Intra-gastric balloon with lifestyle modification: a promising therapeutic option for overweight and obese patients with metabolic dysfunction-associated steatotic liver disease.

Autor: van Dijk AM; Department of Dietetics, University Medical Center Utrecht, D01.314, Po Box 85500, Utrecht, 3508, GA, The Netherlands. adijk20@umcutrecht.nl., de Vries M; Department of Internal Medicine, University Medical Center Utrecht, Utrecht, The Netherlands., El-Morabit F; Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands.; Department of Internal Medicine, Amsterdam University Medical Center, Amsterdam, The Netherlands., Bac ST; Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands., Mundt MW; Department of Gastroenterology and Hepatology, Bergman Clinics, Bilthoven, The Netherlands.; Flevoziekenhuis, Department of Gastroenterology and Hepatology, Almere, The Netherlands., van der Schuit LE; Department of Gastroenterology and Hepatology, Bergman Clinics, Bilthoven, The Netherlands., Hirdes MMC; Department of Gastroenterology and Hepatology, Bergman Clinics, Bilthoven, The Netherlands., Kara M; Department of Gastroenterology and Hepatology, Bergman Clinics, Bilthoven, The Netherlands., de Bruijne J; Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands., van Meer S; Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands., Kaasjager HAH; Department of Internal Medicine, University Medical Center Utrecht, Utrecht, The Netherlands., de Valk HW; Department of Internal Medicine, University Medical Center Utrecht, Utrecht, The Netherlands., Vleggaar FP; Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands., van Erpecum KJ; Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands.
Jazyk: angličtina
Zdroj: Internal and emergency medicine [Intern Emerg Med] 2023 Nov; Vol. 18 (8), pp. 2271-2280. Date of Electronic Publication: 2023 Sep 12.
DOI: 10.1007/s11739-023-03417-2
Abstrakt: Background: Data on effects of intra-gastric balloon (IGB) on metabolic dysfunction-associated steatotic liver disease (MASLD) are scarce, in part with contradictory results, and mainly obtained in tertiary care patients with diabetes and other comorbidities. We here explore effects of IGB in patients with MASLD referred to a first-line obesity clinic.
Methods: In this prospective cohort study, patients with at least significant fibrosis (≥ F2) and/or severe steatosis (S3) according to screening transient elastography (FibroScan®) were offered a second FibroScan® after 6 months lifestyle modification with or without IGB (based on patient preference).
Results: 50 of 100 consecutively screened patients (generally non-diabetic) qualified for repeated evaluation and 29 (58%) of those had a second FibroScan®. At baseline, at least significant fibrosis was present in 28% and severe steatosis in 91%. IGB was placed in 19 patients (59%), whereas 10 patients (41%) preferred only lifestyle modification (no differences in baseline characteristics between both groups). After 6 months, liver stiffness decreased markedly in the IGB group (median: from 6.0 to 4.9 kPa, p = 0.005), but not in the lifestyle modification only group (median: from 5.5 to 6.9 kPa, p = 0.477). Steatosis improved in both groups, (controlled attenuation parameter values; IGB, mean ± SD: from 328 ± 34 to 272 ± 62 dB/m, p = 0.006: lifestyle modification only, mean ± SD: from 344 ± 33 to 305 ± 43 dB/m: p = 0.006).
Conclusion: Both steatosis and fibrosis improve markedly in overweight/obese patients with MASLD after 6 months IGB combined with lifestyle modification. Our results warrant further research into long-term effect of IGB in these patients.
(© 2023. The Author(s).)
Databáze: MEDLINE
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