Hassanian Mazen, Al-Mulhim Amnah, Al-Sabhan Atheer, Al-Amro Shaden, Bamehriz Fahad, Abdo Ayman, Al Khalidi Hisham, Aldoheyan Tamader A
Department of Surgery, College of Medicine, King Khalid University Hospital, Riyadh, Saudi Arabia.
Saudi J Gastroenterol. 2014 Sep-Oct;20(5):270-8. doi: 10.4103/1319-3767.141684.
A review of published data addressing hepatic histopathological, metabolical, and functional changes following gastric banding, sleeve gastrectomy, gastric bypass surgery, and biliopancreatic with duodenal switch surgeries on nonalcoholic fatty liver disease (NAFLD). NAFLD is currently the most common chronic liver disease. Owing to the strong relationship between obesity and NAFLD, the idea of weight reduction as a method to treat NAFLD has rapidly emerged. Bariatric surgery has proved to be the most efficient method for weight reduction; hence, their beneficial effects on NAFLD have been evaluated by several studies. A literature review of published data was performed during the years 2012-2014 using PubMed with the following key words: Bariatric, NAFLD, steatosis, sleeve gastrectomy, gastric bypass, gastric banding, biliopancreatic diversion with duodenal switch, obesity, and insulin resistance (IR). Exclusion criteria were non-English articles and inherited NAFLD, pregnancy-induced NAFLD, and children. The majority of published data are in favor of indicating that bariatric surgeries improve the histologic and metabolic changes associated with NAFLD. The suggested mechanisms are: The reversal of IR, reduction of inflammatory markers, and improved histological features of NAFLD. Accordingly, bariatric surgeries are potentially one of the future methods in treating patients with morbid obesity and NAFLD. However, some questions remain unanswered, such as whether timing of surgery, type of surgery most effective, and whether bariatric surgeries are capable of curing the disease. Long-term and well-designed prospective studies are needed to address these issues.
一篇关于已发表数据的综述，这些数据涉及胃束带术、袖状胃切除术、胃旁路手术以及胆胰转流十二指肠转位手术对非酒精性脂肪性肝病（NAFLD）患者肝脏组织病理学、代谢和功能变化的影响。NAFLD是目前最常见的慢性肝病。由于肥胖与NAFLD之间存在密切关系，通过减重治疗NAFLD的理念迅速兴起。减肥手术已被证明是最有效的减重方法；因此，多项研究对其对NAFLD的有益效果进行了评估。2012 - 2014年期间，使用PubMed对已发表数据进行了文献综述，关键词如下：减肥手术、NAFLD、脂肪变性、袖状胃切除术、胃旁路手术、胃束带术、胆胰转流十二指肠转位术、肥胖和胰岛素抵抗（IR）。排除标准为非英文文章以及遗传性NAFLD、妊娠性NAFLD和儿童。大多数已发表数据表明减肥手术可改善与NAFLD相关的组织学和代谢变化。推测的机制为：胰岛素抵抗的逆转、炎症标志物的降低以及NAFLD组织学特征的改善。因此，减肥手术可能是未来治疗病态肥胖和NAFLD患者的方法之一。然而，一些问题仍未得到解答，例如手术时机、最有效的手术类型以及减肥手术是否能够治愈该疾病。需要长期且设计良好的前瞻性研究来解决这些问题。
