scholarly journals Hepatic Steatosis Is Associated with Elevated Serum Iron in Patients with Obesity and Improves after Laparoscopic Sleeve Gastrectomy

Obesity Facts ◽  
2020 ◽  
pp. 1-8
Author(s):  
Bingwei Ma ◽  
Hang Sun ◽  
Bing Zhu ◽  
Shilin Wang ◽  
Lei Du ◽  
...  
Keyword(s):  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Hepatic Steatosis ◽  
Elevated Serum ◽  
Density Lipoprotein ◽  
Postprandial Blood Glucose ◽  
Iron Level ◽  
Metabolic Markers ◽  
Alcoholic Fatty Liver ◽  
Negatively Associated

<b><i>Background:</i></b> Iron is closely related to metabolism. However, the relationship between iron and hepatic steatosis has not been fully elucidated. <b><i>Objective:</i></b> We aimed to investigate the triangular relationship between iron and hepatic steatosis and laparoscopic sleeve gastrectomy (LSG) in patients with obesity. <b><i>Methods:</i></b> A total of 297 patients with obesity and 43 healthy individuals with a normal BMI were enrolled. Eighty-two patients underwent LSG. Anthropometrics, glucose-lipid metabolic markers, and hepatic steatosis assessed by FibroScan (CAP value and E value) were measured at baseline, and again at follow-up time intervals of 6 months and 1 year after surgery. <b><i>Results:</i></b> (1) Iron was significantly higher in patients with obesity or overweight than in the individuals with normal BMI (8.18 ± 1.47 vs. 7.46 ± 0.99 mmol/L, <i>p</i> = 0.002). Iron was also higher in subjects with high blood pressure, dyslipidemia, and hyperuricemia than non-corresponding disorders (all <i>p</i> &#x3c; 0.05). Moreover, iron was significantly higher in the severe than mild or moderate non-alcoholic fatty liver disease (NAFLD) group (<i>p</i> = 0.046 and 0.018). (2) Iron was positively associated with body weight, BMI, waist-to-hip ratio, uric acid, liver enzymes, postprandial blood glucose, fasting insulin, HOMA-IR, triglycerides, free fatty acid, and hepatic steatosis (CAP value), and negatively associated with high-density lipoprotein cholesterol (all <i>p</i> &#x3c; 0.05). Iron was also positively associated with the visceral adipose area in patients with obesity and negatively associated with the subcutaneous adipose area in patients with overweight (all <i>p</i> &#x3c; 0.05). (3) Iron levels and CAP values were decreased gradually 6 months and 1 year after surgery (all <i>p</i> &#x3c; 0.05). <b><i>Conclusions:</i></b> Overall, our results indicated that iron is associated with hepatic steatosis in obesity. The iron level was significantly higher in patients with severe NAFLD than with mild or moderate NAFLD. LSG may reduce iron levels while improving fat deposition in the liver.

scholarly journals The Combination of Berberine, Tocotrienols and Coffee Extracts Improves Metabolic Profile and Liver Steatosis by the Modulation of Gut Microbiota and Hepatic miR-122 and miR-34a Expression in Mice

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1281
Author(s):  
Valentina Cossiga ◽  
Vincenzo Lembo ◽  
Cecilia Nigro ◽  
Paola Mirra ◽  
Claudia Miele ◽  
...  
Keyword(s):  
Hepatic Steatosis ◽  
Plant Extracts ◽  
Elaeis Guineensis ◽  
Low Density Lipoprotein ◽  
Liver Steatosis ◽  
Density Lipoprotein ◽  
Coffea Canephora ◽  
Standard Diet ◽  
Microbial Composition ◽  
Alcoholic Fatty Liver

Non-alcoholic-fatty liver disease (NAFLD) is spreading worldwide. Specific drugs for NAFLD are not yet available, even if some plant extracts show beneficial properties. We evaluated the effects of a combination, composed by Berberis Aristata, Elaeis Guineensis and Coffea Canephora, on the development of obesity, hepatic steatosis, insulin-resistance and on the modulation of hepatic microRNAs (miRNA) levels and microbiota composition in a mouse model of liver damage. C57BL/6 mice were fed with standard diet (SD, n = 8), high fat diet (HFD, n = 8) or HFD plus plant extracts (HFD+E, n = 8) for 24 weeks. Liver expression of miR-122 and miR-34a was evaluated by quantitativePCR. Microbiome analysis was performed on cecal content by 16S rRNA sequencing. HFD+E-mice showed lower body weight (p < 0.01), amelioration of insulin-sensitivity (p = 0.021), total cholesterol (p = 0.014), low-density-lipoprotein-cholesterol (p < 0.001), alanine-aminotransferase (p = 0.038) and hepatic steatosis compared to HFD-mice. While a decrease of hepatic miR-122 and increase of miR-34a were observed in HFD-mice compared to SD-mice, both these miRNAs had similar levels to SD-mice in HFD+E-mice. Moreover, a different microbial composition was found between SD- and HFD-mice, with a partial rescue of dysbiosis in HFD+E-mice. This combination of plant extracts had a beneficial effect on HFD-induced NAFLD by the modulation of miR-122, miR-34a and gut microbiome.

scholarly journals Five-Year Outcome of Laparoscopic Sleeve Gastrectomy, Resolution of Comorbidities, and Risk for Cumulative Nutritional Deficiencies

2018 ◽  
Vol 108 (1) ◽  
pp. 10-16 ◽  
Author(s):  
E. M. Kikkas ◽  
T. Sillakivi ◽  
J. Suumann ◽  
Ü. Kirsimägi ◽  
T. Tikk ◽  
...  
Keyword(s):  
Weight Loss ◽  
Sleeve Gastrectomy ◽  
Total Cholesterol ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Excess Weight Loss ◽  
Density Lipoprotein ◽  
Nutritional Deficiencies ◽  
Low Density

Background and Aims: The aim of this study was to evaluate the long-term (5-year follow-up) results of laparoscopic sleeve gastrectomy in terms of weight loss and obesity-related comorbidities, as well as the risk factors associated with postoperative nutritional deficiencies. Material and Methods: The first 99 consecutive patients who underwent laparoscopic sleeve gastrectomy for the treatment of morbid obesity between October 2008 and August 2011 at Tartu University Hospital were followed prospectively in cohort study. The outpatient hospital follow-up visits were conducted at 3 months, 1 year, and 5 years postoperatively. At 5 years, the follow-up rate was 90.9%; 86 laparoscopic sleeve gastrectomy patients were included in final analysis. Results: The mean excess weight loss (%EWL) was 44.3% ± 13.0%, 75.8% ± 23.1%, and 61.0% ± 24.3% at 3 months, 1 year, and 5 years, respectively. A linear association between preoperative weight and weight at 5 years was found. Remission rates at 5-year follow-up for type 2 diabetes, hypertension, dyslipidemia, and obstructive sleep apnea were 68.8%, 32.7%, 27.4%, and 61.5%, respectively (all p < 0.05). There was a statistical difference (p < 0.05) in the dynamics of triglyceride, low-density lipoprotein, and high-density lipoprotein level at 5-year follow-up but the level of total cholesterol did not show significant improvement. The risk for cumulative iron, vitamin B12 deficiency, and anemia was 20%, 48%, and 28%, respectively. Conclusion: In conclusion, laparoscopic sleeve gastrectomy ensured long-term excess weight loss 61.0% at 5 years. Laparoscopic sleeve gastrectomy has a long-term effect on significant improvement in the median values of triglycerides, low-density lipoproteins, and high-density lipoproteins, but not on total cholesterol levels. There is a risk of postoperative vitamin B12 and iron deficiency.

Laparoscopic sleeve gastrectomy reverses non-alcoholic fatty liver disease modulating oxidative stress and inflammation

Metabolism ◽  
2019 ◽  
Vol 99 ◽  
pp. 81-89 ◽  
Author(s):  
Noemí Cabré ◽  
Fedra Luciano-Mateo ◽  
Salvador Fernández-Arroyo ◽  
Gerard Baiges-Gayà ◽  
Anna Hernández-Aguilera ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Sleeve Gastrectomy ◽  
Liver Disease ◽  
Fatty Liver ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Fatty Liver Disease ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease

Association Between Visfatin and Hepatic Steatosis in the General Population During Long-Term Follow-Up

2019 ◽  
Vol 51 (09) ◽  
pp. 602-607 ◽  
Author(s):  
Katharina Johannsen ◽  
Marion Flechtner-Mors ◽  
Wolfgang Kratzer ◽  
Wolfgang Koenig ◽  
Bernhard Otto Boehm ◽  
...  
Keyword(s):  
Hepatic Steatosis ◽  
Fatty Infiltration ◽  
Density Lipoprotein ◽  
Enzyme Linked Immunosorbent Assay ◽  
Model Assessment ◽  
Abdominal Ultrasonography ◽  
Cross Sectional ◽  
Alcoholic Fatty Liver

AbstractThe aim of this study was to investigate any association between the adipose tissue-derived protein, visfatin, and non-alcoholic fatty liver disease (NAFLD) and its potential long-term impact on hepatic steatosis. A cross-sectional study including 2429 randomly selected subjects was performed in 2002. Later, 403 subjects were re-evaluated in 2013. Serum visfatin concentrations were determined by sandwich enzyme-linked immunosorbent assay. Phenotyping included abdominal ultrasonography, anthropometric data, and laboratory investigations. No association was found between circulating visfatin levels and the presence of NAFLD at baseline (2002: p=0.0967) or during follow-up (2013: p=0.1312). However, a significant increase in visfatin levels in relation to the level of steatosis was seen during follow-up (p<0.0001). During the more than 10-year follow-up, the metabolic status of the study subjects worsened, with a significant increase in body mass index (BMI) (p<0.0001), waist-to-hip ratio (p<0.0001), triglycerides (TG) (p<0.0001), low-density lipoprotein (p=0.0305), homeostasis model assessment (p<0.0001), and presence of diabetes (p<0.0001). This change was accompanied by an increase in serum visfatin levels, which showed a weak correlation with BMI (p<0.0001, r=0.27586) and presence of diabetes (p<0.0043, r=0.14188). A statistically significant correlation between leucocyte numbers and serum visfatin concentration (p<0.0001, r=0.25615) was found. We found no association between visfatin levels and the presence or absence of NAFLD or the degree of hepatic fatty infiltration at baseline. There was a strong correlation between serum visfatin concentrations and the number of leucocytes, which may suggest a proinflammatory role for visfatin.

scholarly journals Impact of Laparoscopic Sleeve Gastrectomy on the Course of Non-Alcoholic Fatty Liver Disease

2020 ◽  
Vol 13 (3) ◽  
pp. 190-200
Author(s):  
Aleksandra Mitsinskaya ◽  
Victor Kaschenko ◽  
Mikhail Fishman ◽  
Alexey C. Sokolov ◽  
V. S. Samoilov ◽  
...  
Keyword(s):  
Sleeve Gastrectomy ◽  
Liver Disease ◽  
Fatty Liver ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Fatty Liver Disease ◽  
High Density Lipoproteins ◽  
Alcoholic Fatty Liver ◽  
The Impact ◽  
Alcoholic Fatty Liver Disease

Introduction. Non-alcoholic fatty liver disease (NAFLD) is one of the most common pathologies in obesity, at the same time the impact of bariatric operations on the course of NAFLD remains unresolved and debatable, the issue determining the relevance of this work.The aim of the study was to assess the effect of laparoscopic sleeve gastrectomy (LSG) on the course of NAFLD and determine the criteria that affect the dynamics of NAFLD after a performed bariatric intervention.Materials and methods. The study included clinical outcomes of 64 patients who underwent LSG between 2014 and 2017. Intraoperative liver biopsy, laboratory and instrumental investigations, the calculation of FibroTest in dynamics were performed to all patients. The frequency of postoperative complications was assessed. Follow up examinations including 58 (90.6%) patients were carried out during 2 years.Results. Initially, 29 (45,3%) patients manifested signs of fibrosis according to METAVIR, and 19 (29,7%) patients manifested signs of non-alcoholic steatohepatitis (NASH). Elevated transaminases were registered in 14 (21,9%) patients, elevated levels of gamma-glutamyl transpeptidase (GGTP) were registered in 47 (73,4%) patients, increased total bilirubin were registered in 12 (18,8%) patients, increased alkaline phosphatase (ALP) were registered in 21 (32,8%) patients. There was an increased level of trygliceride (TG) and decreased level of high density lipoproteins (HDL) in 54 (84,4%) patients. Ultrasound investigation of the liver revealed an increased liver size in 46 (71,9%) patients, diffuse heterogeneity of the liver in 61 (95,3%), hyperechogenicity in 60 (93,8%) patients. Manifestations of liver cirrhosis were registered in 1 (1,6%) patient.There was a significant decrease in the excess body weight in the postoperative period, and hereat, the % EBMIL (Excess Body Mass Index Loss, percentage of overweight loss) in 1 year after laparoscopic sleeve gastrectomy achieved satisfactory values and amounted to 68,30 [58,67-78,77] %. ALT, AST findings were normal in 79,7% of operated patients, cholestasis parameters - in 76,5% of operated patients, FibroTest findings - in 42,2% of cases. In 6 months after surgery there was a deterioration of the clinical and biochemical properties of non-alcoholic fatty liver disease, which was transient and regressed in one year after surgery. The mortality rate during the entire follow-up period was 0%. The effect of the surgery on the signs of non-alcoholic fatty liver disease persisted for 2 years after surgery.Laparoscopic sleeve gastrectomy demonstrated high effectiveness in patients under 45 years old compared to the patients over 45 years old, and in patients with initial stages of fibrosis F0-F2 by METAVIR compared to patients with stages F3-F4 by METAVIR. In addition, patients with BMI higher than 40 kg/m2 achieved higher FibroTest findings after 6 months compared to subjects with BMI lower than 40 kg/m2, and in fewer cases FibroTest findings normalized in 1 year after surgery, respectively.Conclusions. Therefore, it was noted the efficacy of laparoscopic sleeve gastrectomy in patients with obesity and non-alcoholic fatty liver disease; at the same time, it was revealed a transient worsening of the course of the disease in 6 months after surgery.

scholarly journals Laparoscopic sleeve gastrectomy alters 1H-NMR-measured lipoprotein and glycoprotein profile in patients with severe obesity and nonalcoholic fatty liver disease

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Noemí Cabré ◽  
Míriam Gil ◽  
Núria Amigó ◽  
Fedra Luciano-Mateo ◽  
Gerard Baiges-Gaya ◽  
...  
Keyword(s):  
Morbid Obesity ◽  
Sleeve Gastrectomy ◽  
Liver Disease ◽  
Fatty Liver ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Protein Glycation ◽  
Alcoholic Fatty Liver ◽  
Nonalcoholic Fatty Liver ◽  
Ldl Particles ◽  
One Year

AbstractPatients with morbid obesity frequently present non-alcoholic fatty liver (NAFL) and non-alcoholic steatohepatitis (NASH) associated with pro-atherogenic alterations. Laparoscopic sleeve gastrectomy (LSG) is an effective treatment for weight reduction, and for the remission of hepatic alterations. Using 1H-nuclear magnetic resonance (1H-NMR), we investigated the effects of LSG on lipoprotein and glycoprotein profile in patients with morbid obesity and liver disease. We included 154 patients with morbid obesity (49 non-NASH, 54 uncertain NASH, 51 definite NASH). A blood sample was obtained before surgery and, in patients with definite NASH, one year after surgery. Patients with NASH had increased concentrations of medium and small VLDL particles, VLDL and IDL cholesterol concentrations, IDL, LDL, and HDL triglyceride concentrations, and elevated glycoprotein levels. These changes were more marked in patients with type 2 diabetes mellitus. LSG produced significant decreases in the concentration of VLDL particles, VLDL cholesterol and triglycerides, an increase in the concentration LDL particles and LDL cholesterol concentrations, and a decrease in protein glycation. We conclude that patients with obesity and NASH had significant alterations in circulating levels of lipoproteins and glycoproteins that were associated with the severity of the disease. Most of these changes were reversed post-LSG.

scholarly journals The state of dyslipidemia after laparoscopic sleeve gastrectomy

2018 ◽  
Vol 5 (7) ◽  
pp. 2392
Author(s):  
Ahmed Mahmoud Hussein
Keyword(s):  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
The Body ◽  
P Value ◽  
Morbidly Obese ◽  
Successful Operation ◽  
Restrictive Procedure ◽  
The Mean

Background: Obesity and dyslipidemia have a strong relation to the development of cardiovascular diseases. Bariatric surgery is directed towards the loss of patients weight and resolution of comorbidities as hyperlipidemia. Laparoscopic sleeve gastrectomy, a feasible restrictive procedure, is one the most popular and successful operations for achieving this purpose. The aim of present study was to evaluate the effect of laparoscopic sleeve gastrectomy on the lipid profile, comparing preoperative with postoperative results 12 months after surgery.Methods: This study included fifty morbidly obese cases that underwent laparoscopic sleeve gastrectomy (LSG). Preoperative and postoperative BMI and lipid parameters were documented and analysed at 12 months postoperatively.Results: The mean age of the studied group ±SD was 32.7±9.2 years, female predominance was found. BMI improved significantly after the LSG procedure with a mean±SD of 32.2±4 kg/m2. A significant improvement of dyslipidemia was found with a p-value (<0.001) regarding the mean level±SD of total cholesterol (TC) (180.5±25mg/dl), triglycerides (TG) (127.2±14.7mg/dl), low density lipoprotein (LDL) (94.2±14.5mg/dl) and high density lipoprotein (HDL) (48.4±5.6 mg/dl).Conclusions: Laparoscopic sleeve gastrectomy is a feasible and successful operation in reducing the body weight and subsequently improving the dyslipidemia of the morbid obese individuals.

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