Gastric Bypass Compared with Sleeve Gastrectomy for Nonalcoholic Fatty Liver Disease: a Systematic Review and Meta-analysis

Silva, Miller Barreto de Brito e; Tustumi, Francisco; Neto, Antônio Afonso de Miranda; Dantas, Anna Carolina Batista; Santo, Marco Aurélio; Ivan, Cristina

doi:10.1007/s11695-021-05412-y

Cited by 51 publications

(27 citation statements)

References 62 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Bariatric surgery improves serum transaminases, NAS score and NAFLD fibrosis score in patients with severe obesity, with sleeve gastrectomy and RYGB being equally effective in ameliorating NAFLD [ 9 , 34 , 35 ]. In line with this observation, our data confirmed that sleeve gastrectomy and RYGB ameliorates hepatic function, as evidenced by an improved profile of AST and ALT and hepatosteatosis in an experimental model of NAFLD.…”

Section: Discussionmentioning

confidence: 99%

Role of ANGPTL8 in NAFLD Improvement after Bariatric Surgery in Experimental and Human Obesity

Perdomo

Gómez-Ambrosi

Becerril

et al. 2021

IJMS

View full text Add to dashboard Cite

Angiopoietin-like protein 8 (ANGPTL8) is an hepatokine altered in several metabolic conditions, such as obesity, type 2 diabetes, dyslipidemia and nonalcoholic fatty liver disease (NAFLD). We sought to explore whether ANGPTL8 is involved in NAFLD amelioration after bariatric surgery in experimental models and patients with severe obesity. Plasma ANGPTL8 was measured in 170 individuals before and 6 months after bariatric surgery. Hepatic ANGPTL8 expression was evaluated in liver biopsies of patients with severe obesity undergoing bariatric surgery with available liver pathology analysis (n = 75), as well as in male Wistar rats with diet-induced obesity subjected to sham operation, sleeve gastrectomy or Roux-en-Y gastric bypass (RYGB) (n = 65). The effect of ANGPTL8 on lipogenesis was assessed in human HepG2 hepatocytes under palmitate-induced lipotoxic conditions. Plasma concentrations and hepatic expression of ANGPTL8 were increased in patients with obesity-associated NAFLD in relation to the degree of hepatic steatosis. Sleeve gastrectomy and RYGB improved hepatosteatosis and reduced the hepatic ANGPTL8 expression in the preclinical model of NAFLD. Interestingly, ANGPTL8 inhibited steatosis and expression of lipogenic factors (PPARG2, SREBF1, MOGAT2 and DGAT1) in palmitate-treated human hepatocytes. Together, ANGPTL8 is involved in the resolution of NAFLD after bariatric surgery partially by the inhibition of lipogenesis in steatotic hepatocytes.

show abstract

Section: Discussionmentioning

confidence: 99%

Role of ANGPTL8 in NAFLD Improvement after Bariatric Surgery in Experimental and Human Obesity

Perdomo

Gómez-Ambrosi

Becerril

et al. 2021

IJMS

View full text Add to dashboard Cite

show abstract

“…A meta-analysis performed by Silva et al showed that RYGB patients achieve significant reduction of steatohepatitis and fibrosis, while patients undergoing LSG presented significant reduction only of steatohepatitis. According to their study, the NAFLD Activity Score significantly improved after both procedures and no differences were found between LSG and RYGB regarding histopathological changes [90]. A study conducted by Pedersen et al showed that NAS reduced significantly in both RYGB and LSG patients 12-months after the surgery.…”

Section: Bariatric Surgery and Nafldmentioning

confidence: 91%

Non-Alcoholic Fatty Liver Disease (NAFLD) and Bariatric/Metabolic Surgery as Its Treatment Option: A Review

Głuszyńska

Lemancewicz

Dzięcioł

et al. 2021

JCM

View full text Add to dashboard Cite

The prevalence of non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) has considerably increased over the last years. NAFLD is currently the most common cause of chronic liver disease in the developing world. The diagnosis of NAFLD/NASH is often incidental, as the early-stage of disease is frequently free of symptoms. Most patients recognized with NAFLD have severe obesity and other obesity-related disease such as type 2 diabetes mellitus (T2DM), insulin-resistance, dyslipidemia and hypertension. The only proven method for NAFLD improvement and resolution is weight loss. Bariatric surgery leads to significant and long-term weight loss as well as improvement of coexisting diseases. There is a lot of evidence suggesting that metabolic/bariatric surgery is an effective method of NAFLD treatment that leads to reduction in steatosis, hepatic inflammation and fibrosis. However, there is still a need to perform long-term studies in order to determine the role of bariatric surgery as a treatment option for NAFLD and NASH. This review discusses current evidence about epidemiology, pathogenesis and treatment options for NAFLD including bariatric/metabolic surgery and its effect on improvement and resolution of NAFLD.

show abstract

“…Third, we could not enroll patients who had undergone a malabsorptive procedure, such as Roux-en Y gastric bypass (RYGB) or duodenojejunal bypass with sleeve gastrectomy, as LSG is the only MS procedure covered by Japan’s national health insurance system. However, previous studies have revealed that RYGB is superior to LSG in resolving steatosis, even though there is no significant difference between these two procedures in improving liver fibrosis one year after surgery [ 39 , 40 , 41 ]. Therefore, a long-term histopathological evaluation is warranted to confirm improvements in liver fibrosis in these patients.…”

Section: Discussionmentioning

confidence: 99%

The Concept of Indeterminable NASH Inducted by Preoperative Diet and Metabolic Surgery: Analyses of Histopathological and Clinical Features

et al. 2022

View full text Add to dashboard Cite

Practitioners routinely perform intraoperative liver biopsies during laparoscopic sleeve gastrectomy (LSG) to evaluate nonalcoholic fatty liver disease (NAFLD). In some patients, hepatocyte ballooning, inflammation, and fibrosis without steatosis are observed, even in the absence of other etiologies. We call this finding indeterminable nonalcoholic steatohepatitis (Ind-NASH). In this study, we clarified the prevalence, as well as histopathological and clinical features, of Ind-NASH through intraoperative liver biopsy in Japanese patients presenting with severe obesity. We enrolled 63 patients who had undergone LSG and intraoperative liver biopsy. In patients diagnosed with histopathological NASH, we performed protocol liver biopsies at 6 and 12 months after LSG. We statistically analyzed these histopathological findings and clinical parameters and found the prevalence rate of Ind-NASH discovered through intraoperative biopsy to be 15.9%. Protocol liver biopsy also revealed that Ind-NASH was an intermediate condition between NASH and normal liver. The clinical features of patients with Ind-NASH are a higher body weight compared to NASH (134.9 kg vs. 114.7 kg; p = 0.0245), stronger insulin resistance compared to nonalcoholic fatty liver (homeostasis model assessment–insulin resistance: 7.1 vs. 4.9; p = 0.0188), and mild liver dysfunction compared to NASH. Patients with Ind-NASH observed positive weight-loss effects from a preoperative diet compared to the postoperative course (percentage total weight loss: 32.0% vs. 26.7%; p < 0.0001). Patients with Ind-NASH may also be good candidates for metabolic surgery owing to their good treatment response; therefore, efforts should be made by specialists in the near future to deeply discuss and define Ind-NASH.

show abstract

Gastric Bypass Compared with Sleeve Gastrectomy for Nonalcoholic Fatty Liver Disease: a Systematic Review and Meta-analysis

Cited by 51 publications

References 62 publications

Role of ANGPTL8 in NAFLD Improvement after Bariatric Surgery in Experimental and Human Obesity

Role of ANGPTL8 in NAFLD Improvement after Bariatric Surgery in Experimental and Human Obesity

Non-Alcoholic Fatty Liver Disease (NAFLD) and Bariatric/Metabolic Surgery as Its Treatment Option: A Review

The Concept of Indeterminable NASH Inducted by Preoperative Diet and Metabolic Surgery: Analyses of Histopathological and Clinical Features

Contact Info

Product

Resources

About