogen, tamoxifen, methotrexate, amiodarone or tetracycline in the previous 6 months.
  * Evidence of cirrhosis or previously known cirrhosis based on the results from previous liver biopsy or history of portal hypertension presented by ascites, hepatic encephalopathy or varices
  * Consommation régulière et/ou excessive d'alcool (plus de 30g/j pour les hommes et plus de 15 g/j pour les femmes) sur une période de plus de 2 ans au cours des 10 dernières années.
  * History of known HIV infection
  * History of type 1 diabetes
  * Pregnant women or breastfeeding mothers*.
  * Minor patient
  * Patient deprived of liberty,
  * Patients under psychiatric care
  * Patients admitted to a health or social care establishment for purposes other than research
  * Mentally unbalanced patients, under supervision or guardianship,
  * Patients not affiliated to a social security scheme or benefiting from a similar scheme
  * Patient who does not understand French/ is unable to give consent,
  * Patient already included in a trial who may interfere with the study