Obesity is associated with nonalcoholic fatty liver disease which is one of the most common causes of chronic liver disease. FibroScan is a noninvasive tool for liver stiffness measurement and controlled attenuation parameter to evaluate liver steatosis and fibrosis. We aimed to demonstrate the effect of laparoscopic sleeve gastrectomy on liver steatosis and fibrosis. Of the 120 consecutive patients screened, 72 were enrolled in this study. FibroScan M probe and XL probe were used for the evaluation of liver steatosis and fibrosis. Fiftytwo patients (72.2%) were female individuals and 20 (27.8%) were male individuals; the mean age was 37.9 ± 10.4 years. Percentage of excess weight loss was significant at the third and sixth months: 57.2 ± 18.3 (P < 0.05) and 81.4 ± 24.6 (P < 0.05), respectively. Mean preoperative controlled attenuation parameter and liver stiffness measurement values were 309.2 ± 68.7 dB/m and 7.5 ± 5.0 kPa, respectively, and significantly declined to 217.4 ± 56.4 dB/m and 5.6 ± 2.5 kPa, respectively, at sixth postoperative month (P < 0.001 and <0.01, respectively). These results suggest that laparoscopic sleeve gastrectomy is associated with significant improvement in liver steatosis and fibrosis. Bariatric surgery has a beneficial effect on nonalcoholic fatty liver disease in morbidly obese patients.

Obesity is associated with nonalcoholic fatty liver disease which is one of the most common causes of chronic liver disease. FibroScan is a noninvasive tool for liver stiffness measurement and controlled attenuation parameter to evaluate liver steatosis and fibrosis. We aimed to demonstrate the effect of laparoscopic sleeve gastrectomy on liver steatosis and fibrosis. Of the 120 consecutive patients screened, 72 were enrolled in this study. FibroScan M probe and XL probe were used for the evaluation of liver steatosis and fibrosis. Fifty-two patients (72.2%) were female individuals and 20 (27.8%) were male individuals; the mean age was 37.9±10.4 years. Percentage of excess weight loss was significant at the third and sixth months: 57.2±18.3 (P<0.05) and 81.4±24.6 (P<0.05), respectively. Mean preoperative controlled attenuation parameter and liver stiffness measurement values were 309.2±68.7 dB/m and 7.5±5.0 kPa, respectively, and significantly declined to 217.4±56.4 dB/m and 5.6±2.5 kPa, respectively, at sixth postoperative month (P<0.001 and <0.01, respectively). These results suggest that laparoscopic sleeve gastrectomy is associated with significant improvement in liver steatosis and fibrosis. Bariatric surgery has a beneficial effect on nonalcoholic fatty liver disease in morbidly obese patients.

No abstract

Background and Aims: Neopterin is a proinflammatory indicator that plays a role in cell-mediated immunity, and elevated concentrations of neopterin indicate the presence of interferon-γ in body fluids. In this study, neopterin concentrations were determined in patients with a virus-induced chronic liver disease (chronic hepatitis, liver cirrhosis, and hepatocellular cancer), inactive hepatitis B virus carriers, and in a healthy control group to assess whether neopterin can be used as a disease marker in patients with virus-induced chronic liver disease. Materials and Methods: A total of 110 subjects (42 females and 68 males, with an average age of 44±8.90 years) were included in this study. Of these patients, 33 had chronic hepatitis; 22, liver cirrhosis; 22, hepatoma; 18, inactive hepatitis B virus carriers; and 15 were included in the healthy control group. Neopterin levels were measured before and after interferon treatment in patients with chronic hepatitis. Data collected among the groups were analyzed statistically using the Mann-Whitney test, considering p < 0.05 as statistically significant. Results: Neopterin concentrations and gender showed no statistically significant correlation. Patients with cirrhosis, hepatocellular cancer, and chronic hepatitis had statistically significantly higher neopterin levels than the healthy control and healthy carrier groups. A positive correlation was observed between neopterin levels and other disease activity indicators such as aspartate transaminase, alanine transaminase, hepatitis B virus deoxyribonucleic acid, hepatitis C virus ribonucleic acid, erythrocyte sedimentation rate, and C-reactive protein levels, and their levels were also high. Although 14 patients, who were also evaluated after interferon treatment, showed good response to the treatment, no statistically significant correlation was observed between their neopterin levels and disease activity indicator levels. Conclusion: Neopterin concentrations were found to be significantly higher in patients with inflammation than in inactive hepatitis B virus carriers who had no ongoing inflammatory activity and in the healthy control group. No correlation was detected between neopterin levels and hepatitis B virus deoxyribonucleic acid and hepatitis C virus ribonucleic acid levels in patients who received interferon treatment and benefitted from it. Although neopterin levels indicate inflammatory activity in cases of chronic hepatitis, liver cirrhosis, and hepatocellular cancer, additional studies are necessary to determine its usefulness in clinical practice.

Purpose: Exercise capacity is a well known prognostic indicator in many clinical conditions. This study evaluates the clinical and exercise variables most determinant for estimating exercise capacity in liver transplant candidates. Methods:This prospective cross-sectional study consisted of thirty patients who were scheduled for liver transplantation. Respiratory and peripheral muscle strengths were measured using a mouth pressure device and a hand-held dynamometer, respectively. Physical activity, fatigue, exercise capacity, physical performance, and quality of life of participants were assessed using the International Physical Activity Questionnaire, the Turkish version of the Checklist Individual Strength Questionnaire, the Six-minute Walk Test (6MWT), the 30-sec Sit-to-Stand Test, and the Liver Disease Symptom Index 2.0, respectively. Multivariate analysis was conducted to determine clinical factors predictive of exercise impairment. Results:The participants achieved 62.9% of the predicted six-minute walk distance (6MWD). 6MWD was strongly correlated with age (r=−0.678, p<0.001), dyspnea before the 6MWT (r=−0.668, p<0.001), and chair stands (r=0.745, p<0.001). A moderate correlation was observed between 6MWD and maximal inspiratory pressure (r=0.532, p=0.002), maximal expiratory pressure (r=0.522, p=0.003), and shoulder flexion (r=0.479, p=0.007). Age and maximal expiratory pressure were identified as independent determinants of exercise capacity, accounting for 57.4% of the variance. Conclusion:Assessing respiratory parameters may have a fundamental role in improving posttransplant outcomes in especially older liver transplant candidates.