Digestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy.
Università Cattolica del Sacro Cuore, Roma, Italy.
Expert Rev Gastroenterol Hepatol. 2024 Aug;18(8):397-405. doi: 10.1080/17474124.2024.2387231. Epub 2024 Sep 5.
Metabolic dysfunction-associated steatotic liver disease (MASLD, formerly nonalcoholic fatty liver disease - NAFLD) is a chronic liver condition linked to obesity and metabolic syndrome. It affects one-third of people globally and, in some cases, can lead to metabolic dysfunction-associated steatohepatitis (MASH, formerly nonalcoholic steatohepatitis, NASH) and fibrosis. Weight loss is crucial for the treatment of MASLD, but diet and lifestyle modifications often fail.
In recent years, endoscopic sleeve gastroplasty (ESG) has gained popularity as an effective and minimally invasive option for obesity treatment, with widespread use worldwide. We present a current overview of the most significant studies conducted on ESG for the management of obesity and MASLD. Our report includes data from published studies that have evaluated the impact of ESG on noninvasive hepatic parameters used to estimate steatosis and fibrosis. However, at present, there are no data available on liver histology.
ESG has shown promising results in treating MASLD evaluated by noninvasive tests, but current data is limited to small, nonrandomized studies. More research is needed, particularly on the effects of ESG on histologically proven MASH. If future research confirms its efficacy, ESG may be incorporated into treatment guidelines in the future.
代谢相关脂肪性肝病(MASLD,以前称为非酒精性脂肪性肝病 - NAFLD)是一种与肥胖和代谢综合征相关的慢性肝脏疾病。它影响全球三分之一的人群,在某些情况下,可能导致代谢相关脂肪性肝炎(MASH,以前称为非酒精性脂肪性肝炎,NASH)和纤维化。减轻体重对于 MASLD 的治疗至关重要,但饮食和生活方式的改变往往会失败。
近年来,内镜下袖状胃成形术(ESG)作为一种有效的、微创的肥胖治疗方法越来越受欢迎,在全球范围内得到广泛应用。我们目前对用于肥胖和 MASLD 管理的 ESG 进行的最重要的研究进行了概述。我们的报告包括已评估 ESG 对用于估计脂肪变性和纤维化的非侵入性肝脏参数的影响的已发表研究的数据。然而,目前尚无关于肝组织学的数据。
ESG 在通过非侵入性检查评估 MASLD 方面显示出了有希望的结果,但目前的数据仅限于小型、非随机研究。需要进行更多的研究,特别是关于 ESG 对组织学证实的 MASH 的影响。如果未来的研究证实其疗效,ESG 将来可能会被纳入治疗指南。