Effects of bariatric surgery on nonalcoholic fatty liver disease: Preliminary findings after 2 years

Furuya, Carlos K; Oliveira, Cláudia Pinto Marques Souza de; Mello, Evandro Sobroza de; Faintuch, Joel; Raskovski, Alessandra; Matsuda, Mitsuhiko; Vezozzo, Denise Cerqueira Paranaguá; Halpern, Alfredo; Garrido, Arthur B.; Alves, Venâncio Avancini Ferreira; Carrilho, Flair José

doi:10.1111/j.1440-1746.2007.04833.x

Cited by 176 publications

(119 citation statements)

References 24 publications

(43 reference statements)

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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%

“…A controlled study conducted by Furuya et al, 118 which enrolled 18 individuals who underwent a wedge biopsy during RYGB and a percutaneous biopsy two years later, showed that, after a mean excess weight loss of 60%, steatosis disappeared in 84% of the patients, fibrosis in 75% and ballooning in 50%. A slight lobular inflammatory infiltrate remained in 81%, apparently unrelated to fatty degeneration.…”

Section: Roux-en-y Gastric Bypassmentioning

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: Resultsmentioning

confidence: 99%

Section: Roux-en-y Gastric Bypassmentioning

confidence: 99%

Nonalcoholic fatty liver disease and bariatric surgery: a comprehensive review

2017

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“…Previous studies in morbidly obese subjects who underwent bariatric surgery for significantly more restrictive dietary control have shown improvement in fibrosis in repeat liver biopsies 2 years after surgery. [17][18][19] It can be speculated that with more prolonged follow up, fibrosis might have improved in these patients because improvement in ballooning degeneration was seen after 9 months of treatment.…”

Section: Discussionmentioning

confidence: 99%

Orlistat for overweight subjects with nonalcoholic steatohepatitis: A randomized, prospective trial

Fecht²,

et al. 2008

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The aim of this study was to determine if orlistat, an inhibitor of fat absorption, combined with caloric restriction in overweight subjects with nonalcoholic steatohepatitis results in weight loss and improved liver histology. Fifty overweight subjects (body mass index ‫؍‬ >27) with biopsy proven nonalcoholic steatohepatitis were randomized to receive a 1,400 Kcal/day diet plus vitamin E (800 IU) daily with or without orlistat (120 mg three times a day) for 36 weeks. Liver biopsies were repeated at week 36. Twenty-three subjects in the orlistat/diet/vitamin E group and 18 in the diet/vitamin E group completed the study. The mean age was 47 ؎ 9.0 (standard deviation) years and mean body mass index was 36.4 ؎ 6.3 kg/m 2 . Four subjects were diabetic. The orlistat group lost a mean of 8.3% body weight compared to 6.0% in the diet plus vitamin E group (not significant). Both groups also had similarly improved serum aminotransferases, hepatic steatosis, necroinflammation, ballooning, and nonalcoholic fatty liver disease activity scores. Stratified according to weight loss instead of treatment group, a loss of >5% body weight (n ‫؍‬ 24) compared to <5% body weight (n ‫؍‬ 17) correlated with improvement in insulin sensitivity (P ‫؍‬ 0.001) and steatosis (P ‫؍‬ 0.015). Comparing subjects who lost >9% of body weight (n ‫؍‬ 16), to those that did not (n ‫؍‬ 25), improved insulin sensitivity (P < 0.001), adiponectin (P ‫؍‬ 0.03), steatosis (P ‫؍‬ 0.005), ballooning (P ‫؍‬ 0.04), inflammation (P ‫؍‬ 0.045), and nonalcoholic fatty liver disease activity score (P ‫؍‬ 0.009) were seen. Increases in adiponectin strongly correlated with improved ballooning and nonalcoholic fatty liver disease activity score (P ‫؍‬ 0.03). Orlistat did not enhance weight loss or improve liver enzymes, measures of insulin resistance, and histopathology. However, subjects who lost >5% of body weight over 9 months improved insulin resistance and steatosis, and those subjects who lost >9% also achieved improved hepatic histologic changes. (HEPATOLOGY 2009;49:80-86.)

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“…One of the most effective and permanent methods for weight loss is bariatric surgery. Recent studies revealed some improvements in steatosis, inflammation, and liver fibrosis after bariatric surgery, but its efficiency for fatty liver and metabolic disorders was not proven so far (16)(17)(18)(19)(20)(21)(22)(23)(24). In contrast to several studies in this matter, there is a lack of a serum marker, which could be a decent predictive of NAFLD or the severity of NASH disease.…”

Section: Backgroundsmentioning

confidence: 70%

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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Effects of bariatric surgery on nonalcoholic fatty liver disease: Preliminary findings after 2 years

Abstract: Aspects of NAFLD including steatohepatitis improved significantly with massive weight loss at 2 years after RYGB surgery. No patient in this series had progression of hepatic fibrosis.

Cited by 176 publications

References 24 publications

Nonalcoholic fatty liver disease and bariatric surgery: a comprehensive review

Nonalcoholic fatty liver disease and bariatric surgery: a comprehensive review

Orlistat for overweight subjects with nonalcoholic steatohepatitis: A randomized, prospective trial

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

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