Hepatic Function and Fibrosis Assessment Via 2D-Shear Wave Elastography and Related Biochemical Markers Pre- and Post-Gastric Bypass Surgery
- 1 June 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in Obesity Surgery
- Vol. 30 (6), 2251-2258
- https://doi.org/10.1007/s11695-020-04452-0
Abstract
Background Nonalcoholic fatty liver disease (NAFLD) exhibits a worldwide distribution and encompasses a wider range of hepatic abnormalities that can culminate in serious clinical outcomes. The growing incidence of NAFLD necessitates more efficient management strategies particularly in clinically severe obese patients. Weight reduction is the cornerstone of NAFLD treatment; therefore, bariatric surgery could be a therapeutic approach in selected obese patients afflicted with NAFLD and other cardiometabolic comorbidities. Objective The present study focused on the potential role of bariatric surgery on hepatic function and NAFLD-related histopathological features measured through a noninvasive method. Method Ninety patients entered to this study and underwent initial preoperative assessments including demographic profile, anthropometric measurements, standard laboratory tests, and hepatic biopsy. Liver stiffness was also evaluated via two-dimensional shear wave elastography (2D-SWE). All assessments were repeated over the subsequent 6 months following surgery except for liver biopsy. Results Postoperative hepatic elasticity was lessened after 6 months (p = 0/002).The levels of alanine aminotransferase, gamma-glutamyl transferase, total protein, lipid indices, glucose, and platelet count were also improved following surgery (p < 0/001). Further progression of fibrosis was observed in 25% of patients after surgery. Conclusion Bariatric surgery was associated with a favorable impact on anthropometric and hepatic elasticity indices as well as metabolic parameters. The ideal target population for bariatric surgery should be thoroughly addressed, and the underlying risk factors for fibrosis progression need to be controlled before surgery. However, expanded research designed as comprehensive randomized controlled trials are recommended to confirm these findings.Funding Information
- Mashhad University of Medical Sciences (951586)
This publication has 31 references indexed in Scilit:
- Measurement of Liver Stiffness with 2D-Shear Wave Elastography (2D-SWE) in Bariatric Surgery Candidates Reveals Acceptable Diagnostic Yield Compared to Liver BiopsyObesity Surgery, 2019
- Liver failure caused by prolonged state of malnutrition following bariatric surgeryWorld Journal of Hepatology, 2018
- ASSESSING LIVER STIFFNESS BY 2-D SHEAR WAVE ELASTOGRAPHY IN A HEALTHY COHORTJapanese Journal of Clinical Oncology, 2018
- Utility of transient elastography (fibroscan) and impact of bariatric surgery on nonalcoholic fatty liver disease (NAFLD) in morbidly obese patientsSurgery for Obesity and Related Diseases, 2018
- Supersonic shear imaging for the diagnosis of liver fibrosis and portal hypertension in liver diseases: a meta-analysisExpert Review of Gastroenterology & Hepatology, 2017
- Feasibility of liver stiffness measurement in morbidly obese patients undergoing bariatric surgery using XL probeScandinavian Journal of Gastroenterology, 2016
- Homeostasis model assessment as a clinical index of insulin resistance in type 2 diabetic patients treated with sulfonylureas.Diabetes Care, 1999
- Therapeutic effects of restricted diet and exercise in obese patients with fatty liverJournal of Hepatology, 1997
- Effect of weight control on hepatic abnormalities in obese patients with fatty liverJournal of Korean Medical Science, 1995
- Effect of weight reduction on hepatic abnormalities in overweight patientsGastroenterology, 1990