Bariatric surgery during the evolution of fatty liver –A randomized clinical trial comparing gastric bypass and sleeve gastrectomy based on transient elastography

SummaryNonalcoholic fatty liver disease (NAFLD) is closely related to patients with obesity. For patients with NAFLD, bariatric surgery is the best treatment. However, the best technique to patient with severe NAFLD is still unknown. Currently available, the imaging methods for assessing and monitoring NAFLD are of limited use for diagnosing. In contrast, compared with liver biopsy and transient hepatic elastography (THE) has shown good accuracy in individuals with obesity. To prospectively compare the evolution of THE parameters of NAFLD right after the procedures: gastric bypass vs sleeve gastrectomy. Patients with obesity were randomized into two groups: gastric bypass and sleeve gastrectomy in a previous study. Iin a previous study one week before and three months after surgery the patients underwent evaluation by THE. The patients were also analyzed with controlled attenuation parameter (CAP), which assesses the degree of hepatic steatosis using the same device. Sleeve gastrectomy group showed a greater decrease in THE values (from 8.13 to 5.53  kPa) compared to the gastric bypass group (from 9.25 to 8.81 kPa;P = .004). CAP also revealed a greater decrease in sleeve subjects (from 287 to 242  dB/m) compared to gastric bypass subjects (from 290 to 276 dB/m;P 
Source: Clinical Obesity - Category: Eating Disorders & Weight Management Authors: Tags: Original Research Article Source Type: research

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Bariatric and metabolic surgery (BMS) is the most effective treatment for obesity, type 2 diabetes (T2D) and comorbidities, including nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH). The beneficial effects of BMS are beyond the primary goal of gastric restriction and nutrients malabsorption. Roux-en-Y gastric bypass (RYGB) and vertical sleeve gastrectomy (VSG) are the two most commonly performed procedures of BMS. Both surgeries lead to physiological changes in gastrointestinal tract; subsequently alter bile acids pool and composition, gut microbial activities, gut hormones and circulating ...
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Source Type: research
Obesity is a serious, chronic, treatable, and global disease epidemic. Over 98 million people currently have the disease of obesity, and in a recent New England Journal of Medicine article, Harvard researchers predicted that by 2030, 50% of the population in the United States will have the disease of obesity. Type 2 diabetes (T2D) is significantly associated with obesity. While many people with obesity do not have diabetes, most people with T2D have the disease of obesity. Excess adiposity (body fat storage), which is present in obesity, contributes to many chronic diseases beyond T2D. These include high blood pressure, he...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Diabetes Diet and Weight Loss Health Heart Health Surgery Source Type: blogs
We begin by complimenting Wang et al. for their research into treatment of Non-Alcoholic Fatty Liver Disease (NAFLD) after Roux-en-Y Gastric Bypass (RYGB) and Laparoscopic Sleeve Gastrectomy (LSG) through the analysis of Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST) values at different timepoints. This is a burgeoning field of research, as NAFLD rates continue to rise globally. Bariatric surgery has been proven in numerous studies to improve AST and ALT values after bariatric surgery (1).
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Tags: Letter to the Editor Source Type: research
Response to letter to editor entitled: Improvement of nonalcoholic fatty liver disease in ALT at ≥12 months after Roux-en-Y gastric bypass and sleeve gastrectomy, no effect in ALT and AST at 12 and ≤24 months after RYGB by Wang et al. Surg Obes Relat Dis. 2019 Dec 16;: Authors: Baldwin D, Gangemi A PMID: 31911098 [PubMed - as supplied by publisher]
Source: Surgery for Obesity and Related Diseases : official journal of the American Society for Bariatric Surgery - Category: Surgery Authors: Tags: Surg Obes Relat Dis Source Type: research
Improvement of nonalcoholic fatty liver disease in ALT at ≥12 months after Roux-en-Y gastric bypass and sleeve gastrectomy, no effect in ALT and AST at 12 and ≤24 months after RYGB. Surg Obes Relat Dis. 2019 Nov 29;: Authors: Wang Y, Chen J, Chen Y, Wu XT PMID: 31899104 [PubMed - as supplied by publisher]
Source: Surgery for Obesity and Related Diseases : official journal of the American Society for Bariatric Surgery - Category: Surgery Authors: Tags: Surg Obes Relat Dis Source Type: research
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).
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Tags: Review articles Source Type: research
Conclusions: Bariatric surgery appears to be capable of partially reversing the obesity-related epigenome. The identification of potential epigenetic biomarkers predictive for the success of bariatric surgery may open new doors to personalized therapy for severe obesity. Introduction Obesity is currently a huge healthcare problem, worldwide, and is a risk factor for several diseases such as type 2 diabetes (T2D), cardiovascular disease and cancer (1). As the prevalence of obesity reaches pandemic proportions, this metabolic disease is estimated to become the biggest cause of mortality in the near future (2). In fact,...
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research
AbstractPurpose of ReviewWe review current evidence regarding changes in bile acid (BA) metabolism, transport, and signaling after bariatric surgery and how these might bolster fat mass loss and energy expenditure to promote improvements in type 2 diabetes (T2D) and nonalcoholic fatty liver disease (NAFLD).Recent FindingsThe two most common bariatric techniques, Roux-en-Y gastric bypass (RYGB) and vertical sleeve gastrectomy (VSG), increase the size and alter the composition of the circulating BA pool that may then impact energy metabolism through altered activities of BA targets in the many tissues perfused by systemic bl...
Source: Current Obesity Reports - Category: Eating Disorders & Weight Management Source Type: research
AbstractNonalcoholic fatty liver disease (NAFLD) represents the most common liver disease, and it is expected to become the leading cause of end-stage liver disease in the near future. Bariatric operations have beneficial effects on NAFLD, inducing histological resolution of liver damage through weight loss-dependent and weight loss-independent mechanisms. Due to lack of randomized controlled trials, no specific guidelines have been established so far. Yet there is growing evidence that NAFLD will eventually become a formal indication for metabolic surgery. Data regarding the choice of procedure are conflicting, although g...
Source: Obesity Surgery - Category: Surgery Source Type: research
Bariatric surgery is currently the more efficient technique to treat severe obesity. The two surgical procedures most commonly performed in the world are sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB), because they induce remission or amelioration of obesity-related comorbidities in a majority of cases with an acceptable rate of complications. Notably, numerous studies have shown that these procedures improve non-alcoholic fatty liver diseases (NAFLD) whose prevalence is particularly high in obese patients and thus in candidates for bariatric surgery, reaching 86% on per-operative liver biopsies [1].
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Tags: Original articles Source Type: research
More News: Bariatric Surgery | Clinical Trials | Eating Disorders & Weight Management | Fatty Liver Disease (FLD) | Gastrectomy | Gastric Bypass | Gastroenterology | Liver | Liver Disease | Non-alcoholic Fatty Liver Diseases (NAFLD) | Obesity | Study | Urology & Nephrology