Effects of intragastric balloon placement in metabolic dysfunction-associated fatty liver disease: A systematic review and meta-analysis

Júnior, João Remí de Freitas; Ribeiro, Igor Braga; Sagae, Vitor Massaro Takamatsu; Souza, Gabriel Mayo Vieira de; Oliveira, Guilherme Henrique Peixoto de; Sánchez-Luna, Sergio A.; Souza, Thiago Ferreira de; Moura, Eduardo Turiani Hourneaux de; Oliveira, Cláudia Pinto Marques Souza de; Bernardo, Wanderley Marques

doi:10.4254/wjh.v13.i7.815

Cited by 7 publications

(3 citation statements)

References 38 publications

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“…In addition, a reduction of liver volume was observed in most patients (94%). Furthermore, a similar meta‐analysis by Freitas Junior et al 62 including 10 studies and 508 patients, which also focused on IGBs, showed improvement in liver enzymes and metabolic markers related to NAFLD progression. Our meta‐analysis in comparison, the most comprehensive to date, included 19 studies and 911 patients and showed improvements in NAFLD Activity score (NAS), liver enzymes, liver volume, HOMA‐IR, total body weight loss, glycated haemoglobin and BMI.…”

Section: Discussionmentioning

confidence: 77%

Meta‐analysis: Impact of intragastric balloon therapy on NAFLD‐related parameters in patients with obesity

Aoko,

Maharaj,

Boland

et al. 2023

Aliment Pharmacol Ther

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SummaryBackgroundNon‐alcoholic fatty liver disease (NAFLD) is a leading cause of chronic liver disease affecting approximately 25% of adults in the western world. Intragastric balloon (IGB) is an endoscopic bariatric therapy ‐a therapeutic endoscopic tool that has shown promise in inducing weight loss. Its role in the treatment of NAFLD is yet to be established.AimTo evaluate the effect of IGB as a treatment option in NAFLD.MethodsWe searched MEDLINE (PubMed) and EMBASE from inception to September 2022. We included studies evaluating the impact of IGB on obesity with the assessment of one or more liver‐related outcomes and studies primarily evaluating the impact of IGB on NAFLD. We included comparative and non‐comparative studies; primary outcomes were liver‐related NAFLD surrogates.ResultsWe included 19 studies with 911 patients. IGB demonstrated an effect on NAFLD parameters including NAFLD activity score (NAS): mean difference (MD): −3.0 [95% CI: −2.41 to −3.59], ALT: MD: −10.40 U/L [95% CI: −7.31 to −13.49], liver volume: MD ‐397.9 [95% CI: −212.78 to 1008.58] and liver steatosis: MD: −37.76 dB/m [95% CI: −21.59 to −53.92]. There were significant reductions in non‐liver‐related outcomes of body weight, BMI, glycated haemoglobin and HOMA‐IR.ConclusionIntragastric balloons may play an important role in addressing the treatment gap in NAFLD management.

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Section: Discussionmentioning

confidence: 77%

Meta‐analysis: Impact of intragastric balloon therapy on NAFLD‐related parameters in patients with obesity

Aoko,

Maharaj,

Boland

et al. 2023

Aliment Pharmacol Ther

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“…Most experts agree that the degree of weight loss induced by IGB correlates with improvements in liver enzymes and hepatic steatosis in patients with NAFLD. Multiple studies and meta-analyses have shown that IGB placement improves liver enzyme levels and other metabolic markers (Hemoglobin A1c (HB A1c), systolic blood pressure, triglycerides, abdominal circumference and BMI) in patients with NAFLD [20][21][22][23][24][25]. A study by Nguyen et al analyzed outcomes with serial IGBs, and found that greatest changes in weight loss, insulin resistance and liver enzymes were observed after six months.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…Multiple studies and meta-analyses have shown that IGB placement improves liver enzyme levels and other metabolic markers (hemoglobin A1c [HbA1c], systolic blood pressure, triglycerides, abdominal circumference, and BMI) in patients with NAFLD. [20][21][22][23][24][25] A study by Nguyen et al analyzed outcomes with serial IGBs and found that greatest changes in weight loss, insulin resistance, and liver enzymes were observed after 6 months. Improvements in weight loss and liver enzymes may be seen with subsequent IGB placements, but there was no further improvement in insulin resistance as studied using the Homeostasis Model Assessment for Insulin Resistance (HOMA-IR) score, likely due to the smaller degrees of weight change achieved during these later time points.…”

Section: Introductionmentioning

confidence: 99%

Novel Endoscopic Bariatric Therapies for the Management of Nonalcoholic Steatohepatitis

et al. 2022

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Obesity is strongly associated with nonalcoholic fatty liver disease (NAFLD) as well as advanced forms of the disease such as steatohepatitis (NASH), cirrhosis, and hepatocellular carcinoma. While lifestyle and diet modifications have been the cornerstone of treatment for NASH thus far, they are only effective for less than half of the patients. New endoscopic bariatric therapies (EBT) have already proved to be safe and effective for the treatment of obesity and type 2 diabetes mellitus, and may provide an intermediate, less invasive and cost-effective option for patients with NASH. In this review, we aim to describe the data and evidence as well as outline future areas of development for endobariatric therapies for treatment of NASH. In conclusion, EBTs present an effective and safe therapeutic modality for use in the growing pandemic of obesity related liver disease and should be further investigated with large scale trials in this patient population.

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Intragastric Balloon Significantly Improves Metabolic Parameters at 6 Months: a Meta-Analysis

et al. 2023

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Effects of intragastric balloon placement in metabolic dysfunction-associated fatty liver disease: A systematic review and meta-analysis

Cited by 7 publications

References 38 publications

Meta‐analysis: Impact of intragastric balloon therapy on NAFLD‐related parameters in patients with obesity

Meta‐analysis: Impact of intragastric balloon therapy on NAFLD‐related parameters in patients with obesity

Novel Endoscopic Bariatric Therapies for the Management of Nonalcoholic Steatohepatitis

Intragastric Balloon Significantly Improves Metabolic Parameters at 6 Months: a Meta-Analysis

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