Liver steatosis (LS) evaluated through chemical-shift magnetic resonance imaging liver enzymes in morbid obesity; effect of weight loss obtained with intragastric balloon gastric banding

Abstract

The aim of this study was to evaluate in morbid obesity clinical and metabolic effects related to weight loss on liver steatosis (LS), measured through chemical-shift magnetic resonance imaging (MRI) and liver enzymes. Forty obese subjects (8 M/32 W; BMI 42.8 ± 7.12 kg/m(2), mean ± SD) were evaluated for LS through ultrasound (US-LS), chemical-shift MRI (MRI-LS), liver enzymes [aspartate aminotransferase (AST), alanine aminotransferase (ALT), γ-glutamyltransferase (GGT), alkaline phosphatase (ALP)], anthropometric parameters [weight, BMI, waist circumference (WC)], lipids, insulin, insulin resistance (HOMA-IR), glycated hemoglobin (HbA1c), oral glucose tolerance test, and body composition [fat mass (FM) and fat-free mass (FFM) at bio-impedance analysis (BIA)]. Anthropometric measures, MRI-LS, BIA, and biochemical parameters were reevaluated 6 months later in 18 subjects undergoing restrictive bariatric approach, i.e., intragastric balloon (BIB, n = 13) or gastric banding (LAGB, n = 5), and in 13 subjects receiving hypocaloric diet. At baseline, US-LS correlates only with MRI-LS, and the latter correlates with ALT, AST, and GGT. After 6 months, subjects undergoing BIB or LAGB had significant changes of BMI, weight, WC, ALT, AST, GGT, ALP, HbA1c, insulin, HOMA-IR, FM, FFM, and MRI-LS. Diet-treated obese subjects had no significant change of any parameter under study; change of BMI, fat mass, and fat-free mass was significantly greater in LAGB/BIB subjects than in diet-treated subjects. Change of MRI-LS showed a significant correlation with changes in weight, BMI, WC, GGT, ALP, and basal MRI-LS. Significant weight loss after BIB or LAGB is associated with decrease in chemical-shift MRI-LS and with reduction in liver enzymes; chemical-shift MRI and liver enzymes allow monitoring of LS in follow-up studies.

Efficacy and safety of intragastric balloon in the treatment of obesity in adolescent females

“…These findings were corroborated by studies in adults using IB treatment [12,24,25]. Improvement in insulin resistance and serum insulin concentrations are key points to positive changes in the metabolic profile during weight loss.…”

“…Improvement in insulin resistance and serum insulin concentrations are key points to positive changes in the metabolic profile during weight loss. The rapid decline in insulinemia can be explained by the reduction in adipose tissue, leptin, and proinflammatory cytokine concentrations, such as TNF-α and interleukin-6 [25].…”

Bariatric surgery and prevention of cardiovascular events and mortality in morbid obesity: Mechanisms of action and choice of surgery

“…A number of alternative procedures to bariatric surgery, such as intragastric balloons, and endobarriers, has been evaluated in short term studies. All these procedures are temporary, and, though promising in their weight-loss effect 63,88 , have not been substantiated by data on prevention of CV events or CV mortality. …”

Intragastric Balloon (BIB) for the Management of Obesity, Report on the First Egyptian Experience

“…After 6months of studying 40 obese patients with BMI 42.8 ± 7.12 kg/m 2 , subjects undergoing BIB had significant changes of BMI, weight, liver biochemical profile, HbA1c, insulin, HOMA-IR, fat mass, fat free mass, and MRI-LS. On the other hand, diet-treated obese subjects had no significant change of any parameter under study [24].…”

“…In a recent research done by Folini et al (2014). The authors measured the improvement in liver steatosis by chemical-shift magnetic resonance imaging (MRI-LS) and liver enzymes.…”