Effect of bariatric endoscopy on liver fibrosis and steatosis and the course of NAFLD – a prospective interventional study

Introduction and Objectives: With increases in obesity and metabolic syndrome because of lifestyle-related factors, the prevalence of non-alcoholic fatty liver disease (NAFLD) also is increasing worldwide. In a subset of patients with NAFLD, an inflammatory process arises in the steatotic liver, kno...

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Main Authors: Adam Vašura, Evžen Machytka, Ondřej Urban, Jitka Macháčková, Lubomír Pavliska, Zdeněk Berka, Zdeněk Švagera, Marek Bužga
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:Annals of Hepatology
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Online Access:http://www.sciencedirect.com/science/article/pii/S1665268124005489
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author Adam Vašura
Evžen Machytka
Ondřej Urban
Jitka Macháčková
Lubomír Pavliska
Zdeněk Berka
Zdeněk Švagera
Marek Bužga
author_facet Adam Vašura
Evžen Machytka
Ondřej Urban
Jitka Macháčková
Lubomír Pavliska
Zdeněk Berka
Zdeněk Švagera
Marek Bužga
author_sort Adam Vašura
collection DOAJ
description Introduction and Objectives: With increases in obesity and metabolic syndrome because of lifestyle-related factors, the prevalence of non-alcoholic fatty liver disease (NAFLD) also is increasing worldwide. In a subset of patients with NAFLD, an inflammatory process arises in the steatotic liver, known as non-alcoholic steatohepatitis, that leads to liver fibrosis and liver cirrhosis. In selected patients with obesity, bariatric surgery, and bariatric endoscopy are important therapeutic options. Materials and Methods: This prospective interventional pilot study was conducted to investigate two types of intragastric balloons (IGB). The IGBs were the Orbera and the Spatz3. Liver fibrosis changes were monitored non-invasively using point and 2D shear wave ultrasound elastography (SWE) and transient elastography that allowed for quantification of liver steatosis using the controlled attenuation parameter (CAP). Patients were followed for 12 months. Results: Of 34 patients implanted with an IGB, 30 completed follow-up at month 12; results for one patient were excluded because of initiation of obesity pharmacotherapy. Fifteen patients received the Orbera IGB, and nineteen patients received the Spatz3 type. In month 12, total and excess weight loss was 7.88 % and 30.13 %. Elastography values decreased from baseline (3.88 kPa) to 3.61 kPa at month 12 (p 0.024). 2D SWE values decreased from baseline (5.42 kPa) to a value of 4.91 kPa at month twelve (p 0.135). Transient elastography values decreased from baseline (5.62 kPa) to a value of 4.17 kPa at month twelve (p 0.009). Conclusions: Bariatric endoscopy in the form of IGB implantation leads to weight reduction and improvement of liver fibrosis and steatosis. ClinicalTrials.gov registration: NCT04895943
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spelling doaj-art-d8f045faa1ba4589990bcf183d6308112025-08-20T03:55:17ZengElsevierAnnals of Hepatology1665-26812025-01-0130110176510.1016/j.aohep.2024.101765Effect of bariatric endoscopy on liver fibrosis and steatosis and the course of NAFLD – a prospective interventional studyAdam Vašura0Evžen Machytka1Ondřej Urban2Jitka Macháčková3Lubomír Pavliska4Zdeněk Berka5Zdeněk Švagera6Marek Bužga7Department of Internal Medicine and Cardiology, Division of Gastroenterology, hepatology and pancreatology, University Hospital Ostrava, 17. Listopadu 1740, 70800, Ostrava, Czech Republic; Department of Clinical Studies, Faculty of Medicine, University of Ostrava, Syllabova 19, 70030, Ostrava, Czech RepublicDepartment of Internal Medicine and Cardiology, Division of Gastroenterology, hepatology and pancreatology, University Hospital Ostrava, 17. Listopadu 1740, 70800, Ostrava, Czech RepublicDepartment of Internal Medicine II – Gastroenterology and Geriatrics, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital, Zdravotníků 248/7, 779 00, Olomouc, Czech RepublicDepartment of Epidemiology and Public Health, Faculty of Medicine, University of Ostrava, Syllabova 19, 70030, Ostrava, Czech RepublicResearch and Education department, University Hospital Ostrava, 17. Listopadu 1740, 70800, Ostrava, Czech RepublicDepartment of Internal Medicine II – Gastroenterology and Geriatrics, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital, Zdravotníků 248/7, 779 00, Olomouc, Czech RepublicInstitute of Laboratory Medicine, University Hospital Ostrava,17. Listopadu 1740, 70800, Ostrava, Czech RepublicInstitute of Laboratory Medicine, University Hospital Ostrava,17. Listopadu 1740, 70800, Ostrava, Czech Republic; Department of Physiology and Pathophysiology, Faculty of Medicine, University of Ostrava, Syllabova 19, 70030, Ostrava, Czech Republic; Corresponding author.Introduction and Objectives: With increases in obesity and metabolic syndrome because of lifestyle-related factors, the prevalence of non-alcoholic fatty liver disease (NAFLD) also is increasing worldwide. In a subset of patients with NAFLD, an inflammatory process arises in the steatotic liver, known as non-alcoholic steatohepatitis, that leads to liver fibrosis and liver cirrhosis. In selected patients with obesity, bariatric surgery, and bariatric endoscopy are important therapeutic options. Materials and Methods: This prospective interventional pilot study was conducted to investigate two types of intragastric balloons (IGB). The IGBs were the Orbera and the Spatz3. Liver fibrosis changes were monitored non-invasively using point and 2D shear wave ultrasound elastography (SWE) and transient elastography that allowed for quantification of liver steatosis using the controlled attenuation parameter (CAP). Patients were followed for 12 months. Results: Of 34 patients implanted with an IGB, 30 completed follow-up at month 12; results for one patient were excluded because of initiation of obesity pharmacotherapy. Fifteen patients received the Orbera IGB, and nineteen patients received the Spatz3 type. In month 12, total and excess weight loss was 7.88 % and 30.13 %. Elastography values decreased from baseline (3.88 kPa) to 3.61 kPa at month 12 (p 0.024). 2D SWE values decreased from baseline (5.42 kPa) to a value of 4.91 kPa at month twelve (p 0.135). Transient elastography values decreased from baseline (5.62 kPa) to a value of 4.17 kPa at month twelve (p 0.009). Conclusions: Bariatric endoscopy in the form of IGB implantation leads to weight reduction and improvement of liver fibrosis and steatosis. ClinicalTrials.gov registration: NCT04895943http://www.sciencedirect.com/science/article/pii/S1665268124005489Non-alcoholic fatty liver diseaseLiver fibrosisElastographyIntragastric balloonObesity
spellingShingle Adam Vašura
Evžen Machytka
Ondřej Urban
Jitka Macháčková
Lubomír Pavliska
Zdeněk Berka
Zdeněk Švagera
Marek Bužga
Effect of bariatric endoscopy on liver fibrosis and steatosis and the course of NAFLD – a prospective interventional study
Annals of Hepatology
Non-alcoholic fatty liver disease
Liver fibrosis
Elastography
Intragastric balloon
Obesity
title Effect of bariatric endoscopy on liver fibrosis and steatosis and the course of NAFLD – a prospective interventional study
title_full Effect of bariatric endoscopy on liver fibrosis and steatosis and the course of NAFLD – a prospective interventional study
title_fullStr Effect of bariatric endoscopy on liver fibrosis and steatosis and the course of NAFLD – a prospective interventional study
title_full_unstemmed Effect of bariatric endoscopy on liver fibrosis and steatosis and the course of NAFLD – a prospective interventional study
title_short Effect of bariatric endoscopy on liver fibrosis and steatosis and the course of NAFLD – a prospective interventional study
title_sort effect of bariatric endoscopy on liver fibrosis and steatosis and the course of nafld a prospective interventional study
topic Non-alcoholic fatty liver disease
Liver fibrosis
Elastography
Intragastric balloon
Obesity
url http://www.sciencedirect.com/science/article/pii/S1665268124005489
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