Effect of Bariatric Surgery on Liver Fibrosis

Moretto, Myriam; Kupski, Carlos; Silva, Vinícius Duval da; Padoin, Alexandre Vontobel; Mottin, Cláudio Corá

doi:10.1007/s11695-011-0559-y

Cited by 103 publications

(52 citation statements)

References 18 publications

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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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Section: Resultsmentioning

confidence: 99%

Nonalcoholic fatty liver disease and bariatric surgery: a comprehensive review

2017

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“…Patients suffering from liver fibrosis are easy to developing into liver cirrhosis, which was associated with severe mortality (Pellicoro et al, 2014;Kochanek et al, 2016). Although much improvement has been made on the patients with liver fibrosis based on the prevalent therapeutic methods, such as radiotherapy, chemotherapy and surgery, the prognosis remains poor (Justinger et al, 2015;Li et al, 2012a;Moretto et al, 2012). However, to fully understand the pathogenesis of fibrosis is necessary for its further treatment.…”

Section: Introductionmentioning

confidence: 99%

MiR-29a and miR-652 Attenuate Liver Fibrosis by Inhibiting the Differentiation of CD4+ T Cells

Xuan

Guo

Huang

et al. 2017

Cell Struct. Funct.

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ABSTRACT. Background: Liver fibrosis is the response of liver diseases that puzzles patients. MiRNAs were involved in the regulating processes of liver fibrosis. This study aims to investigate the effects of ARRB1 mediated by miR-29a and miR-652 on liver fibrosis and its possible mechanism. Methods: Liver fibrosis of mice was induced by intraperitoneal injection of CCl 4 . Liver function was observed by the levels of alanine transaminase (ALT) and aspartate transaminase (AST). Flow cytometry was used to detect the percent of T helper17 (Th17). ELISA (Enzyme linked immunoassay) was used to detect the levels of

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“…In recent years, bariatric surgery has become an important therapeutic option for MO. Some studies document a significant reduction of fibrosis in liver biopsies conducted during the surgery and after weight loss in these patients (5,10,13,15) . However, the same works report that, if the degree of fibrosis is advanced, the chances of regression reduce, moreover, there is an increase in morbimortality after bariatric surgery in patients with advanced fibrosis.…”

Section: Discussionmentioning

confidence: 99%

“…The results of this surgery have determined an improvement in the hepatic histopathology of these patients (10,13) . On the other hand, the need for liver biopsy in pre-operative evaluation has been the object of discussion, in some selected cases, considering that patients with advanced fibrosis in pre-operation have increased risk of decompensation in the post-operative, increasing morbimortability of this surgical modality (3,14,20) .…”

Section: Introductionmentioning

confidence: 96%

Nonalcoholic Fatty Liver Disease in Severe Obese Patients, Subjected to Bariatric Surgery

Losekann

Weston

Carli

et al. 2013

Arq. Gastroenterol.

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-Context -Nonalcoholic fatty liver disease encompasses a spectrum of histopathological changes that range from simple steatosis to nonalcoholic steatohepatitis. Works suggest that iron (Fe) deposits in the liver are involved in the physiopathology of nonalcoholic steatohepatitis. Objective -The aim of this study was to determine the prevalence of simple steatosis and nonalcoholic steatohepatitis in patients with morbid obesity, subjected to bariatric surgery and to establish a correlation of the anatomopathological findings with the presence of liver fibrosis. Methods -A total of 250 liver biopsies were conducted in the transoperation of the surgeries. were moderate, and 6 (2.4%) cases were intense. Fibrosis was referred to in 108 (43.2%) biopsies, 95 of which (38%) were mild; 2 (0.8%) were moderate; 7 (2.8%) were intense, and cirrhosis was diagnosed in 4 (1.6%) cases. There was a correlation between the degree of steatosis and the level of inflammatory activity (r s = 0.460; P<0.001) and between the degree of this activity and the degree of fibrosis (r s = 0.583; P<0.001). Only 13 (5.2%) samples showed Fe deposits. Conclusion -There is a high prevalence of nonalcoholic steatohepatitis in these patients and a positive correlation of the degrees of nonalcoholic steatohepatitis with the intensity of fibrosis. The low prevalence of Fe deposits found makes it questionable that the presence of this ion has any participation in the physiopathogeny of nonalcoholic fatty liver disease. HEADINGS -Fatty Liver. Liver cirrhosis. Morbid obesity. Bariatric surgery. Iron metabolism disorders.

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Effect of Bariatric Surgery on Liver Fibrosis

Abstract: Weight loss in morbidly obese patients was associated with a reduction in the prevalence of hepatic fibrosis.

Cited by 103 publications

References 18 publications

Nonalcoholic fatty liver disease and bariatric surgery: a comprehensive review

Nonalcoholic fatty liver disease and bariatric surgery: a comprehensive review

MiR-29a and miR-652 Attenuate Liver Fibrosis by Inhibiting the Differentiation of CD4+ T Cells

Nonalcoholic Fatty Liver Disease in Severe Obese Patients, Subjected to Bariatric Surgery

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