Liver Function in Patients With Nonalcoholic Fatty Liver Disease Randomized to Roux-en-Y Gastric Bypass Versus Sleeve Gastrectomy

Kalinowski, Piotr; Paluszkiewicz, Rafał; Ziarkiewicz‐Wróblewska, Bogna; Wróblewski, Tadeusz; Remiszewski, Piotr; Grodzicki, Mariusz; Krawczyk, Marek

doi:10.1097/sla.0000000000002397

Cited by 78 publications

(61 citation statements)

References 28 publications

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“…Weight loss after LSG resulted in a significant reduction of ALT, AST, GGT, and ALT/AST ratio, and we proved that the improvement of transaminases is related to the degree of weight loss. This fact has already been described in other recent studies [23-26]. In the Swedish Obese Subjects Study [46] the reduction in ALT levels was proportional to the degree of weight loss.…”

Section: Discussionsupporting

confidence: 77%

“…No robust data on the effects of LSG on liver fat are actually available and the exact mechanisms that lead to the improvement in NAFLD following bariatric surgery are not completely understood [23, 24, 26, 27]. Our study proved that LSG have a significant positive effect on biochemical parameters of NAFLD with a correlation between the improvement of ALT/AST ratio and the decrease of BMI and TG.…”

Section: Discussionsupporting

confidence: 50%

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SCCA-IgM as a Potential Biomarker of Non-Alcoholic Fatty Liver Disease in Patients with Obesity, Prediabetes and Diabetes Undergoing Sleeve Gastrectomy

et al. 2019

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Background: Non-alcoholic fatty liver disease (NAFLD) has a high prevalence in obesity and its presence should be screened. Laparoscopic sleeve gastrectomy (LSG) is an effective treatment for obesity, but its effects on NAFLD are still to be firmly established. The diagnosis of non-alcoholic steatohepatitis (NASH) is currently performed by liver biopsy, a costly and invasive procedure. Squamous cell carcinoma antigen-IgM (SCCA-IgM) is a biomarker of viral hepatitis to hepatocellular carcinoma development and its role in NAFLD to NASH progression has not yet been investigated. Objective: The aim of this study was to evaluate SCCA-IgM as a non-invasive biomarker of NAFLD/NASH in patients with different degrees of metabolic-complicated obesity before and after LSG. Method: Fifty-six patients with obesity were studied before and 12 months after LSG; anthropometric, biochemical, clinical, and imaging data were collected. Results: At baseline steatosis was strongly associated with the glycaemic profile (p = 0.016) and was already present in prediabetic patients with obesity (82%). Only 3 patients had an SCCA-IgM level above the normal cut-off. SCCA-IgM titre did not change according to glycaemic profile or steatosis. Metabolic and inflammatory factors and transaminases significantly reduced after LSG-induced weight loss, except for SCCA-IgM. The ALT/AST ratio decreased post-LSG correlated with BMI (r = 0.297, p = 0.031), insulin (r = 0.354, p = 0.014), and triglycerides (r = 0.355, p = 0.009) reduction. Conclusions: Our results confirm the tight link between NAFLD and metabolic complications, suggesting prediabetes as a new risk factor of steatosis. SCCA-IgM does not seem to have a role in the identification and prognosis of NAFLD.

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Section: Discussionsupporting

confidence: 77%

Section: Discussionsupporting

confidence: 50%

SCCA-IgM as a Potential Biomarker of Non-Alcoholic Fatty Liver Disease in Patients with Obesity, Prediabetes and Diabetes Undergoing Sleeve Gastrectomy

et al. 2019

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“…The study was approved by the Ethical Committee at the Medical University of Warsaw, and all patients gave informed consent for echocardiography and abdominal ultrasound examination. Each patient underwent a wedge liver biopsy during the bariatric surgery as a part of the routine protocol implemented at the Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Poland [ 23 ]. Tissue sample was extracted from the subcapsular part of the left liver lobe.…”

Section: Methodsmentioning

confidence: 99%

Transfer learning with deep convolutional neural network for liver steatosis assessment in ultrasound images

et al. 2018

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PurposeThe nonalcoholic fatty liver disease is the most common liver abnormality. Up to date, liver biopsy is the reference standard for direct liver steatosis quantification in hepatic tissue samples. In this paper we propose a neural network-based approach for nonalcoholic fatty liver disease assessment in ultrasound.MethodsWe used the Inception-ResNet-v2 deep convolutional neural network pre-trained on the ImageNet dataset to extract high-level features in liver B-mode ultrasound image sequences. The steatosis level of each liver was graded by wedge biopsy. The proposed approach was compared with the hepatorenal index technique and the gray-level co-occurrence matrix algorithm. After the feature extraction, we applied the support vector machine algorithm to classify images containing fatty liver. Based on liver biopsy, the fatty liver was defined to have more than 5% of hepatocytes with steatosis. Next, we used the features and the Lasso regression method to assess the steatosis level.ResultsThe area under the receiver operating characteristics curve obtained using the proposed approach was equal to 0.977, being higher than the one obtained with the hepatorenal index method, 0.959, and much higher than in the case of the gray-level co-occurrence matrix algorithm, 0.893. For regression the Spearman correlation coefficients between the steatosis level and the proposed approach, the hepatorenal index and the gray-level co-occurrence matrix algorithm were equal to 0.78, 0.80 and 0.39, respectively.ConclusionsThe proposed approach may help the sonographers automatically diagnose the amount of fat in the liver. The presented approach is efficient and in comparison with other methods does not require the sonographers to select the region of interest.

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“…We have previously reported that in obese patients with T2DM, SG normalizes liver function tests after 12 months, whereas RYGB was not able to achieve normal transaminases (129). These findings are supported by a recent RCT, which also found that SG normalizes liver function tests within 12 months after surgery but not RYGB (130). In contrast to these findings, a very recent analysis from our cohort of all bariatric patients found that the liver stiffness may be better improved by RYGB than SG (131).…”

Section: Nafld/nash Improvement After Metabolic Surgerymentioning

confidence: 55%

MANAGEMENT OF ENDOCRINE DISEASE: Which metabolic procedure? Comparing outcomes in sleeve gastrectomy and Roux-en Y gastric bypass

Billeter

Herrera

Scheurlen

et al. 2018

European Journal of Endocrinology

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Obesity and its associated comorbidities have become one of the largest challenges for health care in the near future. Conservative therapy for obesity and related comorbidities has a very high failure rate and poor long-term results. Similarly, the conservative and medical management of the majority of metabolic diseases such as type 2 diabetes mellitus are only able to slow down disease progression but have no causal effect on the disease process. Obesity surgery has evolved as a highly effective therapy for severe obesity achieving long-lasting weight loss. Furthermore, several studies have demonstrated the beneficial effects of obesity surgery on reduction of overall mortality, reduction of cardiovascular events and superior control of obesity-related diseases such as type 2 diabetes mellitus, dyslipidemia and also the non-alcoholic steatohepatitis compared to medical therapy. Based on these findings, the term 'metabolic surgery' with the focus on treating metabolic diseases independent of body weight has been coined. Of great interest are recent studies that show that even existing complications of metabolic diseases such as diabetic nephropathy or the non-alcoholic steatohepatitis can be reversed by metabolic surgery. Although metabolic surgery has proven to be a safe and effective treatment for obesity, resolution of comorbidities and enhancing quality of life, it is still uncertain and unclear, which surgical procedure is the most effective to achieve these metabolic effects. The aim of this review is to compare the effects of the two currently most widely used metabolic operations, the Roux-en-Y gastric bypass and the sleeve gastrectomy in the treatment of obesity and its related comorbidities.

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Liver Function in Patients With Nonalcoholic Fatty Liver Disease Randomized to Roux-en-Y Gastric Bypass Versus Sleeve Gastrectomy

Abstract: Patients with NASH undergoing RYGB are more susceptible to early transient deterioration of liver function than after SG.

Cited by 78 publications

References 28 publications

SCCA-IgM as a Potential Biomarker of Non-Alcoholic Fatty Liver Disease in Patients with Obesity, Prediabetes and Diabetes Undergoing Sleeve Gastrectomy

SCCA-IgM as a Potential Biomarker of Non-Alcoholic Fatty Liver Disease in Patients with Obesity, Prediabetes and Diabetes Undergoing Sleeve Gastrectomy

Transfer learning with deep convolutional neural network for liver steatosis assessment in ultrasound images

MANAGEMENT OF ENDOCRINE DISEASE: Which metabolic procedure? Comparing outcomes in sleeve gastrectomy and Roux-en Y gastric bypass

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