THE ROLE OF BARIATRIC SURGERY IN NON-ALCOHOLIC FATTY LIVER DISEASE (NAFLD) MANAGEMENT: A PROSPECTIVE STUDY AT AFRIDI MEDICAL COMPLEX, PESHAWAR
Abstract
Abstract:
Background: The prevalence of non-alcoholic fatty liver disease (NAFLD) has significantly
increased due to the obesity pandemic.Reducing body weight by 5 to 10% in obese patients can improve all aspects of NAFLD. This study aimed to
determine the Role of Bariatric Surgery in Non-Alcoholic Fatty Liver Disease (NAFLD).
Methods: Over the course of one year, this prospective study was carried out from August 2021-august 2022.Patients undergoing laparoscopic sleeve gastrectomy (LSG) with a diagnosis of non-alcoholic fatty liver disease (NAFLD) were included.Preoperative data including demoraphics and Laboratory tests included HbA1c, lipid profile, fasting glucose, and liver function tests (ALT, AST, and GGT). The BARD score, NAFLD fibrosis score and De Ritis ratio (AST/ALT), , and the AST to platelet ratio index (APRI) were among the serum marker scores that were evaluated post-surgery at different follow ups of 3, 6, and 12 and 18 months.
Results:. A total of 461 (50%) of the 922 patients had non-alcoholic steatohepatitis (NASH). A total of 382 (83%) patients showed continued improvement in steatosis at eighteen months post-surgery while 51 (37%) patients with F2 fibrosis and 165 (60%) of those with F1 fibrosis demonstrated lower fibrosis stage at 1 year following surgery.
Conclusion: The degree of fibrosis, hepatic inflammation, and steatosis in obese people is found to be decreased after bariatric surgery and is a safe and successful surgical procedure in the management of non-alcoholic fatty liver disease.
Keywords: Bariatric Surgery, Management, Non-Alcoholic Fatty Liver Disease (NAFLD), Sleeve gastrectomy
References
References:
Jaacks LM, Vandevijvere S, Pan A, McGowan CJ, Wallace C, Imamura F, Mozaffarian D, Swinburn B, Ezzati M. The obesity transition: stages of the global epidemic. The lancet Diabetes & endocrinology. 2019 Mar 1;7(3):231-40.
Divella R, Mazzocca A, Daniele A, Sabbà C, Paradiso A. Obesity, nonalcoholic fatty liver disease and adipocytokines network in promotion of cancer. International journal of biological sciences. 2019;15(3):610.
Khan RT, Akbar N, Ismail H, Adeel M, Lail G, Khalid MA, Mandhwani R, ul Haq MM, Nasir A, Laeeq SM, Luck NH. Factors Predictive of Non-Alcoholic Fatty Liver Disease in Non-Obese Pakistani Population. Journal of Health and Rehabilitation Research. 2024 Jun 3;4(2):1122-8.
Estes C, Razavi H, Loomba R, Younossi Z, Sanyal AJ. Modeling the epidemic of nonalcoholic fatty liver disease demonstrates an exponential increase in burden of disease. Hepatology. 2018 Jan;67(1):123-33.
Hernáez Ã, Zomeño MD, Degano IR, Pérez-Fernández S, Goday A, Vila J, Civeira F, Moure R, Marrugat J. Excess weight in Spain: Current situation, projections for 2030, and estimated direct extra cost for the Spanish health system. Revista Española de CardiologÃa (English Edition). 2019 Nov 1;72(11):916-24.
Netanel C, Goitein D, Rubin M, Kleinbaum Y, Katsherginsky S, Hermon H, Tsaraf K, Tachlytski I, Herman A, Safran M, Ben-Ari Z. The impact of bariatric surgery on nonalcoholic fatty liver disease as measured using non-invasive tests. The American Journal of Surgery. 2021 Jul 1;222(1):214-9.
Głuszyńska P, Lemancewicz D, Dzięcioł JB, Razak Hady H. Non-alcoholic fatty liver disease (NAFLD) and bariatric/metabolic surgery as its treatment option: a review. Journal of clinical medicine. 2021 Dec 7;10(24):5721.
Chalasani N, Younossi Z, Lavine JE, Charlton M, Cusi K, Rinella M, Harrison SA, Brunt EM, Sanyal AJ. The diagnosis and management of nonalcoholic fatty liver disease: practice guidance from the American Association for the Study of Liver Diseases. Hepatology. 2018 Jan 1;67(1):328-57.
EASL E. EASO. Clinical Practice Guidelines for the Management of Non-Alcoholic Fatty Liver Disease, Obes Facts. 2016 Jun;9:65-90.
Dudekula A, Rachakonda V, Shaik B, Behari J. Weight loss in nonalcoholic Fatty liver disease patients in an ambulatory care setting is largely unsuccessful but correlates with frequency of clinic visits. PloS one. 2014 Nov 6;9(11):e111808.
Ha J, Jang M, Kwon YK, Park YS, Park DJ, Lee JH, Lee HJ, Ha TK, Kim YJ, Han SM, Han SU. Metabolomic profiles predict diabetes remission after bariatric surgery. Journal of Clinical Medicine. 2020 Dec 1;9(12):3897.
Doumouras AG, Wong JA, Paterson JM, Lee Y, Sivapathasundaram B, Tarride JE, Thabane L, Hong D, Yusuf S, Anvari M. Bariatric surgery and cardiovascular outcomes in patients with obesity and cardiovascular disease: a population-based retrospective cohort study. Circulation. 2021 Apr 13;143(15):1468-80.
Chaim FD, Pascoal LB, Chaim FH, Palma BB, Damázio TA, da Costa LB, Carvalho R, Cazzo E, Gestic MA, Utrini MP, Milanski M. Histological grading evaluation of non-alcoholic fatty liver disease after bariatric surgery: a retrospective and longitudinal observational cohort study. Scientific reports. 2020 May 22;10(1):8496.
Anja G, Lefere S. Bariatric surgery for NAFLD: Indications and post-operative management. Clin Mol Hepatol. 2022 Dec 22.
Mummadi RR, Kasturi KS, Chennareddygari S, Sood GK. Effect of bariatric surgery on nonalcoholic fatty liver disease: systematic review and meta-analysis. Clinical Gastroenterology and Hepatology. 2008 Dec 1;6(12):1396-402.
Xanthakos SA, Jenkins TM, Kleiner DE, Boyce TW, Mourya R, Karns R, Brandt ML, Harmon CM, Helmrath MA, Michalsky MP, Courcoulas AP. High prevalence of nonalcoholic fatty liver disease in adolescents undergoing bariatric surgery. Gastroenterology. 2015 Sep 1;149(3):623-34.
Zhou H, Luo P, Li P, Wang G, Yi X, Fu Z, Sun X, Cui B, Zhu L, Zhu S. Bariatric surgery improves nonalcoholic fatty liver disease: systematic review and meta-analysis. Obesity Surgery. 2022 Jun;32(6):1872-83.
Lassailly G, Caiazzo R, Ntandja-Wandji LC, Gnemmi V, Baud G, Verkindt H, Ningarhari M, Louvet A, Leteurtre E, Raverdy V, Dharancy S. Bariatric surgery provides long-term resolution of nonalcoholic steatohepatitis and regression of fibrosis. Gastroenterology. 2020 Oct 1;159(4):1290-301.
Nickel F, Tapking C, Benner L, Sollors J, Billeter AT, Kenngott HG, Bokhary L, Schmid M, von Frankenberg M, Fischer L, Mueller S. Bariatric surgery as an efficient treatment for non-alcoholic fatty liver disease in a prospective study with 1-year follow-up: BariScan study. Obesity surgery. 2018 May;28:1342-50.
Jastrzębska-Mierzyńska M, Ostrowska L, Hady H, Dadan J, Konarzewska-Duchnowska E. The impact of bariatric surgery on nutritional status of patients. Videosurgery and Other Miniinvasive Techniques. 2015 Apr;10(1):115-24.
Buchwald H, Avidor Y, Braunwald E, Jensen MD, Pories W, Fahrbach K, Schoelles K. Bariatric surgery: a systematic review and meta-analysis. Jama. 2004 Oct 13;292(14):1724-37.
Svegliati-Baroni G, Saccomanno S, Rychlicki C, Agostinelli L, De Minicis S, Candelaresi C, Faraci G, Pacetti D, Vivarelli M, Nicolini D, Garelli P. Glucagon-like peptide-1 receptor activation stimulates hepatic lipid oxidation and restores hepatic signalling alteration induced by a high-fat diet in nonalcoholic steatohepatitis. Liver International. 2011 Oct;31(9):1285-97.
Uzun H, Zengin K, Taskin M, Aydin S, Simsek G, Dariyerli N. Changes in leptin, plasminogen activator factor and oxidative stress in morbidly obese patients following open and laparoscopic Swedish adjustable gastric banding. Obesity surgery. 2004 May;14(5):659-65.
Bower G, Athanasiou T, Isla AM, Harling L, Li JV, Holmes E, Efthimiou E, Darzi A, Ashrafian H. Bariatric surgery and nonalcoholic fatty liver disease. European journal of gastroenterology & hepatology. 2015 Jul 1;27(7):755-68.
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