scholarly journals Risks and Rewards of Bariatric Surgery in Advanced Chronic Liver Diseases

2021 ◽  
Author(s):  
Yuly P. Mendoza ◽  
Chiara Becchetti ◽  
Kymberly D. Watt ◽  
Annalisa Berzigotti
Keyword(s):  
Bariatric Surgery ◽  
Metabolic Syndrome ◽  
Weight Loss ◽  
Liver Disease ◽  
Liver Function ◽  
Alcohol Misuse ◽  
Early Recognition ◽  
Chronic Liver ◽  
Chronic Liver Diseases ◽  
Marked Weight

AbstractThe burden of obesity and metabolic syndrome has determined a sharp increase in bariatric surgery (BS) procedures, which lead to marked weight loss, improved metabolic syndrome, reduced cardiovascular risk, and even improvement in nonalcoholic steatohepatitis (NASH). Despite these promising results, BS in patients with chronic liver disease can rarely lead to worsening of liver function, progression to cirrhosis and its complications, and even liver transplantation. On the other hand, since obesity in patients with cirrhosis is a major cofactor for progression to a decompensated stage of the disease and a risk factor for hepatocellular carcinoma, BS has been used to achieve weight loss in this population. In this review, we critically analyze the existing data on outcomes of BS in patients with cirrhosis and the possible mechanisms leading to fibrosis progression and worsening liver function in patients undergoing BS. Finally, we propose a set of measures that could be taken to improve the multidisciplinary management of liver disease in patients undergoing BS, including early recognition of malnutrition and alcohol misuse.

scholarly journals The Role of the Gut Microbiome in Liver Cirrhosis Treatment

2020 ◽  
Vol 22 (1) ◽  
pp. 199
Author(s):  
Na Young Lee ◽  
Ki Tae Suk
Keyword(s):  
Liver Cirrhosis ◽  
Liver Disease ◽  
Liver Fibrosis ◽  
Gut Microbiota ◽  
Gut Microbiome ◽  
Liver Diseases ◽  
Sclerosing Cholangitis ◽  
Chronic Liver ◽  
Chronic Liver Diseases

Liver cirrhosis is one of the most prevalent chronic liver diseases worldwide. In addition to viral hepatitis, diseases such as steatohepatitis, autoimmune hepatitis, sclerosing cholangitis and Wilson’s disease can also lead to cirrhosis. Moreover, alcohol can cause cirrhosis on its own and exacerbate chronic liver disease of other causes. The treatment of cirrhosis can be divided into addressing the cause of cirrhosis and reversing liver fibrosis. To this date, there is still no clear consensus on the treatment of cirrhosis. Recently, there has been a lot of interest in potential treatments that modulate the gut microbiota and gut-liver axis for the treatment of cirrhosis. According to recent studies, modulation of the gut microbiome by probiotics ameliorates the progression of liver disease. The precise mechanism for relieving cirrhosis via gut microbial modulation has not been identified. This paper summarizes the role and effects of the gut microbiome in cirrhosis based on experimental and clinical studies on absorbable antibiotics, probiotics, prebiotics, and synbiotics. Moreover, it provides evidence of a relationship between the gut microbiome and liver fibrosis.

scholarly journals Utility of Fibroscan XL to assess the severity of non-alcoholic fatty liver disease in patients undergoing bariatric surgery

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Andrew Yang ◽  
Melinda Nguyen ◽  
Irene Ju ◽  
Anthony Brancatisano ◽  
Brendan Ryan ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Liver Stiffness ◽  
Convincing Evidence ◽  
Alcoholic Fatty Liver ◽  
Post Surgery

AbstractSignificant weight loss can modify the progression of Nonalcoholic fatty liver disease (NAFLD) with the most convincing evidence coming from bariatric surgery cohorts. Effective ways to non-invasively characterise NAFLD in these patients has been lacking, with high Fibroscan failure rates reported. We prospectively evaluated the utility of Fibroscan using XL-probe over a two-year period. 190 consecutive patients undergoing bariatric surgery were followed as part of their routine care. All patients had Fibroscan performed on the day of surgery and at follow-up a mean of 13 months (± 6.3) later. The majority of patients were female (82%) with mean age of 42. Fibroscan was successful in 167 (88%) at baseline and 100% at follow up. Patients with a failed Fibroscan had higher body mass index (BMI) and alanine transaminase (ALT), but no difference in FIB-4/NAFLD score. Mean baseline Liver stiffness measurement was 5.1 kPa, with 87% of patients classified as no fibrosis and 4% as advanced fibrosis. Mean baseline controlled attenuation parameter was 291, with 78% having significant steatosis, 56% of which was moderate-severe. Significant fibrosis was associated with higher BMI and HbA1c. Significant steatosis was associated with higher BMI, ALT, triglycerides and insulin resistance. Mean follow up time was 12 months with weight loss of 25.7% and BMI reduction of 10.4 kg/m2. Seventy patients had repeat fibroscan with reductions in steatosis seen in 90% and fibrosis in 67%. Sixty-four percent had complete resolution of steatosis. Fibroscan can be performed reliably in bariatric cohorts and is useful at baseline and follow-up. Significant steatosis, but not fibrosis was seen in this cohort with substantial improvements post-surgery.

scholarly journals Novel Laboratory Tests in Assessment of Liver Function in Acute and Chronic Liver Diseases

2009 ◽  
Vol 63 (4-5) ◽  
pp. 228-233
Author(s):  
Ludmila Vīksna ◽  
Jāzeps Keišs ◽  
Artūrs Sočņevs ◽  
Baiba Rozentāle ◽  
Māra Pilmane ◽  
...  
Keyword(s):  
Liver Function ◽  
Liver Biopsy ◽  
Liver Diseases ◽  
Laboratory Tests ◽  
Serum Markers ◽  
Chronic Liver ◽  
Chronic Liver Diseases ◽  
Noninvasive Methods ◽  
Disease Evolution ◽  
Prognostic Accuracy

Novel Laboratory Tests in Assessment of Liver Function in Acute and Chronic Liver Diseases Liver biopsy in clinical practice has been widely used for the diagnosis and management of patients with liver diseases, particularly, with chronic liver diseases. However, liver biopsy is an invasive method with potential complications, sampling and interpretation errors. Therefore, noninvasive tests are being developed and introduced to replace liver biopsy. The aim of the present study was to identify the new noninvasive methods to be used for the assessment of liver structure and function, by use of the appropriate serum surrogate markers and to evaluate the clinical diagnostic and prognostic accuracy of these methods, including immunogenetic methods, in cases of acute and chronic liver diseases. The obtained data showed that serum markers of apoptosis (cytokeratin-18 neoepitope and citochrome c) and fibrosis (hyaluronic acid) should be included in viral and toxic liver damage management algorithms. The punctual identification of immunogenetic factors (HLA class II antigens) may prove to be useful in predicting disease evolution, and in guiding the appropriate therapy for patients with poor prognosis.

scholarly journals Author Reply—Bariatric Surgery and Liver Function Tests in Nonalcoholic Fatty Liver Disease

2017 ◽  
Vol 27 (4) ◽  
pp. 1060-1060
Author(s):  
Geraldine J. Ooi ◽  
Paul R. Burton ◽  
William W. Kemp ◽  
Stuart K. Roberts ◽  
Wendy A. Brown
Keyword(s):  
Bariatric Surgery ◽  
Liver Disease ◽  
Liver Function ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Fatty Liver Disease ◽  
Liver Function Tests ◽  
Author Reply ◽  
Nonalcoholic Fatty Liver ◽  
Function Tests

scholarly journals TOLAK UKUR FUNGSI HATI BERDASARKAN DERAJAT FIBROSIS PENYAKIT HATI KRONIS (Liver Function Parameters based on Degree of Liver Fibrosis in Chronic Liver Disease)

2018 ◽  
Vol 21 (1) ◽  
pp. 57
Author(s):  
Rahmafitria Rahmafitria ◽  
Mutmainnah Mutmainnah ◽  
Ibrahim Abdul Samad
Keyword(s):  
Liver Disease ◽  
Liver Fibrosis ◽  
Liver Function ◽  
Chronic Liver Disease ◽  
Total Bilirubin ◽  
Chronic Liver ◽  
Low Degree ◽  
Significant Difference ◽  
The Mean ◽  
High Degree

Evaluating the degree of liver fibrosis degree is invasive as well as uncomfortable, therefore, non invasive examinations such as liverfunction tests and elastography (Fibro Scan) as a predictor‘s device of liver fibrosis degree are necessary. The aim of this study was toknow the differences of liver function parameters based on the fibrosis degree in patients with chronic liver disease. This study was a crosssectional design using data from chronic liver disease patients treated at the Dr. Wahidin Sudirohusodo Hospital. The elasticity of the liverwas measured using a fibro scan device during June 2010–July 2011. The analysis was carried out by ANOVA test on various parametersof liver function particularly on the fibrosis degree in chronic liver disease. In this study PT, albumin, total bilirubin and platelet countshowed a significant difference of 0.019, 0.009, 0.017 and 0.000 respectively. The mean values of PT and total bilirubin were significantlyhigher in the high degree of fibrosis compared to those with medium and low degree of fibrosis in the chronic liver disease patients. Basedon this study, the mean albumin levels and platelet count were significantly lower in the high degree of fibrosis compared with the mediumand low degree of fibrosis, however, no significant differences in AST, ALT, APTT and GGT were found.

scholarly journals Asthenia and fatigue in hyperammonemia: etiopathogenesis and methods of correction

2022 ◽  
pp. 95-104
Author(s):  
E. Yu. Plotnikova ◽  
M. N. Sinkova ◽  
L. K. Isakov
Keyword(s):  
Liver Disease ◽  
Liver Diseases ◽  
Signs And Symptoms ◽  
Chronic Liver ◽  
Blood Levels ◽  
Chronic Liver Diseases ◽  
Life Threatening ◽  
Underlying Causes ◽  
Principles Of Treatment ◽  
The Brain

Asthenia and fatigue are the most common syndromes in patients with liver disease, which significantly affects their quality of life. The prevalence of fatigue in chronic liver diseases is from 50% to 85%. While some progress has been made in understanding the processes that can cause fatigue in general, the underlying causes of fatigue associated with liver disease remain not well understood. In particular, many data suggest that fatigue associated with liver disease likely results from changes in neurotransmission in the brain against the background of hyperammonemia. Hyperammonemia is a metabolic state characterized by an increased level of  ammonia, a  nitrogen-containing compound. The  present review describes hyperammonemia, which is likely important in the pathogenesis of fatigue associated with liver disease. Ammonia is a potent neurotoxin, its elevated blood levels can cause neurological signs and symptoms that can be acute or chronic, depending on the  underlying pathology. Hyperammonemia should be recognized early, and immediately treated to prevent the development of life-threatening complications, such as, swelling of the brain and coma. The article gives pathophysiological mechanisms of influence of hyperammonemia on state of psychovegetative status of patients with liver diseases, also lists basic principles of treatment. A significant part of the article is devoted to L-ornithine-L-aspartate, which is effective in asthenia and fatigue to reduce the level of hyperammonemia through a variety of well-studied mechanisms in chronic liver diseases.

scholarly journals The Course Of Chronic Liver Disease In Patients With Covid-2019 (Literature Review And Own Data)

2021 ◽  
Vol 03 (09) ◽  
pp. 69-74
Author(s):  
Muxamedova Z.R. ◽  
Keyword(s):  
Liver Disease ◽  
Literature Review ◽  
Liver Diseases ◽  
Chronic Liver ◽  
Chronic Liver Diseases ◽  
Biochemical Activity ◽  
Severe Liver ◽  
Risk Of Mortality ◽  
The World ◽  
Severe Liver Damage

The pandemic of the new coronavirus COVID-19 has switched medicine around the world on the primary fight against this infection. Patients with chronic liver diseases require increased attention of doctors during an epidemic, since against the background of an exacerbation of their disease, not only the risk of contracting the COVID 19 viral infection increases, but also its more severe course. Patients with confirmed COVID-19 with severe liver damage - high biochemical activity. According to some reports, patients with a severe course of COVID-19 have an increase in ALT levels, a decrease in the number of platelets, a decrease in the level of albumin, and a connection (although not all indicators) with a higher risk of mortality is possible.

scholarly journals Dynamic changes in liver function parameters in patients with coronavirus disease 2019: a multicentre, retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Qing-Lei Zeng ◽  
Zu-Jiang Yu ◽  
Fanpu Ji ◽  
Guang-Ming Li ◽  
Guo-Fan Zhang ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Liver Disease ◽  
Liver Function ◽  
Chronic Liver Disease ◽  
Chronic Liver ◽  
Gamma Glutamyl Transferase ◽  
Dynamic Changes ◽  
Viral Shedding ◽  
Glutamyl Transferase ◽  
Multicentre Retrospective Study

Abstract Background Liver injuries have been reported in patients with coronavirus disease 2019 (COVID-19). This study aimed to investigate the clinical role played by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods In this multicentre, retrospective study, the parameters of liver function tests in COVID-19 inpatients were compared between various time-points in reference to SARS-CoV-2 shedding, and 3 to 7 days before the first detection of viral shedding was regarded as the reference baseline. Results In total, 70 COVID-19 inpatients were enrolled. Twenty-two (31.4%) patients had a self-medication history after illness. At baseline, 10 (14.3%), 7 (10%), 9 (12.9%), 2 (2.9%), 15 (21.4%), and 4 (5.7%) patients already had abnormal alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), albumin, and total bilirubin (TBIL) values, respectively. ALT and AST abnormal rates and levels did not show any significant dynamic changes during the full period of viral shedding (all p > 0.05). The GGT abnormal rate (p = 0.008) and level (p = 0.033) significantly increased on day 10 of viral shedding. Meanwhile, no simultaneous significant increases in abnormal ALP rates and levels were observed. TBIL abnormal rates and levels significantly increased on days 1 and 5 of viral shedding (all p < 0.05). Albumin abnormal decrease rates increased, and levels decreased consistently from baseline to SARS-CoV-2 clearance day (all p < 0.05). Thirteen (18.6%) patients had chronic liver disease, two of whom died. The ALT and AST abnormal rates and levels did not increase in patients with chronic liver disease during SARS-CoV-2 shedding. Conclusions SARS-CoV-2 does not directly lead to elevations in ALT and AST but may result in elevations in GGT and TBIL; albumin decreased extraordinarily even when SARS-CoV-2 shedding ended.

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