Esteato-hepatite não-alcoólica em pré-operatório de bypass gástrico: ausência de correlação com grau de obesidade

Cordeiro, Lúcia Helena de Oliveira; Campos, Josemberg Marins; Paula, Patrícia S. de; Vilar, Lúcio; Lopes, Edmundo Pessoa de Almeida; Arruda, Pedro Carlos Loureiro de; Ramos, Almino Cardoso; Ferraz, A.

doi:10.1590/s0102-67202013000600009

Cited by 7 publications

(3 citation statements)

References 16 publications

(19 reference statements)

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“…It is clear that while weight loss plays an important role in controlling metabolic abnormalities, this effect appears to be more significant over the long term. [158][159][160] Furthermore, there is evidence that excess weight is not the main pathophysiological feature relating to NAFLD. 158 The causes of early improvement of MetS after bariatric surgery are complex and relate to changes on the entero-insular axis mediated by gastrointestinal hormones called incretins.…”

Section: Mechanisms Underlying Post-surgical Improvements In Nafldmentioning

confidence: 99%

“…[158][159][160] Furthermore, there is evidence that excess weight is not the main pathophysiological feature relating to NAFLD. 158 The causes of early improvement of MetS after bariatric surgery are complex and relate to changes on the entero-insular axis mediated by gastrointestinal hormones called incretins. [160][161][162] The anatomical changes caused by the surgical procedures, particularly duodenal exclusion and overflow of nutrients to the distal small bowel, lead to release of incretins, especially glucagon-like peptide 1 (GLP-1) and gastrointestinal insulinotropic polypeptide (GIP).…”

Section: Mechanisms Underlying Post-surgical Improvements In Nafldmentioning

confidence: 99%

“…160 Recent research has indicated that surgery leads to changes in the gut microbiota and bile acid circulation that may be beneficial regarding MetS and NAFLD. [158][159][160][161][162] Furthermore, there is a decrease in portal influx of free fatty acids following surgery, which may be related both to feeding restrictions and to metabolic changes in visceral insulin sensitivity.…”

Section: Mechanisms Underlying Post-surgical Improvements In Nafldmentioning

confidence: 99%

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Nonalcoholic fatty liver disease and bariatric surgery: a comprehensive review

2017

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CONTEXT AND OBJECTIVE: Nonalcoholic fatty liver disease (NAFLD) has been increasingly diagnosed worldwide and is now recognized as a source of public health concern. It comprises a wide spectrum of histological features that range from simple steatosis to severe forms of fibrosis, steatohepatitis and even cirrhosis. The impact of bariatric surgery on the course of NAFLD in individuals with obesity has been extensively studied. DESIGN AND SETTING: Narrative review; public university hospital. METHODS: A comprehensive review was conducted based on an online search on the electronic databases MEDLINE and LILACS using the MeSH terms "fatty liver" and "bariatric surgery". RESULTS:The exact mechanisms that lead to improvement in NAFLD following bariatric surgery are not completely understood. Since Roux-en-Y gastric bypass (RYGB) is the bariatric surgical procedure most performed worldwide, it is also the one from which the effects on NAFLD have been most studied, although there is also consistent evidence regarding the effects from gastric banding, sleeve gastrectomy and biliopancreatic diversions. CONCLUSION: According to the currently available evidence, bariatric surgery leads to significant improvement in NAFLD. Further research, especially by means of randomized controlled trials enrolling larger cohorts of individuals, is needed to determine the optimal procedure for this group of subjects. RESUMO CONTEXTO E OBJETIVO:A doença hepática gordurosa não alcoólica (DHGNA) tem sido diagnosticada com maior frequência em todo o mundo na atualidade, sendo agora reconhecida como motivo de preocupação em saúde pública. Abrange um amplo espectro de alterações histológicas que variam desde a simples esteatose até formas graves de fibrose, esteato-hepatite e até cirrose. O impacto da cirurgia bariátrica sobre o curso da DHGNA em indivíduos com obesidade tem sido profundamente estudado. TIPO DE ESTUDO E LOCAL: Revisão narrativa; hospital universitário público. MÉTODOS: Uma revisão abrangente da literatura foi conduzida baseada na pesquisa on-line nas bases de dados eletrônicas MEDLINE e LILACS por meio dos termos MeSH "fígado gorduroso" e "cirurgia bariátrica". RESULTADOS: Os mecanismos exatos que levam à melhora da DHGNA após a cirurgia bariátrica não são completamente conhecidos. Como o bypass gástrico em Y de Roux é a cirurgia bariátrica mais realizada em todo o mundo, é também o procedimento cujos efeitos sobre DHGNA foram mais estudados, embora haja também evidências consistentes sobre os efeitos de banda gástrica, gastrectomia vertical e derivações biliopancreáticas. CONCLUSÃO: De acordo com as evidências atualmente disponíveis, a cirurgia bariátrica leva à melhora significativa da DHGNA. Mais estudos, especialmente por meio de ensaios clínicos randomizados e controlados, recrutando coortes maiores de indivíduos, são necessários para determinar o melhor procedimento para esse grupo de pacientes.

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Section: Mechanisms Underlying Post-surgical Improvements In Nafldmentioning

confidence: 99%

Section: Mechanisms Underlying Post-surgical Improvements In Nafldmentioning

confidence: 99%

Section: Mechanisms Underlying Post-surgical Improvements In Nafldmentioning

confidence: 99%

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Nonalcoholic fatty liver disease and bariatric surgery: a comprehensive review

2017

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Benefit of Physical Activity before Surgery: Improvement of Comorbidities and Reduction of Operative Risk

Marc-Hernández

Hernández

2023

Physical Activity and Bariatric Surgery

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Mechanisms linking bariatric surgery to adipose tissue, glucose metabolism, fatty liver disease and gut microbiota

Latteri

Miceli

Puleo

et al. 2023

Langenbecks Arch Surg

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Purpose In the last 20 years, bariatric surgery has achieved an important role in translational and clinical research because of obesity comorbidities. Initially, a tool to lose weight, bariatric surgery now has been shown to be involved in several metabolic pathways. Methods We conducted a narrative review discussing the underlying mechanisms that could explain the impact of bariatric surgery and the relationship between obesity and adipose tissue, T2D, gut microbiota, and NAFLD. Results Bariatric surgery has an impact in the relation between obesity and type 2 diabetes, but in addition it induces the white-to-brown adipocyte trans-differentiation, by enhancing thermogenesis. Another issue is the connection of bariatric surgery with the gut microbiota and its role in the complex mechanism underlying weight gain. Conclusion Bariatric surgery modifies gut microbiota, and these modifications influence lipid metabolism, leading to improvement of non-alcoholic fatty liver disease.

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Esteato-hepatite não-alcoólica em pré-operatório de bypass gástrico: ausência de correlação com grau de obesidade

Abstract: Nonalcoholic steatohepatitis is highly prevalent in morbidly obese patients, but there was no positive correlation between aminotransferases and degree of obesity and liver histopathology. Hypertriglyceridemia and waist-hip ratio were positively correlated with the intensity of disease.

Cited by 7 publications

References 16 publications

Nonalcoholic fatty liver disease and bariatric surgery: a comprehensive review

Nonalcoholic fatty liver disease and bariatric surgery: a comprehensive review

Benefit of Physical Activity before Surgery: Improvement of Comorbidities and Reduction of Operative Risk

Mechanisms linking bariatric surgery to adipose tissue, glucose metabolism, fatty liver disease and gut microbiota

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