减重手术对非酒精性脂肪性肝病的影响的无创性检测评估。
The impact of bariatric surgery on nonalcoholic fatty liver disease as measured using non-invasive tests.
机构信息
Liver Disease Center, Sheba Medical Center, Tel Hashomer, Israel.
Department of Surgery C, Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
出版信息
Am J Surg. 2021 Jul;222(1):214-219. doi: 10.1016/j.amjsurg.2020.11.045. Epub 2020 Nov 25.
BACKGROUND
Nonalcoholic fatty liver disease (NAFLD) is common in bariatric surgery candidates. We evaluated the effect of sleeve gastrectomy (SG) on NAFLD using validated non-invasive measures.
METHODS
Patients with morbid obesity and NAFLD, planned for SG, were evaluated before and after surgery. Data collected included anthropometrics, biochemistry, adiponectin, SteatoTest™, NashTest™, FibroTest™, OWLiver® test and real-time ShearWave™ elastography (SWE).
RESULTS
Twenty-six subjects were included in the study, mean age 44.1 ± 4.8 years, 69.2% males. One year following SG, body mass index decreased significantly from 41.7 ± 4.8 kg/m to 29.6 ± 4.5 kg/m. Concomitantly, significant improvements in triglycerides, ALT, diabetes markers and adiponectin were observed. Mean steatosis, as measured by SteatoTest™, was significantly improved. Steatohepatitis score measured by NashTest™ and OWLiver® significantly decreased. Mean fibrosis, as measured by SWE liver stiffness and FibroTest™, did not change over time.
CONCLUSION
Steatosis and steatohepatitis are significantly improved by SG as measured by non-invasive measures.
背景
非酒精性脂肪性肝病（NAFLD）在肥胖症手术患者中较为常见。我们使用经过验证的非侵入性方法评估袖状胃切除术（SG）对 NAFLD 的影响。
方法
对计划接受 SG 的病态肥胖和 NAFLD 患者进行手术前后评估。收集的数据包括人体测量学、生物化学、脂联素、SteatoTest™、NashTest™、FibroTest™、OWLiver®试验和实时剪切波弹性成像（SWE）。
结果
本研究共纳入 26 例患者，平均年龄 44.1±4.8 岁，男性占 69.2%。SG 后 1 年，体重指数从 41.7±4.8kg/m 显著下降至 29.6±4.5kg/m。同时，甘油三酯、ALT、糖尿病标志物和脂联素显著改善。SteatoTest™ 测量的平均脂肪变性显著改善。NashTest™ 和 OWLiver® 测量的肝脂肪性肝炎评分显著降低。SWE 肝硬度和 FibroTest™ 测量的平均纤维化随时间无变化。
结论
SG 可通过非侵入性方法显著改善脂肪变性和脂肪性肝炎。
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