Serviço de Endoscopia Gastrointestinal, Departamento de Gastroenterologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
Departamento de Gastroenterologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Av. Dr Eneas de Carvalho Aguiar, 225, 6o Andar, Bloco 3, Cerqueira Cesar, Sao Paulo, SP 05403‑010, Brazil.
Obes Surg. 2023 Sep;33(9):2917-2926. doi: 10.1007/s11695-023-06747-4. Epub 2023 Aug 4.
Non-alcoholic fatty liver disease (NAFLD) is the most common cause of liver disease worldwide. Endoscopic sleeve gastroplasty (ESG) has proven to be feasible, safe, and effective in the management of obesity. We performed the first systematic review and meta-analysis evaluating NAFLD and other metabolic parameters 12 months post-ESG. Four observational studies with a total of 175 patients were included. The results showed a significant (p < 0.05) reduction of 4.85 in hepatic steatosis index (95% CI - 6.02, - 3.67), 0.5 in NAFLD fibrosis score (95% CI - 0.80, - 0.19), 6.32 U/l in ALT (95% CI - 9.52, - 3.11), 17.28% in TWL (95% CI - 18.24, - 16.31), 6.31 kg/m in BMI (95% CI - 8.11, - 4.52), 47.97% in EWL (95% CI - 49.10, - 46.84), and 0.51% in HbA1c (95% CI - 0.90, - 0.12). ESG improves liver parameters, provides weight loss, and reduces HbA1c levels in patients suffering from NAFLD.
非酒精性脂肪性肝病 (NAFLD) 是全球最常见的肝病病因。内镜下袖状胃切除术 (ESG) 已被证明在肥胖症的治疗中是可行、安全且有效的。我们进行了首次系统评价和荟萃分析，评估了 ESG 治疗后 12 个月的 NAFLD 及其他代谢参数。共纳入了 4 项观察性研究，总计 175 例患者。结果显示，肝脂肪变性指数显著降低（p<0.05），降幅为 4.85（95%CI：-6.02，-3.67），NAFLD 纤维化评分降低 0.5（95%CI：-0.80，-0.19），丙氨酸氨基转移酶 (ALT) 降低 6.32 U/L（95%CI：-9.52，-3.11），体重减轻率（TWL）降低 17.28%（95%CI：-18.24，-16.31），体重指数 (BMI) 降低 6.31 kg/m（95%CI：-8.11，-4.52），体质量减轻率（EWL）降低 47.97%（95%CI：-49.10，-46.84），糖化血红蛋白 (HbA1c) 降低 0.51%（95%CI：-0.90，-0.12）。ESG 可改善 NAFLD 患者的肝脏参数，减轻体重，降低 HbA1c 水平。
