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Bariatric surgery and nonalcoholic fatty liver disease.
Eur J Gastroenterol Hepatol 2015; 27(7):755-68EJ

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.

Authors+Show Affiliations

Department of Surgery and Cancer, Imperial College London, Imperial College Healthcare NHS Trust at St Mary's Hospital, London, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

25919774

Citation

Bower, Guy, et al. "Bariatric Surgery and Nonalcoholic Fatty Liver Disease." European Journal of Gastroenterology & Hepatology, vol. 27, no. 7, 2015, pp. 755-68.
Bower G, Athanasiou T, Isla AM, et al. Bariatric surgery and nonalcoholic fatty liver disease. Eur J Gastroenterol Hepatol. 2015;27(7):755-68.
Bower, G., Athanasiou, T., Isla, A. M., Harling, L., Li, J. V., Holmes, E., ... Ashrafian, H. (2015). Bariatric surgery and nonalcoholic fatty liver disease. European Journal of Gastroenterology & Hepatology, 27(7), pp. 755-68. doi:10.1097/MEG.0000000000000375.
Bower G, et al. Bariatric Surgery and Nonalcoholic Fatty Liver Disease. Eur J Gastroenterol Hepatol. 2015;27(7):755-68. PubMed PMID: 25919774.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bariatric surgery and nonalcoholic fatty liver disease. AU - Bower,Guy, AU - Athanasiou,Thanos, AU - Isla,Alberto M, AU - Harling,Leanne, AU - Li,Jia V, AU - Holmes,Elaine, AU - Efthimiou,Evangelos, AU - Darzi,Ara, AU - Ashrafian,Hutan, PY - 2015/4/29/entrez PY - 2015/4/29/pubmed PY - 2016/3/25/medline SP - 755 EP - 68 JF - European journal of gastroenterology & hepatology JO - Eur J Gastroenterol Hepatol VL - 27 IS - 7 N2 - 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. SN - 1473-5687 UR - https://www.unboundmedicine.com/medline/citation/25919774/Bariatric_surgery_and_nonalcoholic_fatty_liver_disease_ L2 - http://Insights.ovid.com/pubmed?pmid=25919774 DB - PRIME DP - Unbound Medicine ER -