Non-Alcoholic Steatohepatitis: Effect of Roux-en-Y Gastric Bypass Surgery

Barker, Kevin B.; Palekar, Nicole; Bowers, Steven P.; Goldberg, Joel; Pulcini, Joseph P.; Harrison, Stephen A.

doi:10.1111/j.1572-0241.2006.00419.x

Cited by 198 publications

(137 citation statements)

References 18 publications

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“…Unfortunately, we had only 11 liver biopsies taken at 1 year follow-up. As expected (44)(45)(46), they consistently showed improved histology (data not shown).…”

Section: Discussionsupporting

confidence: 55%

Lipoprotein subclass metabolism in nonalcoholic steatohepatitis

Männistö

Simonen

Soininen

et al. 2014

Journal of Lipid Research

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“…Unfortunately, we had only 11 liver biopsies taken at 1 year follow-up. As expected (44)(45)(46), they consistently showed improved histology (data not shown).…”

Section: Discussionsupporting

confidence: 55%

Lipoprotein subclass metabolism in nonalcoholic steatohepatitis

Männistö

Simonen

Soininen

et al. 2014

Journal of Lipid Research

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“…Considering the possible ominous risks of NAFLD/NASH, especially endstage liver disease and liver cancer, this benefit is even more pronounced. [12][13][14][15][16][17][18][35][36][37] This study has some limitations, especially its use of data collected from the medical records, which may provide data of poor quality and may lead to the impossibility of evaluating a considerable number of individuals, because of incomplete medical reports. In this study, incomplete medical records caused high loss of subjects who might have been suitable for analysis.…”

Section: Discussionmentioning

confidence: 99%

Influence of type 2 diabetes mellitus on liver histology among morbidly obese individuals. A cross-sectional study

et al. 2016

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CONTEXT AND OBJECTIVE: Nonalcoholic fatty liver disease (NAFLD) has become a public health concern. It encompasses a wide spectrum of histological abnormalities and has close relationships with insulin resistance and type 2 diabetes mellitus (T2DM). This study sought to compare the histological alterations observed in morbidly obese individuals with and without T2DM who underwent Roux-en-Y gastric bypass. DESIGN AND SETTING: Cross-sectional study in a tertiary-level public hospital.METHODS: This was a cross-sectional study on 197 individuals who underwent gastric bypass surgery between 2011 and 2013. NAFLD was assessed through liver biopsies. T2DM was diagnosed through the International Diabetes Federation criteria. RESULTS: Non-diabetics presented significantly more biopsies without any histological abnormalities, regarding steatosis (42.6% versus 25.5%; P = 0.0400), fibrosis (60.6% versus 36.2%; P = 0.0042) and steatohepatitis (27.3% versus 12.8%; P = 0.0495), while diabetics presented significantly higher frequency of moderate forms of steatosis (36.2% versus 20%; P = 0.0307) and fibrosis (23.4% versus 4%; P = 0.0002). DISCUSSION: T2DM was associated with more advanced forms of NAFLD within the population studied. NAFLD has previously been correlated with severe forms of heart disease. CONCLUSION: Screening for and early detecting of NAFLD in high-risk populations are important for avoiding further development of severe forms and the need for liver transplantation. RESUMO CONTEXTO E OBJETIVO:A doença gordurosa não alcoólica do fígado se tornou um problema de saúde pública. Ela compreende um amplo espectro de alterações histológicas e se relaciona intimamente com a resistência insulínica e o diabetes mellitus tipo 2. Este estudo tem por objetivo comparar as alterações histológicas observadas em obesos mórbidos com e sem diabetes submetidos ao bypass gástrico em Y de Roux. TIPO DE ESTUDO E LOCAL: Estudo transversal em um hospital terciário público. MÉTODOS: Este é um estudo transversal que envolveu 197 indivíduos submetidos ao bypass gástrico entre 2011 e 2013. A doença gordurosa do fígado foi avaliada através de biópsia hepática. O diabetes mellitus tipo 2 foi diagnosticado através dos critérios da Federação Internacional de Diabetes. RESULTADOS: Indivíduos não diabéticos apresentaram significativamente mais biópsias sem anormalidades histológicas, em relação a esteatose (42,6% versus 25,5%; P = 0.04), fibrose (60,6% versus 36,2%; P = 0.0042) e esteato-hepatite (27,3% versus 12,8%; P = 0.0495); os diabéticos apresentaram uma frequên-cia significativamente mais alta de formas moderadas de esteatose (36,2% versus 20%; P = 0.0307) e fibrose (23,4% versus 4%; P = 0.0002). DISCUSSÃO: O DM-2 associou-se a formas mais avançadas de doença gordurosa do fígado dentro da população estudada. A doença gordurosa não alcoólica do fígado foi associada previamente com formas graves de doença cardíaca. CONCLUSÃO: A busca e detecção precoce da doença gordurosa em populações de alto risco são importantes para evitar o fut...

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“…77 Further evidence for the benefit of weight loss is provided by the observation that 89% of morbidly obese patients with NASH, who had gastric bypass surgery, no longer had the histological criteria for NASH at repeat liver biopsy, after successful postoperative weight loss. 78 As with all chronic liver diseases, avoidance of alcohol is a wise precaution. It is self-evident that other features of the metabolic syndrome should be screened for and treated in patients with NAFLD.…”

Section: Diagnosing Fatty Livermentioning

confidence: 99%