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Bariatric surgery and nonalcoholic fatty liver disease

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Title: Bariatric surgery and nonalcoholic fatty liver disease
Authors: Bower, G
Athanasiou, T
Isla, AM
Harling, L
Li, JV
Holmes, E
Efthimiou, E
Darzi, A
Ashrafian, H
Item Type: Journal Article
Abstract: The rising prevalence of nonalcoholic fatty liver disease (NAFLD) is associated with the increasing global pandemic of obesity. These conditions cluster with type II diabetes mellitus and the metabolic syndrome to result in obesity-associated liver disease. The benefits of bariatric procedures on diabetes and the metabolic syndrome have been recognized for some time, and there is now mounting evidence to suggest that bariatric procedures improve liver histology and contribute to the beneficial resolution of NAFLD in obese patients. These beneficial effects derive from a number of weight-dependent and weight-independent mechanisms including surgical BRAVE actions (bile flow changes, restriction of stomach size, anatomical gastrointestinal rearrangement, vagal manipulation, enteric hormonal modulation) and subsequent effects such as reduced lipid intake, adipocytokine secretion, modulation of gut flora, improvements in insulin resistance and reduced inflammation. Here, we review the clinical investigations on bariatric procedures for NAFLD, in addition to the mounting mechanistic data supporting these findings. Elucidating the mechanisms by which bariatric procedures may resolve NAFLD can help enhance surgical approaches for metabolic hepatic dysfunction and also contribute toward developing the next generation of therapies aimed at reducing the burden of obesity-associated liver disease.
Issue Date: 31-Jul-2015
Date of Acceptance: 23-Mar-2015
URI: http://hdl.handle.net/10044/1/39036
DOI: http://dx.doi.org/10.1097/MEG.0000000000000375
ISSN: 0954-691X
Publisher: Wolters Kluwer
Start Page: 755
End Page: 768
Journal / Book Title: European Journal of Gastroenterology & Hepatology
Volume: 27
Issue: 7
Copyright Statement: © 2015 Wolters Kluwer Health, Inc. All rights reserved. This is the accepted version of an article published in final form at http://dx.doi.org/10.1097/MEG.0000000000000375.
Sponsor/Funder: National Institute for Health Research
Funder's Grant Number: DH PO:481818
Keywords: Science & Technology
Life Sciences & Biomedicine
Gastroenterology & Hepatology
bariatric surgery
metabolic surgery
nonalcoholic fatty liver disease
Y GASTRIC BYPASS
MORBIDLY OBESE-PATIENTS
INDUCED WEIGHT-LOSS
NECROSIS-FACTOR-ALPHA
INSULIN-RESISTANCE
METABOLIC SYNDROME
HEPATIC STEATOSIS
FETUIN-A
LIPID-METABOLISM
SERUM RETINOL-BINDING-PROTEIN-4
Bariatric Surgery
Body Mass Index
Diabetes Mellitus, Type 2
Global Health
Humans
Metabolic Syndrome X
Non-alcoholic Fatty Liver Disease
Obesity, Morbid
Prevalence
Risk Factors
Treatment Outcome
Weight Loss
1103 Clinical Sciences
Publication Status: Published
Appears in Collections:Division of Surgery
Faculty of Medicine



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