Omega-loop gastric bypass is more effective for weight loss but negatively impacts liver enzymes: a registry-based comprehensive first-year analysis

Spivak, Hadar; Munz, Yaron; Rubin, Moshe; Shohat, Tamy; Blumenfeld, Orit

doi:10.1016/j.soard.2017.11.006

Cited by 17 publications

(26 citation statements)

References 20 publications

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“…The impact of OAGB on the metabolism of various compounds at this time has been very poorly described. Current research shows that OAGB is more effective for weight loss than Roux-en-Y gastric bypass (RYGB) and laparoscopic sleeve gastrectomy (LSG), but may negatively impact the liver, which is suggested by increased serum activity of liver enzymes, including alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase [1]. Moreover, it may lead to malnutrition [2].…”

Section: Introductionmentioning

confidence: 99%

One Anastomosis Gastric Bypass Reconstitutes the Appropriate Profile of Serum Amino Acids in Patients with Morbid Obesity

Haliński

Pakiet

Jabłońska

et al. 2019

JCM

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Bariatric surgery leads to metabolic benefits in patients with obesity, but their mechanisms are not well understood. The appropriate composition of serum amino acids (AA) is important for sufficient supply of these components into various tissues and organs. Obesity leads to alterations in serum AA concentrations. The aim of this study was to examine the effect of one anastomosis gastric bypass (OAGB), a promising type of bariatric surgery, on serum AA concentrations, which were assayed by LC-MS in serum of 46 bariatric patients prior to and 6–9 months after OAGB, as well as in 30 lean control subjects. The results were analyzed by principle components analysis and metabolic pathway analysis. PCA analysis showed that OAGB led to normalization of serum AA concentrations of patients with obesity to a pattern similar to the control subjects, and the concentrations of essential AA remained decreased after OAGB. Changes of individual AA and their associated metabolic pathways were also presented. OAGB caused normalization of the AA profile, which may contribute to improvement of glucose homeostasis and reduction of cardiovascular risk. Considering decreased essential AA concentrations after OAGB, increased intake of high protein food should be recommended to the patients after this type of bariatric surgery.

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Section: Introductionmentioning

confidence: 99%

One Anastomosis Gastric Bypass Reconstitutes the Appropriate Profile of Serum Amino Acids in Patients with Morbid Obesity

Haliński

Pakiet

Jabłońska

et al. 2019

JCM

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“…In addition, to biochemical we also con irmed by histological indings showed some severe necrosis in liver tissue with in iltration of cells and centrilobular vein congestion (Kretzrommel and Boelsterli, 1993) (Hargus et al, 1994). Previous studies show that administration of diclofenac sodium cause increase in the liver enzyme markers and reduction in body weight, which indicates severe liver damage (Spivak et al, 2018).…”

Section: Histopathological Changesmentioning

confidence: 70%

Antioxidant effects of vitamin E on diclofenac induced hepatotoxicity in male rats

Siva¹,

Sivakumar²,

Pk³

et al. 2019

ijrps

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Drug induced liver injury possesses a major clinical problem and has become leading cause of acute liver failure and transplantation. Overstressed liver compromises its detoxification role which may expose it to a variety of diseases and disorders. The present study was to determine whether pre- administration of various doses of vitamin E would have protective effect against diclofenac induced hepatotoxicity in wistar male rats. Twenty-four albino male rats weighing 180-200g were divided equally into four groups. In control group rats were administrated with physiological saline 2ml/kg b.wt /intramuscularly. Another group with 50mg/kg b.wt/ intramuscularly/seven days diclofenac was used for inducing toxicity. In experimental groups rats were administrated with different doses of vitamin E along with diclofenac sodium [200 and 400 IU orally and 50mg/kg b.wt/ intramuscularly/seven days]. Showed that there was a rapid increase in the levels of liver function test in diclofenac treated group, which was significantly decreased after pre-treatment with high dose than low dose of vitamin E. The liver acinus showed Centro acinar necrosis of hepatocytes after 7 days of diclofenac treatment, which was prevented by administration of Vitamin E. Drug-induced liver injury possesses a major clinical problem and has become a leading cause of acute liver failure and transplantation. Overstressed liver compromises its detoxification role which may expose it to a variety of diseases and disorders. Diclofenac sodium is a phenylacetic acid derivative, a widely used nonsteroidal anti-inflammatory drug (NSAID) for the treatment of inflammatory conditions such as osteoarthritis, rheumatoid arthritis, polymyositis, dermatomyositis, dental pain, spondyloarthritis, acute migraine, gout attacks and pain management in gall and renal stones. Although the exact mechanism by with diclofenac injuries liver is not understood, some studies explain the toxicity by affecting cytochrome P 450 leading to the production of active metabolites. Administration of different dose of diclofenac sodium induces severe adverse effects in liver and kidney.

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“…A recent study of patients undergoing a very low calorie diet (VLCD) for three weeks prior to bariatric surgery noted a transient rise in ALT [20]. This and other studies [16] have the limitation of measuring ALT levels at two time-points only, whereas we have described short and medium term changes at several time-points, during an acute weight loss phase and then a subsequent period of less intensive weight loss. This approach has allowed us to demonstrate both the acute rise in ALT associated with the early weight loss phase of our LELD intervention as well as the subsequent reduction in ALT levels in the aftermath of significant weight loss once weight had started to stabilise.…”

Section: Details Of Patients' Characteristics Are Shown Inmentioning

confidence: 74%

“…However it must be emphasised that this assertion is speculative, because ALT is regarded as a "modestly good at best" indicator of hepatocyte damage in patients with NAFLD [13]. There have been contradictory findings from previous studies on the response of ALT to different types of weight-loss interventions [15][16][17][18][19][20]. Our findings also suggest that patients with elevated ALT (suggesting a degree of NAFLD) are at higher risk of additional hepatic inflammation, at least during the early stages of dietary restriction-based weight loss interventions.…”

Section: Details Of Patients' Characteristics Are Shown Inmentioning

confidence: 99%

Changes in Alanine Aminotransferase in Adults with Severe and Complicated Obesity during a Milk-Based Meal Replacement Programme

Abdalgwad

Rafey

Murphy

et al. 2020

Preprint

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Introduction: Excess adiposity is associated with fat accumulation within the liver, and non-alcoholic steatohepatitis (NASH) is highly prevalent in bariatric patients. Elevated alanine aminotransferase (ALT) is associated with prevalent NASH. We sought to determine the influence of a milk-based meal replacement weight-loss programme on ALT levels in adults with severe and complicated obesity. Methods We conducted a retrospective cohort study of patients who completed a 24-week meal replacement programme, comprised of a weight loss phase followed by weight stabilisation and maintenance phases, each eight weeks long. ALT was quantified using an enzymatic assay with spectrophotometric detection. We examined changes over time in ALT using the non-parametric Wilcoxon singed-rank test and the Friedman test. Results Of 105 patients, 56 were female, mean age was 51.2 ± 11.2 (range 18.0-71.6) years. There was an unanticipated but transient increase in ALT from 28.0 [20.0, 40.5] iu/l at baseline to 40.0 [26.0, 55.0] iu/l after two weeks (p < 0.0005), followed by a gradual reduction to 21.0 [17.0, 28.3] iu/l by 24 weeks (p < 0.0005). The overall reductions in ALT were more pronounced in patients who had elevated levels at baseline. Body weight decreased from 144.2 ± 28.0 kg at baseline to 121.6 ± 25.4 kg at 24 weeks (p < 0.0005) and body mass index (BMI) decreased from 50.7 ± 8.1 kg m− 2 at baseline to 43.0 ± 7.6 kg m− 2 by 24 weeks (p < 0.0005). Conclusion In adults with severe and complicated obesity undergoing a milk-based meal replacement programme, there was an initial unanticipated rise in ALT in the first two weeks, followed by a gradual overall reduction by 24 weeks. These findings suggest that rapid weight loss secondary to significant caloric restriction might induce a transient deterioration in hepatic steatosis prior to an ultimate overall improvement.

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Omega-loop gastric bypass is more effective for weight loss but negatively impacts liver enzymes: a registry-based comprehensive first-year analysis

Cited by 17 publications

References 20 publications

One Anastomosis Gastric Bypass Reconstitutes the Appropriate Profile of Serum Amino Acids in Patients with Morbid Obesity

One Anastomosis Gastric Bypass Reconstitutes the Appropriate Profile of Serum Amino Acids in Patients with Morbid Obesity

Antioxidant effects of vitamin E on diclofenac induced hepatotoxicity in male rats

Changes in Alanine Aminotransferase in Adults with Severe and Complicated Obesity during a Milk-Based Meal Replacement Programme

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