INTRODUCTION: Hepatic lipid accumulation (Fatty Liver, FL) is often associated with obesity especially when a cluster of metabolic disturbances (Metabolic Syndrome, MS) occurs. A "bright liver" at abdominal ultrasonography (US) and, in most cases, increased levels of hepatic enzymes, alanine aminotransferases (ALT) and gamma-glutamyltranspeptidases (GGT), are considered the hallmarks of Nonalcoholic Fatty Liver Disease (NAFLD) in obese and severely obese patients. Insulin resistance (IR) is reported to be the main link among obesity, NAFLD and MS. Bioenterics Intragastric Balloon (BIB; Bioenterics, Santa Barbara, Ca., USA) is considered a safe procedure for preparing the patients to the bariatric surgery. AIMS & METHODS:20g/day, or known drugs in the history were excluded. RESULTS: The investigated patients showed at US a "bright liver", consistent with NAFLD. BMI significantly decreased (42.8±5.9 vs. 38.8±5.1; p126 mg/dL in 18% pts.) did not change after BIB (113±37 vs. 103±36). After BIB, ALT values decreased (43.5±34.5 vs. 28.5±16.4; p<.01), as well as GGT (42.3±35.2 vs. 28.9±20.7; p<.05). Before BIB, HOMA-IR was <2.5 in 9% pts. and it showed a significant decrease (7.14±6.14 vs. 3.54±2.08; p<.02); after BIB, HOMA-IR was <2.5 in 43% pts. Hypertrigliceridemia in 33.3% pts., HDL cholesterol levels <40mg/dL in 32% pts., arterial hypertension in 22.2 % pts did not significantly improve after BIB. CONCLUSION: The significant weight loss induced by BIB treatment improves insuline resistance and liver enzymes in obese patients. Our findings confirm the pivotal role of insuline resistance in NAFLD.
NONALCOHOLIC FATTY LIVER DISEASE AND INTRAGASTRIC BALLOON TRATMENT FOR OBESITY
RICCI, Giorgio;ALVISI, Vittorio
2006
Abstract
INTRODUCTION: Hepatic lipid accumulation (Fatty Liver, FL) is often associated with obesity especially when a cluster of metabolic disturbances (Metabolic Syndrome, MS) occurs. A "bright liver" at abdominal ultrasonography (US) and, in most cases, increased levels of hepatic enzymes, alanine aminotransferases (ALT) and gamma-glutamyltranspeptidases (GGT), are considered the hallmarks of Nonalcoholic Fatty Liver Disease (NAFLD) in obese and severely obese patients. Insulin resistance (IR) is reported to be the main link among obesity, NAFLD and MS. Bioenterics Intragastric Balloon (BIB; Bioenterics, Santa Barbara, Ca., USA) is considered a safe procedure for preparing the patients to the bariatric surgery. AIMS & METHODS:20g/day, or known drugs in the history were excluded. RESULTS: The investigated patients showed at US a "bright liver", consistent with NAFLD. BMI significantly decreased (42.8±5.9 vs. 38.8±5.1; p126 mg/dL in 18% pts.) did not change after BIB (113±37 vs. 103±36). After BIB, ALT values decreased (43.5±34.5 vs. 28.5±16.4; p<.01), as well as GGT (42.3±35.2 vs. 28.9±20.7; p<.05). Before BIB, HOMA-IR was <2.5 in 9% pts. and it showed a significant decrease (7.14±6.14 vs. 3.54±2.08; p<.02); after BIB, HOMA-IR was <2.5 in 43% pts. Hypertrigliceridemia in 33.3% pts., HDL cholesterol levels <40mg/dL in 32% pts., arterial hypertension in 22.2 % pts did not significantly improve after BIB. CONCLUSION: The significant weight loss induced by BIB treatment improves insuline resistance and liver enzymes in obese patients. Our findings confirm the pivotal role of insuline resistance in NAFLD.I documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
