Generic placeholder image

Reviews on Recent Clinical Trials

Author(s): Tannaz Jamialahamdi, Matthew Kroh, Sorour Ashari, Wael Almahmeed, Ali Jangjoo, Luis E Simental-Mendía, Sepideh Salehabadi, Khalid Al-Rasadi and Amirhossein Sahebkar*

DOI: 10.2174/0115748871303052240529102003

DownloadDownload PDF Flyer Cite As
Systematic Review and Meta-analysis of the Impact of Metabolic Surgery on Hepatic Stiffness

  • * (Excluding Mailing and Handling)

Explore Articles
About Journal
For Authors
For Editors
For Reviewers

Abstract

Background: Bariatric surgery is one of the effective therapeutic options for people with obesity and obesity-related co-morbidities. In addition to weight-related co-morbid diseases, including diabetes, hypertension, and hypercholesterolemia, non-alcoholic fatty liver disease (NAFLD) is common in patients with morbid obesity. Bariatric surgery is one of the therapeutic options in the management of NAFLD. Hence, this review focused on the potential role of bariatric surgery on hepatic elasticity measured through shear wave elastography.

Methods: A systematic literature search was performed, and the studies regarding heterogeneity were evaluated using the random-effects model.

Results: The meta-analysis on 6 trials (3-12 months follow-up) including 350 participants showed a significant reduction of liver elasticity after surgery (WMD: -1.149, 95% CI: -1.767, -0.532, p < 0.001; I2:81.55%).

Conclusion: Bariatric surgery is associated with decreased liver elasticity. This improvement could be related to weight loss or other mechanisms of bariatric surgery.

[1]
Lammers WJ, Tilburg AJP, Apers JA, Wiebolt J. Liver failure caused by prolonged state of malnutrition following bariatric surgery. World J Hepatol 2018; 10(3): 396-9.
[http://dx.doi.org/10.4254/wjh.v10.i3.396] [PMID: 29599903]
[2]
Santos RD, Valenti L, Romeo S. Does nonalcoholic fatty liver disease cause cardiovascular disease? Current knowledge and gaps. Atherosclerosis 2019; 282: 110-20.
[http://dx.doi.org/10.1016/j.atherosclerosis.2019.01.029] [PMID: 30731283]
[3]
Palmer M, Schaffner F. Effect of weight reduction on hepatic abnormalities in overweight patients. Gastroenterology 1990; 99(5): 1408-13.
[http://dx.doi.org/10.1016/0016-5085(90)91169-7] [PMID: 2210247]
[4]
Park HS, Kim MW, Shin ES. Effect of weight control on hepatic abnormalities in obese patients with fatty liver. J Korean Med Sci 1995; 10(6): 414-21.
[http://dx.doi.org/10.3346/jkms.1995.10.6.414] [PMID: 8924225]
[5]
Ueno T, Sugawara H, Sujaku K, et al. Therapeutic effects of restricted diet and exercise in obese patients with fatty liver. J Hepatol 1997; 27(1): 103-7.
[http://dx.doi.org/10.1016/S0168-8278(97)80287-5] [PMID: 9252081]
[6]
von Schönfels W, Beckmann JH, Ahrens M, Hendricks A, Röcken C, Szymczak S. Histologic improvement of NAFLD in patients with obesity after bariatric surgery based on standardized NAS (NAFLD activity score). Surg Obesity Rel Disea: Official J American Soci Bariat Surg 2018; 14(10): 1607-16.
[7]
Deng H, Qi X, Zhang T, Qi X, Yoshida EM, Guo X. Supersonic shear imaging for the diagnosis of liver fibrosis and portal hypertension in liver diseases: a meta-analysis. Expert Rev Gastroenterol Hepatol 2018; 12(1): 91-8.
[http://dx.doi.org/10.1080/17474124.2018.1412257] [PMID: 29186994]
[8]
Weiss J, Rau M, Meertens J, et al. Feasibility of liver stiffness measurement in morbidly obese patients undergoing bariatric surgery using XL probe. Scand J Gastroenterol 2016; 51(10): 1263-8.
[http://dx.doi.org/10.1080/00365521.2016.1191084] [PMID: 27308959]
[9]
Garg H, Aggarwal S. Utility of transient elastography (fibroscan) and impact of bariatric surgery on nonalcoholic fatty liver disease (NAFLD) in morbidly obese patients. Surg obes related dis : off j Am Soc Bariatric Surg 2018; 14(1): 81-91.
[10]
Bende F, Mulabecirovic A, Sporea I, et al. Assessing liver stiffness by 2-D shear wave elastography in a healthy cohort. Ultrasound Med Biol 2018; 44(2): 332-41.
[http://dx.doi.org/10.1016/j.ultrasmedbio.2017.10.013] [PMID: 29249457]
[11]
Jamialahmadi T, Jangjoo A, Rezvani R, et al. Hepatic function and fibrosis assessment via 2D-shear wave elastography and related biochemical markers Pre-and post-gastric bypass surgery. Obes Surg 2020; 30(6): 2251-8.
[http://dx.doi.org/10.1007/s11695-020-04452-0] [PMID: 32198617]
[12]
Jamialahmadi T, Nematy M, Jangjoo A, et al. Measurement of liver stiffness with 2D-shear wave elastography (2D-SWE) in bariatric surgery candidates reveals acceptable diagnostic yield compared to liver biopsy. Obes Surg 2019; 29(8): 2585-92.
[http://dx.doi.org/10.1007/s11695-019-03889-2] [PMID: 31077025]
[13]
Fu J, Wu B, Wu H, Lin F, Deng W. Accuracy of real-time shear wave elastography in staging hepatic fibrosis: a meta-analysis. BMC Med Imaging 2020; 20(1): 16.
[http://dx.doi.org/10.1186/s12880-020-0414-5] [PMID: 32046659]
[14]
Higgins JP. Cochrane Handbook for Systematic Reviews of Interventions Cochrane Collabaration 2008.
[15]
Wells GA, Shea B, O’Connell D, Peterson J, Welch V, Losos M, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Oxford 2000.
[16]
Borenstein M, Hedges L, Higgins J, Rothstein H. Comprehensive meta-analysis, version 2 Biostat. Englewood NJ 2005.
[17]
Sutton AJ, Abrams KR, Jones DR, Jones DR, Sheldon TA, Song F. Methods for meta-analysis in medical research. Wiley 2000; p. 352.
[18]
Sahebkar A, Serban C, Ursoniu S, et al. Lack of efficacy of resveratrol on C-reactive protein and selected cardiovascular risk factors-Results from a systematic review and meta-analysis of randomized controlled trials. Int J Cardiol 2015; 189: 47-55.
[http://dx.doi.org/10.1016/j.ijcard.2015.04.008]
[19]
Jangjoo S, Emami N, Sahranavard M, et al. Diagnostic value of non-invasive liver function tests in liver fibrosis and changes in these parameters post-metabolic surgery. Obes Surg 2023; 33(2): 548-54.
[http://dx.doi.org/10.1007/s11695-022-06416-y] [PMID: 36538211]
[20]
Netanel C, Goitein D, Rubin M, et al. The impact of bariatric surgery on nonalcoholic fatty liver disease as measured using non-invasive tests. Am J Surg 2021; 222(1): 214-9.
[http://dx.doi.org/10.1016/j.amjsurg.2020.11.045] [PMID: 33309037]
[21]
Abdelbary MS, Marzaban R, Gamal Eldeen H, et al. Clinical utility of transient elastography as an imaging tool to assess the short-term impact of laparoscopic sleeve gastrectomy, together with clinical and biochemical parameters and clinico-biochemical indices, on obese patients with nonalcoholic fatty liver disease: An Egyptian pilot study. Revista de Gastroenterología de México (English Edition) 2021; 86(2): 125-32.
[http://dx.doi.org/10.1016/j.rgmxen.2020.04.008] [PMID: 33004251]
[22]
Jamialahmadi T, Reiner Z, Alidadi M, et al. The effect of bariatric surgery on circulating levels of oxidized low-density lipoproteins is apparently independent of changes in body mass index: A systematic review and meta-analysis. Oxid Med Cell Longev 2021 Dec 6; 2021; 4136071.
[http://dx.doi.org/10.1155/2021/4136071] [PMID: 34912496] [PMCID: PMC8668329]
[23]
Singh J, Goel D, Garg A, et al. Effect of bariatric surgery on non-alcoholic fatty liver disease inmorbidly obese patients undergoing bariatric surgery. Indian J Gastroenterol 2017; 36(1) (Suppl. 1): A3.
[24]
Capoccia D, Testa M, Guarisco G, De Santis A, Parlati L, Ferri F. Liver stiffness and glycolipid metabolism in morbid obese patients: Effects of marked weight loss obtained by Laparoscopic Sleeve Gastrectomy. Obesity Facts 2016; 1: 175.
[25]
English WJ, Williams DB. Metabolic and briatric surgery: An effective treatment option for obesity and cardiovascular disease. Prog Cardiovasc Dis 2018; 61(2): 253-69.
[http://dx.doi.org/10.1016/j.pcad.2018.06.003] [PMID: 29953878]
[26]
Biobaku F, Ghanim H, Monte SV, Caruana JA, Dandona P. Bariatric surgery: Remission of inflammation, cardiometabolic benefits, and common adverse effects. J Endocr Soc 2020; 4(9): bvaa049.
[http://dx.doi.org/10.1210/jendso/bvaa049] [PMID: 32775937]
[27]
Wei L, Li M, Zeng N, et al. Bariatric surgery for non-alcoholic fatty liver disease in individuals with obesity (Base-NAFLD): protocol of a prospective multicenter observational follow-up study. BMC Surg 2021; 21(1): 298.
[http://dx.doi.org/10.1186/s12893-021-01296-y] [PMID: 34167531]
[28]
Fischer L, Wekerle AL, Bruckner T, et al. BariSurg trial: Sleeve gastrectomy versus Roux-en-Y gastric bypass in obese patients with BMI 35–60 kg/m2 – a multi-centre randomized patient and observer blind non-inferiority trial. BMC Surg 2015; 15(1): 87.
[http://dx.doi.org/10.1186/s12893-015-0072-7] [PMID: 26187377]
[29]
Paisant A, Lemoine S, Cassinotto C, et al. Reliability criteria of two-dimensional shear wave elastography: Analysis of 4277 measurements in 788 patients. Clin Gastroenterol Hepatol 2022; 20(2): 400-408.e10.
[http://dx.doi.org/10.1016/j.cgh.2020.12.013] [PMID: 33340779]
[30]
Chowdhury AB, Mehta KJ. Liver biopsy for assessment of chronic liver diseases: a synopsis. Clin Exp Med 2022; 23(2): 273-85.
[http://dx.doi.org/10.1007/s10238-022-00799-z] [PMID: 35192111]