Gastroenterology Department, University of Sao Paulo, Av. Dr. Enéas de Carvalho Aguiar 255, São Paulo, SP, 05403-000, Brazil.
Obes Surg. 2021 Jun;31(6):2762-2772. doi: 10.1007/s11695-021-05412-y. Epub 2021 Apr 13.
The effects of bariatric procedures on nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) remain unclear. A systematic review and meta-analysis was performed to compare the impact of Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) on NAFLD/NASH. Patients submitted to RYGB presented significant reduction of steatohepatitis (RD: 0.53; 95% CI 0.33 to 0.74) and fibrosis (RD: 0.26; 95% CI 0.14 to 0.37). SG caused a significant reduction of steatohepatitis (RD: 0.42; 95% CI 0.27 to 0.57), but not of fibrosis (RD: 0.20; 95% CI -0.00 to 0.39). The NAFLD Activity Score was significantly improved after both procedures, as well as biochemical tests. No difference was found between RYGB and SG regarding the histopathological outcomes. SG and RYGB are equivalently effective for treating NAFLD/NASH.
减重手术对非酒精性脂肪性肝病（NAFLD）和非酒精性脂肪性肝炎（NASH）的影响仍不清楚。我们进行了一项系统评价和荟萃分析，以比较 Roux-en-Y 胃旁路术（RYGB）和袖状胃切除术（SG）对 NAFLD/NASH 的影响。接受 RYGB 的患者肝脂肪变性（RD：0.53；95%CI 0.33 至 0.74）和纤维化（RD：0.26；95%CI 0.14 至 0.37）明显减少。SG 可显著减少肝脂肪变性（RD：0.42；95%CI 0.27 至 0.57），但对纤维化无影响（RD：0.20；95%CI -0.00 至 0.39）。两种手术均能显著改善 NAFLD 活动评分和生化指标。RYGB 和 SG 在组织病理学结果方面无差异。SG 和 RYGB 治疗 NAFLD/NASH 的效果相当。
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