Nonalcoholic fatty liver disease and bariatric surgery: a comprehensive review

ABSTRACT CONTEXT AND OBJECTIVE: Nonalcoholic fatty liver disease (NAFLD) has been increasingly diagnosed worldwide and is now recognized as a source of public health concern. It comprises a wide spectrum of histological features that range from simple steatosis to severe forms of fibrosis, steatohepatitis and even cirrhosis. The impact of bariatric surgery on the course of NAFLD in individuals with obesity has been extensively studied. DESIGN AND SETTING: Narrative review; public university hospital. METHODS: A comprehensive review was conducted based on an online search on the electronic databases MEDLINE and LILACS using the MeSH terms “fatty liver” and “bariatric surgery”. RESULTS: The exact mechanisms that lead to improvement in NAFLD following bariatric surgery are not completely understood. Since Roux-en-Y gastric bypass (RYGB) is the bariatric surgical procedure most performed worldwide, it is also the one from which the effects on NAFLD have been most studied, although there is also consistent evidence regarding the effects from gastric banding, sleeve gastrectomy and biliopancreatic diversions. CONCLUSION: According to the currently available evidence, bariatric surgery leads to significant improvement in NAFLD. Further research, especially by means of randomized controlled trials enrolling larger cohorts of individuals, is needed to determine the optimal procedure for this group of subjects.

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The impact of bariatric surgery on nonalcoholic fatty liver disease as measured using non-invasive tests

The American Journal of Surgery ◽

10.1016/j.amjsurg.2020.11.045 ◽

2020 ◽

Author(s):

Carmit Netanel ◽

David Goitein ◽

Moshe Rubin ◽

Yeruham Kleinbaum ◽

Sima Katsherginsky ◽

...

Keyword(s):

Bariatric Surgery ◽

Liver Disease ◽

Fatty Liver ◽

Nonalcoholic Fatty Liver Disease ◽

Fatty Liver Disease ◽

Nonalcoholic Fatty Liver ◽

Non Invasive ◽

The Impact

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The impact of bariatric surgery on nonalcoholic fatty liver disease

Current Opinion in Clinical Nutrition & Metabolic Care ◽

10.1097/mco.0b013e3282fbd33f ◽

2008 ◽

Vol 11 (3) ◽

pp. 267-274 ◽

Cited By ~ 20

Author(s):

Alexandre Coutinho Teixeira de Freitas ◽

Antonio Carlos Ligocki Campos ◽

Julio Cezar Uili Coelho

Keyword(s):

Bariatric Surgery ◽

Liver Disease ◽

Fatty Liver ◽

Nonalcoholic Fatty Liver Disease ◽

Fatty Liver Disease ◽

Nonalcoholic Fatty Liver ◽

The Impact

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The impact of bariatric surgery on nonalcoholic fatty liver disease and cardiovascular risk utilizing non-invasive measures

Journal of Hepatology ◽

10.1016/s0168-8278(17)30768-7 ◽

2017 ◽

Vol 66 (1) ◽

pp. S232-S233

Author(s):

C. Netanel ◽

D. Goitein ◽

M. Rubin ◽

M. Shechter ◽

Y. Kleinbaum ◽

...

Keyword(s):

Bariatric Surgery ◽

Cardiovascular Risk ◽

Liver Disease ◽

Fatty Liver ◽

Nonalcoholic Fatty Liver Disease ◽

Fatty Liver Disease ◽

Nonalcoholic Fatty Liver ◽

Non Invasive ◽

The Impact

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Nonalcoholic fatty liver disease and the risk of atrial fibrillation stratified by body mass index: a nationwide population-based study

Scientific Reports ◽

10.1038/s41598-021-83367-x ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

So-Ryoung Lee ◽

Kyung-Do Han ◽

Eue-Keun Choi ◽

Seil Oh ◽

Gregory Y. H. Lip

Keyword(s):

Atrial Fibrillation ◽

Body Mass Index ◽

Liver Disease ◽

Fatty Liver ◽

Nonalcoholic Fatty Liver Disease ◽

Body Mass ◽

Fatty Liver Disease ◽

Nonalcoholic Fatty Liver ◽

Increased Risk ◽

The Impact

AbstractWe evaluated the association between nonalcoholic fatty liver disease (NAFLD) and incident atrial fibrillation (AF) and analyzed the impact of NAFLD on AF risk in relation to body mass index (BMI). A total of 8,048,055 subjects without significant liver disease who were available fatty liver index (FLI) values were included. Subjects were categorized into 3 groups based on FLI: < 30, 30 to < 60, and ≥ 60. During a median 8-year of follow-up, 534,442 subjects were newly diagnosed as AF (8.27 per 1000 person-years). Higher FLI was associated with an increased risk of AF (hazard ratio [HR] 1.053, 95% confidence interval [CI] 1.046–1.060 in 30 ≤ FLI < 60, and HR 1.115, 95% CI 1.106–1.125 in FLI ≥ 60). In underweight subjects (BMI < 18.5 kg/m2), higher FLI raised the risk of AF (by 1.6-fold in 30 ≤ FLI < 60 and by twofold in FLI ≥ 60). In normal- and overweight subjects, higher FLI was associated with an increased risk of AF, but the HRs were attenuated. In obese subjects, higher FLI was not associated with higher risk of AF. NAFLD as assessed by FLI was independently associated with an increased risk of AF in nonobese subjects with BMI < 25 kg/m2. The impact of NAFLD on AF risk was accentuated in lean subjects with underweight.

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