Endoscopic bariatric treatment with duodenal-jejunal bypass liner improves Non-invasive markers of non-alcoholic steatohepatitis
| Autor: | Thomas Karlas, David Petroff, Jürgen Feisthammel, Sebastian Beer, Matthias Blüher, Tatjana Schütz, Ralf Lichtinghagen, Albrecht Hoffmeister, Johannes Wiegand |
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| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
Liver Cirrhosis
Nutrition and Dietetics Endocrinology Diabetes and Metabolism Bariatric Surgery Middle Aged Diabetes Duodenal-jejunal Bypass Liner Endobarrier Fibroscan Liver Elastography Nash Fibrosis Obesity Morbid Diabetes Mellitus Type 2 Non-alcoholic Fatty Liver Disease Elasticity Imaging Techniques Humans Female Surgery Aspartate Aminotransferases Biomarkers |
| Zdroj: | Obes. Surg. 32, 2495-2503 (2022) |
| Popis: | Purpose People with obesity often develop non-alcoholic fatty liver disease (NAFLD) and are at high risk of progression to non-alcoholic steatohepatitis (NASH). Few therapies are effective other than bariatric surgery. We therefore analyzed data from duodenal-jejunal bypass liner (DJBL) patients regarding steatosis, fibrosis, and NASH. Methods Consecutive DJBL patients with type 2 diabetes underwent standardized assessments up to device removal at 48 weeks. These included aspartate and alanine transaminase (AST, ALT), controlled attenuation parameter (CAP, for steatosis), and liver stiffness measurement (LSM, for fibrosis). The NAFLD fibrosis score (NFS), fibrosis-4 score (FIB4), and enhanced liver fibrosis (ELF) test were also used to assess fibrosis and the Fibroscan-AST (FAST) score to assess NASH. Mixed models were used and missing data were accounted for with multiple imputation. Results Thirty-two patients (18 female, mean age 55.1, mean BMI 40.2 kg/m2) were included. After 48 weeks, the change compared to baseline with 95% CI was a factor 0.74 (0.65 to 0.84) for AST, 0.63 (0.53 to 0.75) for ALT, and a difference of − 0.21 (− 0.28 to − 0.13) for FAST, all with p Conclusions One year of DJBL therapy is associated with relevant improvements in non-invasive markers of steatosis and NASH, but not fibrosis, and is accompanied by a substantial number of complications. Given the lack of alternatives, DJBL deserves further attention. Graphical abstract |
| Databáze: | OpenAIRE |
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