How bariatric surgery affects liver volume and fat density in NAFLD patients.
How bariatric surgery affects liver volume and fat density in NAFLD patients.
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DOI：
10.1007/s00464-017-5846-9
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发表时间：
2018-04
期刊：
影响因子：
--
通讯作者：
Jacobsen GR
中科院分区：
文献类型：
--
作者：
Luo RB;Suzuki T;Hooker JC;Covarrubias Y;Schlein A;Liu S;Schwimmer JB;Reeder SB;Funk LM;Greenberg JA;Campos GM;Sandler BJ;Horgan S;Sirlin CB;Jacobsen GR
非酒精性脂肪肝（NAFLD）是肥胖人群中的一种流行病。众所周知，减肥手术可以逆转肥胖的多种代谢并发症，例如糖尿病、血脂异常和 NAFLD，但肝脏变化的时间尚未得到很好的描述。这是一项经 IRB 批准的、两家机构的前瞻性研究。肥胖患者在基线时和术前流质饮食后接受了 MRI 检查。在手术期间进行肝活检，如果 NAFLD 呈阳性，患者将在 1、3 和 6 个月时接受 MRI 检查。根据离线 MRI 图像计算肝脏体积和质子密度脂肪分数 (PDFF)。主要结果是体重、体重指数 (BMI)、超重减轻百分比 (EWL%)、肝脏体积和 PDFF 的变化。评估了脂肪变性的消退，定义为基于先前发布的临界值 PDFF < 6.4%。其次，比较了接受腹腔镜袖状胃切除术 (LSG) 与腹腔镜 Roux-en-Y 胃绕道术 (LRYGB) 的患者的结果。 2010年10月至2015年6月，招募了124名患者。 49 名患者 (39.5%) 完成了全部五次扫描。 6 个月时的 EWL% 为 55.6 ± 19.0%。 BMI从45.3±5.9下降到34.4±5.1 kg/m2，平均肝脏体积从2464.6±619.4下降到1874.3±387.8 cm3，体积变化为21.4±11.4%。 PDFF 从 16.6 ± 7.8 下降至 4.4 ± 3.4%。 6 个月时，83.7% 的患者脂肪变性得到缓解。肝脏体积在 1 个月时趋于稳定，但 PDFF 和 BMI 继续下降。 LSG 与 LRYGB 亚组之间从基线到 6 个月的肝脏体积或 PDFF 减少没有统计学上的显着差异。接受减肥手术的 NAFLD 患者预计在 6 个月时肝脏体积和肝脏脂肪变性会显着减少，其中 83.7% 的患者脂肪变性得到缓解。减肥手术后 1 个月，肝脏体积减少趋于稳定，但 PDFF 继续减少。 LSG 和 LRYGB 在诱导肝脂肪变性消退方面的功效没有差异。
Nonalcoholic fatty liver disease (NAFLD) is an epidemic in the obese population. Bariatric surgery is known to reverse multiple metabolic complications of obesity such as diabetes, dyslipidemia, and NAFLD, but the timing of liver changes has not been well described. This was an IRB-approved, two-institutional prospective study. Bariatric patients received MRIs at baseline and after a pre-operative liquid diet. Liver biopsies were performed during surgery and if NAFLD positive, the patients received MRIs at 1, 3, and 6 months. Liver volumes and proton-density fat fraction (PDFF) were calculated from offline MRI images. Primary outcomes were changes in weight, body mass index (BMI), percent excess weight loss (EWL%), liver volume, and PDFF. Resolution of steatosis, as defined as PDFF < 6.4% based on previously published cutoffs, was assessed. Secondarily, outcomes were compared between patients who underwent laparoscopic sleeve gastrectomy (LSG) versus laparoscopic Roux-en-Y gastric bypass (LRYGB). From October 2010 to June 2015, 124 patients were recruited. 49 patients (39.5%) completed all five scans. EWL% at 6 months was 55.6 ± 19.0%. BMI decreased from45.3 ± 5.9 to 34.4 ± 5.1 kg/m2 and mean liver volume decreased from 2464.6 ± 619.4 to 1874.3 ± 387.8 cm3 with a volume change of 21.4 ± 11.4%. PDFF decreased from16.6 ± 7.8 to 4.4 ± 3.4%. At 6 months, 83.7% patients had resolution of steatosis. Liver volume plateaued at 1 month, but PDFF and BMI continued to decrease. There were no statistically significant differences in liver volume or PDFF reduction from baseline to 6 months between the LSG versus LRYGB subgroups. Patients with NAFLD undergoing bariatric surgery can expect significant decreases in liver volume and hepatic steatosis at 6 months, with 83.7% of patients achieving resolution of steatosis. Liver volume reduction plateaus 1-month post-bariatric surgery, but PDFF continues to decrease. LSG and LRYGB did not differ in efficacy for inducing regression of hepatosteatosis.
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DOI：
10.1002/hep.26455
发表时间：
2013-12
期刊：
Hepatology (Baltimore, Md.)
影响因子：
--
作者：
Noureddin M;Lam J;Peterson MR;Middleton M;Hamilton G;Le TA;Bettencourt R;Changchien C;Brenner DA;Sirlin C;Loomba R
通讯作者：
Loomba R
影响因子：
2.9
作者：
Iannelli, Antonio;Martini, Francesco;Gugenheim, Jean
通讯作者：
Gugenheim, Jean
影响因子：
3.1
作者：
Edholm, David;Kullberg, Joel;Sundbom, Magnus
通讯作者：
Sundbom, Magnus
影响因子：
19.7
作者：
Tang, An;Desai, Ajinkya;Sirlin, Claude B.
通讯作者：
Sirlin, Claude B.
DOI：
10.1002/jmri.22701
发表时间：
2011-10
期刊：
Journal of magnetic resonance imaging : JMRI
影响因子：
--
作者：
Kang GH;Cruite I;Shiehmorteza M;Wolfson T;Gamst AC;Hamilton G;Bydder M;Middleton MS;Sirlin CB
通讯作者：
Sirlin CB