Complete resolution of postbariatric surgery associated hepatic steatosis after nutrition support
Bariatric surgery (BS) has been known to have favorable effects on preexisting nonalcoholic fatty liver disease (NAFLD) with weight loss [1,2]. Contradictorily, several cases of liver injuries with rapid weight loss or malnutrition after bariatric surgery have been reported . The pathophysiology of liver injuries due to BS remains poorly understood. Here, we report the case of a postRYGB patient with severe malnutrition who developed NAFLD and will propose a mechanism with supportive findings.
AbstractPurpose of ReviewThis review summarizes our current understanding of the metabolic syndrome (MetS) in children and adolescents. Special emphasis is given towards diagnostic criteria and therapeutic options.Recent FindingsConsistent diagnostic criteria to define MetS in childhood and adolescence are not available to date. There is common agreement that the main features defining MetS include (1) disturbed glucose metabolism, (2) arterial hypertension, (3) dyslipidemia, and (4) abdominal obesity. However, settings of cut-off values are still heterogeneous in the pediatric population. Additional features that may defi...
We report a case of a post RYGB patient with severe malnutrition who developed non-alcoholic fatty liver disease. Severe chronic malnutrition predisposed by bariatric surgery is considered as potential mechanism of hepatic steatosis. Liver function should be routinely monitored for post bariatric patients with nutritional risk. Proper enteral and parenteral nutrition support can be a major treatment for hepatic steatosis induced by severe malnutrition.
Obesity and its complications, which affect myriad organ systems, continue to be major worldwide public health problems in adults and children.1 Nonalcoholic fatty liver disease (NAFLD) is associated with obesity and the metabolic syndrome that encompasses insulin resistance, dyslipidemia, and hypertension. The prevalence of NAFLD in children varies widely and is dependent on the method of diagnosis, age, sex, and ethnicity, but the estimated global prevalence is 7.6% in the general pediatric population and 34.2% in obese children.
Obesity is a worldwide epidemic leading to non-alcoholic fatty liver disease. Alterations of liver fat by magnetic resonance imaging (MRI) following bariatric surgery is a promising feature, but few studies have been fully elucidated. Purpose. MRI was used to determine alterations of liver fat fraction (LFF) features following surgery. These were compared with the clinical non-alcoholic steatohepatitis score (C-NASH score) and evaluated for predictive factors for score changes postoperatively. Methods.
Nonalcoholic fatty liver disease (NAFLD) is tied to the rise in obesity and type 2 diabetes. Bariatric endoscopic interventions may provide an option to treat patients but there is scant data at present evaluating the effects on liver disease and diabetes.
Non-alcoholic fatty liver disease (NAFLD) is a common chronic progressive parenchymal liver disease with strong pathophysiological underpinnings to adiposity-based chronic disease or obesity. One of the hallmarks of the disease is an insulin-resistant state driven by increased body fat promoting adipose tissue dysfunction, a chronic inflammatory state, altered gut mucosal barrier and microbiome, and permissive abnormal signaling between the central nervous system and peripheral metabolic organs.
Nonalcoholic Fatty Liver Disease (NAFLD) prevalence is rising worldwide, as a direct consequence of the obesity epidemic. Bariatric Surgery provides proven NAFLD amelioration, although questions remain if Roux-en-Y Gastric Bypass (RYGB) or Laparoscopic Sleeve Gastrectomy (LSG) is more effective. To answer this question, we conducted a Systematic review and meta-analysis exclusively comparing RYGB against LSG for amelioration of NAFLD using four separate criteria: ALT, AST, NAFLD activity score (NAS), and NAFLD fibrosis score (NFS).
ConclusionAmong individuals with morbid obesity, the findings of this study are suggestive that liver fibrosis confirmed by histopathological examination is associated with a slight impairment of left ventricular function. Further studies are needed to confirm this association.
Bariatric surgery is still not recommended to alleviate the long-term sequelae of non-alcoholic fatty liver disease (NAFLD) despite some evidence to suggest bariatric surgery can mitigate the risk of non-alcoholic steatohepatitis (NASH) and/or hepatocellular carcinoma. This current study is the first to use a propensity match analysis of a large cohort of bariatric surgery patients with non-surgery controls to show that patients who had undergone bariatric surgery had fewer new cases of NASH and HCC with extended follow up, and further risk adjustment also revealed bariatric surgery was associated with fewer cases of NASH ...
ConclusionsIntraoperative liver biopsy during bariatric surgery is safe and identified liver disease in 89%, with 9% meeting referral criteria. Pasifika patients have a higher rate of NAFLD than non-Pasifika.