Nonalcoholic fatty liver disease and bariatric surgery: a comprehensive review

Cazzo, Everton; Pareja, José Carlos; Chaim, Élinton Adami

doi:10.1590/1516-3180.2016.0306311216

Cited by 41 publications

(28 citation statements)

References 191 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Studies involving long-term followup of patients reveal significant decreases in AST and ALT levels after bariatric surgeries were performed. 26,27 Similarly in our study, both metabolic profile control and weight reduction might lead to the decrease in transaminase levels of our patients. Both AST and ALT decreased significantly at the end of 6 months of LSG.…”

Section: Sleeve Gastrectomy Versus Exenatide Treatmentsupporting

confidence: 76%

Comparison Between Sleeve Gastrectomy and Exenatide on Type 2 Diabetic Patients

Elbasan

Sisman

Peynirci

et al. 2020

Bariatric Surgical Practice and Patient Care

View full text Add to dashboard Cite

Background: Diabetes and obesity are major causes of mortality and morbidity that are increasing all over the world. As obesity is a major risk factor for type 2 diabetic patients, weight loss is important in the treatment of type 2 diabetic patients. In our study, our aim was to evaluate the effects of exenatide and laparoscopic sleeve gastrectomy (LSG) in obese type 2 diabetic patients on the clinical and laboratory parameters. Methods: Twenty-five LSG and 25 exenatide patients followed up in our outpatient clinic were involved in the study. Results: At the end of the 6-month follow-up, weight loss was *35.4 kg in the surgery group and 11.5 kg in the exenatide group. Although postprandial glucose and hemoglobin A1c were significantly decreased in both groups, the decrease was significantly higher in LSG group compared to the exenatide group. Although there was no significant change in fasting blood glucose (FBG) in the exenatide group, there was a significant decrease in FBG in LSG group. Conclusion: LSG is a method that should be performed up on indication and much more radical compared to exenatide administration, but appears to be a more efficient application that corrects diabetes-and obesity-related metabolic parameters compared to exenatide therapy in type 2 diabetic obese patients.

show abstract

Section: Sleeve Gastrectomy Versus Exenatide Treatmentsupporting

confidence: 76%

Comparison Between Sleeve Gastrectomy and Exenatide on Type 2 Diabetic Patients

Elbasan

Sisman

Peynirci

et al. 2020

Bariatric Surgical Practice and Patient Care

View full text Add to dashboard Cite

show abstract

“…Although the validity of our considerations is limited by the small study population, this observation may also be due to the relatively young age of our patients (41 years). Age is indeed known to be one of the most important variables influencing NASH onset and evolution; in fact, as age increases, there is also an increased incidence of insulin resistance, MS, and diabetes mellitus [35,36]. In a systematic review of this issue, Argo et al found that age was the independent predictor of advanced fibrosis (HR 0.98, 95% CI: 0.96-0.99, p = 0:009) and that young people have a lower risk for the presence of fibrosis [37].…”

Section: Discussionmentioning

confidence: 99%

The Prevalence of NAFLD and Fibrosis in Bariatric Surgery Patients and the Reliability of Noninvasive Diagnostic Methods

Soresi

Cabibi

Giglio

et al. 2020

BioMed Research International

View full text Add to dashboard Cite

Background. Bariatric surgery patients have a higher prevalence of nonalcoholic fatty liver (NAFL) than the general population; however, its assessment and the accurate staging of fibrosis are often complicated because noninvasive tests are not very accurate in patients with morbid obesity, and liver biopsy cannot be performed as a routine exam. The aim of this study was to evaluate (A) the histological prevalence of NAFL, nonalcoholic steatohepatitis (NASH), and fibrosis in patients undergoing bariatric surgery; (B) the reliability of ultrasound (US) in diagnosing NAFL; and (C) the reliability of various fibrosis scoring systems for defining fibrosis. Methods. US and intraoperative liver biopsy results were reviewed in 57 bariatric surgery patients. NAFL, NASH, and fibrosis were diagnosed according to the Kleiner scoring system. US diagnosis of liver steatosis was based on the bright liver. Fibrosis scores used were (i) the BMI, AST/ALT Ratio, Diabetes (BARD) scoring system; (ii) the nonalcoholic fatty liver disease (NAFLD) fibrosis score; and (iii) the fibrosis-4 (FIB-4) index. Results. The prevalence of NAFL was 81%, NASH 61.4%, and fibrosis 94% (F3 5.7%, cirrhosis 2.8%). The sensitivity of US was 95%, specificity 50%, and likelihood ratio (LR+, LR-) 1.91 and 0.1. The reliability of fibrosis scores for F≥2 were as follows: BARD score: sensitivity 46%, specificity 54%, and area under the receiver-operating characteristics (AUROC) curve 0.5; NAFLD score: sensitivity 30%, specificity 89%, and AUROC 0.5; and FIB-4: sensitivity 68%, specificity 67%, and AUROC 0.7. Conclusions. In bariatric surgery patients, the prevalence of NAFL was 81%, NASH 61.4%, and fibrosis 94%. US is able to rule out the presence of NAFL, while the commonly used scores may be inaccurate in defining fibrosis in patients with morbid obesity.

show abstract

“…Due in part to availability of detailed data, only chronic conditions (T2D, HTN, and DLP) were included. Surgery also has an impact on other costattributable obesity-related conditions such as cardiovascular disease risk (including myocardial infarction, stroke or heart failure), [21] osteoarthritis requiring joint replacement surgery [22] and non-alcoholic fatty liver disease [23]. Bariatric surgery has been shown for these conditions to have a positive effect in reducing their prevalence, and one might thus expect considerable corresponding differences in treatment costs, but in the absence of further data, no reasonable estimate could be determined.…”

Section: Discussionmentioning

confidence: 99%

Impact of weight trajectory after bariatric surgery on co-morbidity evolution and burden

Davis

Saunders

2020

BMC Health Serv Res

View full text Add to dashboard Cite

Background: Bariatric surgery, such as Roux-en-Y gastric bypass [RYGB] has been shown to be an effective intervention for weight management in select patients. After surgery, different patients respond differently even to the same surgery and have differing weight-change trajectories. The present analysis explores how improving a patient's post-surgical weight change could impact co-morbidity prevalence, treatment and associated costs in the Canadian setting. Methods: Published data were used to derive statistical models to predict weight loss and co-morbidity evolution after RYGB. Burden in the form of patient-years of co-morbidity treatment and associated costs was estimated for a 100-patient cohort on one of 6 weight trajectories, and for real-world simulations of mixed patient cohorts where patients experience multiple weight loss outcomes over a 10-year time horizon after RYGB surgery. Costs (2018 Canadian dollars) were considered from the Canadian public payer perspective for diabetes, hypertension and dyslipidaemia. Robustness of results was assessed using probabilistic sensitivity analyses using the R language. Results: Models fitted to patient data for total weight loss and co-morbidity evolution (resolution and new onset) demonstrated good fitting. Improvement of 100 patients from the worst to the best weight loss trajectory was associated with a 50% reduction in 10-year co-morbidity treatment costs, decreasing to a 27% reduction for an intermediate improvement. Results applied to mixed trajectory cohorts revealed that broad improvements by one trajectory group for all patients were associated with 602, 1710 and 966 patient-years of treatment of type 2 diabetes, hypertension and dyslipidaemia respectively in Ontario, the province of highest RYGB volume, corresponding to a cost difference of $3.9 million. Conclusions: Post-surgical weight trajectory, even for patients receiving the same surgery, can have a considerable impact on subsequent co-morbidity burden. Given the potential for alleviated burden associated with improving patient trajectory after RYGB, health care systems may wish to consider investments based on local needs and available resources to ensure that more patients achieve a good long-term weight trajectory.

show abstract

Nonalcoholic fatty liver disease and bariatric surgery: a comprehensive review

Cited by 41 publications

References 191 publications

Comparison Between Sleeve Gastrectomy and Exenatide on Type 2 Diabetic Patients

Comparison Between Sleeve Gastrectomy and Exenatide on Type 2 Diabetic Patients

The Prevalence of NAFLD and Fibrosis in Bariatric Surgery Patients and the Reliability of Noninvasive Diagnostic Methods

Impact of weight trajectory after bariatric surgery on co-morbidity evolution and burden

Contact Info

Product

Resources

About