Effect of Endoscopic Bariatric and Metabolic Therapies on Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-analysis

Jirapinyo, Pichamol; McCarty, Thomas R.; Dolan, Russell D.; Shah, Raj; Thompson, Christopher C.

doi:10.1016/j.cgh.2021.03.017

Cited by 38 publications

(29 citation statements)

References 37 publications

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“…EMBT is safer and less invasive than bariatric surgery, making it an attractive option for patients with NAFLD who have other obesity-related complications. EBMT has been shown to improve parameters associated with NAFLD in the short term and should be further evaluated in randomised controlled trials 149,150.…”

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confidence: 99%

Changing clinical management of NAFLD in Asia

Nakatsuka

Tateishi

Koike

2021

Liver International

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Non-alcoholic fatty liver disease (NAFLD) has become the leading cause of chronic liver disease, affecting approximately 25% of the world's population. Recently, because of the sedentary lifestyle and overnutrition resulting from urbanisation, the burden of NAFLD has rapidly increased in many Asian countries. Currently, the prevalence of NAFLD in Asia is approximately 30%, as is the case in many Western countries. In Asia, the prevalence and presentation of NAFLD vary widely across regions because of the substantial diversity in race, socioeconomic status and living environment. Furthermore, the dual aetiology of fatty liver, particularly with viral hepatitis in Asia, makes it complex and challenging to manage. Because Asians are likely to have central adiposity and insulin resistance, approximately 7%-20% of non-obese Asians with body mass indexes of less than 25 kg/m 2 are estimated to have NAFLD.Accumulating evidence indicates that NAFLD is associated with various extrahepatic comorbidities such as cardiovascular disease, chronic kidney disease, malignancy, in addition to liver-specific complications. Therefore, NAFLD should be managed as a multisystem disease in conjunction with metabolic syndrome. Lifestyle modification remains the basis of NAFLD management, but few patients can achieve adequate weight loss and maintain it long term. While various pharmacological agents are in phase 3 trials for steatohepatitis, Asian patients are underrepresented in most trials.

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confidence: 99%

Changing clinical management of NAFLD in Asia

Nakatsuka

Tateishi

Koike

2021

Liver International

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“…There have not been any major studies comparing EBTs, however a recent review compared ALT and AST between the different treatment options. ALT decreased the most after IGB followed by AT and AST decreased the most after IGB followed by ESG and then AT [61]. There are advantages to either procedure.…”

Section: Discussionmentioning

confidence: 97%

Novel Endoscopic Bariatric Therapies for the Management of Nonalcoholic Steatohepatitis

et al. 2022

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Obesity is strongly associated with nonalcoholic fatty liver disease (NAFLD) as well as advanced forms of the disease such as steatohepatitis (NASH), cirrhosis, and hepatocellular carcinoma. While lifestyle and diet modifications have been the cornerstone of treatment for NASH thus far, they are only effective for less than half of the patients. New endoscopic bariatric therapies (EBT) have already proved to be safe and effective for the treatment of obesity and type 2 diabetes mellitus, and may provide an intermediate, less invasive and cost-effective option for patients with NASH. In this review, we aim to describe the data and evidence as well as outline future areas of development for endobariatric therapies for treatment of NASH. In conclusion, EBTs present an effective and safe therapeutic modality for use in the growing pandemic of obesity related liver disease and should be further investigated with large scale trials in this patient population.

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“…Endoscopic bariatric and metabolic therapies (EBMTs) have emerged as promising alternative options for the treatment of obesity and metabolic disorders, such as type 2 diabetes and nonalcoholic fatty liver disease [4][5][6]. Most procedures such as intragastric balloons, endoscopic sleeve gastroplasty, primary obesity surgery endoluminal, aspiration therapy, and transpyloric shuttle predominantly target the stomach, while other procedures such as endoscopic duodenal-jejunal bypass liner and duodenal mucosal resurfacing focus on the duodenum [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Effect of Novel Gastro-Duodenal Flow Restrictor on Relative Weight Loss and Glucose Levels in a Porcine Model: A Pilot Randomized Study

et al. 2022

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Endoscopic bariatric and metabolic therapies are promising for obesity. We developed a novel gastro-duodenal flow restrictor (G-DFR) device for relative weight loss and lowering of glucose level and evaluated its safety and efficacy in a porcine model. The G-DFR comprised self-expandable gastro-duodenal partially covered polytetrafluoroethylene (PTFE) metal stent distally attached to a PTFE skirt. Eleven juvenile pigs were randomized into the evaluation of migration (n = 3), mid-term efficacy (n = 5), and control (n = 3) groups. Five pigs showed G-DFR migration at 2, 4, 7, and 10 weeks after placement in the migration and mid-term efficacy group. Compared to the control group, the mid-term efficacy group showed up to 55.4% relative weight loss in 12 weeks. Compared to the case group, the control group showed higher mean ghrelin hormone level from 6 to 12 weeks. Glucose level was significantly lower in the efficacy group than in the control group after 6 weeks. Serum alanine transferase levels and histological collagen deposition were lower in the liver of the case group than in the control group. Although it did not demonstrate consistent performance with respect to migration, a well-positioned G-DFR in the pyloroduodenal portion may lead to relative weight loss, lowering of glucose levels, and improved hepatic parameters.

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Effect of Endoscopic Bariatric and Metabolic Therapies on Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-analysis

Cited by 38 publications

References 37 publications

Changing clinical management of NAFLD in Asia

Changing clinical management of NAFLD in Asia

Novel Endoscopic Bariatric Therapies for the Management of Nonalcoholic Steatohepatitis

Effect of Novel Gastro-Duodenal Flow Restrictor on Relative Weight Loss and Glucose Levels in a Porcine Model: A Pilot Randomized Study

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