scholarly journals Caspase-Cleaved Keratin 18 Measurements Identified Ongoing Liver Injury after Bariatric Surgery

2021 ◽  
Vol 10 (6) ◽  
pp. 1233
Author(s):  
Felix Hempel ◽  
Martin Roderfeld ◽  
Lucas John Müntnich ◽  
Jens Albrecht ◽  
Ziya Oruc ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Liver Disease ◽  
Liver Injury ◽  
Response To Treatment ◽  
Morbidly Obese ◽  
Alcoholic Fatty Liver ◽  
Laboratory Parameters ◽  
Nafld Fibrosis Score ◽  
Keratin 18 ◽  
One Year

Bariatric surgery has emerged as an effective treatment option in morbidly obese patients with non-alcoholic fatty liver disease (NAFLD). However, worsening or new onset of non-alcoholic steatohepatitis (NASH) and fibrosis have been observed. Caspase-cleaved keratin 18 (ccK18) has been established as a marker of hepatocyte apoptosis, a key event in NASH development. Thus, ccK18 measurements might be feasible to monitor bariatric surgery patients. Clinical data and laboratory parameters were collected from 39 patients undergoing laparoscopic Roux-en-Y gastric bypass at six timepoints, prior to surgery until one year after the procedure. ccK18 levels were measured and a high-throughput analysis of serum adipokines and cytokines was carried out. Half of the cohort’s patients (20/39) presented with ccK18 levels indicative of progressed liver disease. 21% had a NAFLD-fibrosis score greater than 0.676, suggesting significant fibrosis. One year after surgery, a mean weight loss of 36.87% was achieved. Six and twelve months after surgery, ccK18 fragments were significantly reduced compared to preoperative levels (p < 0.001). Yet nine patients did not show a decline in ccK18 levels ≥ 10% within one year postoperatively, which was considered a response to treatment. While no significant differences in laboratory parameters or ccK18 could be observed, they presented with a greater expression of leptin and fibrinogen before surgery. Consecutive ccK18 measurements monitored the resolution of NAFLD and identified non-responders to bariatric surgery with ongoing liver injury. Further studies are needed to elicit the pathological mechanisms in non-responders and study the potential of adipokines as prognostic markers.

Prevalence and Predictors of Non-Alcoholic Fatty Liver Disease in Morbidly Obese South Indian Patients Undergoing Bariatric Surgery

2015 ◽  
Vol 25 (11) ◽  
pp. 2078-2087 ◽  
Author(s):  
Palanivelu Praveenraj ◽  
Rachel M. Gomes ◽  
Saravana Kumar ◽  
Purushothaman Karthikeyan ◽  
Annapoorni Shankar ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Morbidly Obese ◽  
Alcoholic Fatty Liver ◽  
Indian Patients ◽  
South Indian ◽  
Alcoholic Fatty Liver Disease

scholarly journals Plasma sgp130 is an independent predictor of non-alcoholic fatty liver disease severity

2022 ◽  
Author(s):  
Aysim Gunes ◽  
Laurent Bilodeau ◽  
Catherine Huet ◽  
Assia Belblidia ◽  
Cindy Baldwin ◽  
...  
Keyword(s):  
Metabolic Disease ◽  
Liver Disease ◽  
Disease Severity ◽  
Liver Stiffness ◽  
Morbidly Obese ◽  
Resonance Spectroscopy ◽  
Liver Pathology ◽  
Alcoholic Fatty Liver ◽  
Non Invasive ◽  
Nafld Fibrosis Score

Background: Nonalcoholic steatohepatitis (NASH) is a metabolic disease associated with liver failure and cancer. Accurate monitoring of advancing NASH is challenging. There are few reliable, non-invasive biomarkers of early NASH. Since liver inflammation is a main driver of fibrosis, we investigated relationships between circulating components of the interleukin-6 signaling pathway (IL-6, sIL-6R and sgp130) and liver pathology in subjects with NAFLD and NASH. Methods: Predictive performance of plasma IL-6, sIL-6R and sgp130 were investigated in two independent cohorts: 1) patients with biopsy-confirmed NASH (n=49), where magnetic resonance spectroscopy (MRS), imaging (MRI) and elastography (MRE) assessed liver fat, volume and stiffness; and 2) patients with morbid obesity (n=245) undergoing bariatric surgery where Bedossa algorithm and steatosis, activity, and fibrosis scores assessed NASH severity. Correlations were evaluated between circulating IL-6, sIL-6R and sgp130 and anthropomorphic characteristics, plasma markers of metabolic disease or liver pathology, adjusting for covariates of liver disease such as age, sex, BMI and diabetes. Results: In patients with NASH, plasma IL-6 and sgp130 strongly correlated with liver stiffness, which for sgp130, was independent of age, sex, BMI, and chronic disease (diabetes, hyperlipidemia, hypertension or history of HCC). Plasma sgp130 was the strongest predictor of liver stiffness compared to commonly used biomarkers and predictive algorithms. Plasma sIL-6R correlated with liver volume independent of age, sex, and BMI. In stepwise forward regression analysis, plasma sgp130 followed by NAFLD fibrosis score and plasma globulin, predicted up to 74% of liver stiffness with/without adjustment for sex. In morbidly obese subjects, circulating IL-6 correlated with hepatocellular ballooning and sgp130 correlated with advanced liver fibrosis. Conclusions: Circulating sgp130 could represent a robust biomarker of active NASH and may be used alone or in combination with other biomarkers as a non-invasive measure of liver disease severity.

scholarly journals Review article: non-alcoholic fatty liver disease in morbidly obese patients and the effect of bariatric surgery

2007 ◽  
Vol 26 ◽  
pp. 195-201 ◽  
Author(s):  
R. J. J. DE RIDDER ◽  
E. J. SCHOON ◽  
J. F. SMULDERS ◽  
G. C. M. VAN HOUT ◽  
R. W. STOCKBRÜGGER ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Review Article ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease

scholarly journals MON-592 The Impact of Bariatric Surgery on the Risk of Non-Alcoholic Fatty Liver Disease in Morbidly Obese Patients

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Marta Borges-Canha ◽  
João Sérgio Neves ◽  
Fernando Mendonça ◽  
Maria Manuel Silva ◽  
Cláudia Costa ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Fatty Liver ◽  
Gastric Band ◽  
Hepatic Function ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Hepatic Enzymes ◽  
Alcoholic Fatty Liver ◽  
One Year ◽  
Alcoholic Fatty Liver Disease

Abstract Introduction: Non-alcoholic fatty liver disease (NAFLD) is strongly associated with obesity, and the prevalence of both diseases is increasing notably. The lack of effective treatment options for NAFLD is leading to a great consideration towards the identification of new approaches. Aim: We aimed to evaluate the change one year after bariatric surgery of parameters of hepatic function and in the hepatic scores, Fatty Liver Index (FLI, predictor of hepatic steatosis), and BARD, BMI, AST/ALT ratio and DM, (predictor of hepatic fibrosis). Methods: Observational retrospective cohort study in morbidly obese patients that underwent bariatric surgery between January 2010 and July 2018. We excluded patients missing hepatic function parameters before or one year after the surgical procedure. We used two linear regression models: 1) unadjusted; 2) adjusted for surgery type (gastric sleeve, gastric band and gastric bypass), sex, age, body mass index, diabetes and dyslipidaemia. Results: The included population (n=1955) had an average age of 43.1±10 years and 85.8% were female. We observed a relevant decrease in transaminases (pre-operative AST and ALT, 24.8±12.4 and 29.5±19.5U/L, vs 22.4 ± 11.1 and 22.2±14.7 post-operatively, respectively, p&lt;0.01) and gamma-glutamyltransferase (36.9±35.4 vs 21.4±22.0U/L, p&lt;0.01), and an increase in alkaline phosphatase (77.8±23.5 vs 80.8±25.4U/L, p&lt;0.01) and total bilirubin (0.56±0.23 vs 0.68±0.24mg/dL, p&lt;0.01). Both FLI and BARD markedly decrease one year after surgery (p&lt;0.01). Comparing the surgical procedures, gastric sleeve was associated with a greater reduction of hepatic enzymes and of both FLI and BARD comparing with gastric band. Comparing with gastric bypass, sleeve was associated with a greater reduction of transaminases and alkaline phosphatase, but a smaller reduction of FLI and BARD. Conclusion: Bariatric surgery is associated with a reduction of the hepatic enzymes and an improvement of FLI and BARD. Bariatric surgery may represent an effective therapeutic approach to NAFLD.

scholarly journals Bariatric Metabolic Surgery Reduced Liver Enzyme Levels in Patients with Non-Alcohol Fatty Liver Disease

2021 ◽  
Vol 14 ◽  
pp. 209-214
Author(s):  
Kennedy Kirkpatrick ◽  
Bobbie Paull-Forney ◽  
Hayrettin Okut ◽  
Tiffany Schwasinger-Schmidt
Keyword(s):  
Bariatric Surgery ◽  
Liver Disease ◽  
Blood Glucose ◽  
Fatty Liver ◽  
Liver Enzyme ◽  
Fatty Liver Disease ◽  
Surgical Intervention ◽  
The United States ◽  
Alcoholic Fatty Liver ◽  
One Year

Introduction. Approximately 93.3 million Americans are obese (BMI>30) and 51% have non-alcoholic fatty liver disease (NAFLD).  Progression of NAFLD can lead to Non-Alcoholic Steatohepatitis (NASH), the leading cause of liver transplant in the United States. This study analyzed liver enzymes following bariatric surgery in NAFLD patients up to one-year post-surgical intervention. Methods. A retrospective analysis of adults with NAFLD who underwent bariatric surgery from 2009 to 2016 was conducted. The primary outcome were transaminase levels following weight loss. Secondary outcomes included effects on blood glucose, lipids, and blood pressure. Results. A total of 130 participants consisting of 80% Caucasian females with an average BMI of 47.5 participated in the study. Reductions were noted in ALT (66.2 to 28.6 units/L) and AST (46.3 to 24.2 units/L) at 1 year post-surgical intervention.  Significant reductions were also noted in blood glucose (22.34%; p < .0001), HbA1c (17.11% p < .0001), LDL (19.75% p = .0046), total cholesterol (10.12% p = .0153), and triglycerides (37.21% p < .0001) with an increase in HDL (17.22% p = .0007). Significant correlations between alkaline phosphatase and ALT were noted at six months (p=.0101) and one year (p= .0547) and AST at six months (p=.0009). When separated by obesity class, participants with class II obesity experienced improved outcomes. Conclusions. Data obtained from this study indicated that bariatric surgery reduces liver enzyme levels in NAFLD. These findings suggest that bariatric surgery is a viable treatment option for participants with NAFLD.

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