Changes in Liver Histology Accompanying Massive Weight Loss after Gastroplasty for Morbid Obesity

Stratopoulos, Charalabos; Papakonstantinou, Alexandros; Terzis, Ioannis; Spiliadi, Charis; Dimitriades, George; Komesidou, Vasiliki; Kitsanta, Panagiota; Argyrakos, Theodoros; Hadjiyannakis, E

doi:10.1381/0960892055002239

Cited by 120 publications

(75 citation statements)

References 31 publications

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“…In the current study, 85% of the subjects were associated with NASH reported more scarcely in previous studies (14,(25)(26)(27)(28). This difference of prevalence is discussed further.…”

Section: Discussioncontrasting

confidence: 41%

Predictive Factors of Steatosis and Non-Alcoholic Steatohepatitis in Morbidly Obese Patients Undergoing Bariatric Surgery

et al. 2017

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Background and Objectives: Obesity is one of the most health-threatening phenomena. It is estimated that over 1 billion adults have overweight or obesity. The current study aimed at presenting a detailed account of the findings that attempted to predict the severity of fatty liver disease and its sequelae, including non-alcoholic steatohepatitis (NASH), fibrosis, and cirrhosis, by correlating biopsy results with liver function tests and various metabolic markers of laboratory results in patients with morbid obesity.

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“…In the current study, 85% of the subjects were associated with NASH reported more scarcely in previous studies (14,(25)(26)(27)(28). This difference of prevalence is discussed further.…”

Section: Discussioncontrasting

confidence: 41%

Predictive Factors of Steatosis and Non-Alcoholic Steatohepatitis in Morbidly Obese Patients Undergoing Bariatric Surgery

et al. 2017

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“…[115][116][117][118][119][120][121][122][123][124][125][126][127][128][129][130][131][132][133] A schematic representation of the search in the online databases and the identification, exclusion and selection of the articles is presented in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

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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“…It has been proven that lifestyle modification and regular physiological exercise will regulate the individual's body weight and improve NASH and the associated metabolic syndrome [3][4][5] . However, if there is no change in the course of disease after adequate lifestyle changes, pharmacological interventions should be considered, especially for those patients at a high risk of progression.…”

Section: Introductionmentioning

confidence: 99%

Protective effects of tiopronin against high fat diet-induced non-alcoholic steatohepatitis in rats

et al. 2012

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Aim: To study the protective effects of tiopronin against high fat diet-induced non-alcoholic steatohepatitis in rats. Methods: Male Sprague-Dawley rats were given a high-fat diet for 10 weeks. The rats were administered tiopronin (20 mg/kg) or a positive control drug ursodeoxycholic acid (UDCA, 15 mg/kg) via gavage daily from week 5 to week 10. After the rats were sacrificed, serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total cholesterol (TC), triglyceride (TG), free fatty acids (FFA), high-density lipoprotein (HDL-C) and low-density lipoprotein (LDL-C), and liver homogenate FFA, superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and malondialdehyde (MDA) were measured using commercial analysis kits. The expression levels of CYP2E1 mRNA and protein were determined using RT-PCR and immunoblot assays, respectively. Results: Tiopronin significantly lowered both the serum ALT and AST levels, while only the serum ALT level was lowered by UDCA. Tiopronin significantly decreased the serum and liver levels of TG, TC and FFA as well as the serum LDL-C level, and increased the serum HDL-C level, while UDCA decreased the serum and liver TC levels as well as the serum LDL-C level, but did not change the serum levels of TG, FFA and HDL-C. Tiopronin apparently ameliorated the hepatocyte degeneration and the infiltration of inflammatory cells in the livers, but UDCA did not affect the pathological features of the livers. Both tiopronin and UDCA ameliorated the mitochondrial abnormality in the livers. The benefits of tiopronin were associated with increased SOD and GSH-Px activities, and with decreased MDA activity and CYP2E1 expression in the livers. Conclusion: Tiopronin exerts protective effects against non-alcoholic steatohepatitis in rats, which may be associated with its antioxidant properties and regulation of lipid metabolism.

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Changes in Liver Histology Accompanying Massive Weight Loss after Gastroplasty for Morbid Obesity

Abstract: NASH improved significantly with massive weight loss in non-diabetic, non-alcoholic, morbidly obese subjects, while fibrosis improved in nearly half of the patients.

Cited by 120 publications

References 31 publications

Predictive Factors of Steatosis and Non-Alcoholic Steatohepatitis in Morbidly Obese Patients Undergoing Bariatric Surgery

Predictive Factors of Steatosis and Non-Alcoholic Steatohepatitis in Morbidly Obese Patients Undergoing Bariatric Surgery

Nonalcoholic fatty liver disease and bariatric surgery: a comprehensive review

Protective effects of tiopronin against high fat diet-induced non-alcoholic steatohepatitis in rats

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