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Hepatic Function and Fibrosis Assessment Via 2D-Shear Wave Elastography and Related Biochemical Markers Pre- and Post-Gastric Bypass Surgery

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Abstract

Background

Nonalcoholic fatty liver disease (NAFLD) exhibits a worldwide distribution and encompasses a wider range of hepatic abnormalities that can culminate in serious clinical outcomes. The growing incidence of NAFLD necessitates more efficient management strategies particularly in clinically severe obese patients. Weight reduction is the cornerstone of NAFLD treatment; therefore, bariatric surgery could be a therapeutic approach in selected obese patients afflicted with NAFLD and other cardiometabolic comorbidities.

Objective

The present study focused on the potential role of bariatric surgery on hepatic function and NAFLD-related histopathological features measured through a noninvasive method.

Method

Ninety patients entered to this study and underwent initial preoperative assessments including demographic profile, anthropometric measurements, standard laboratory tests, and hepatic biopsy. Liver stiffness was also evaluated via two-dimensional shear wave elastography (2D-SWE). All assessments were repeated over the subsequent 6 months following surgery except for liver biopsy.

Results

Postoperative hepatic elasticity was lessened after 6 months (p = 0/002).The levels of alanine aminotransferase, gamma-glutamyl transferase, total protein, lipid indices, glucose, and platelet count were also improved following surgery (p < 0/001). Further progression of fibrosis was observed in 25% of patients after surgery.

Conclusion

Bariatric surgery was associated with a favorable impact on anthropometric and hepatic elasticity indices as well as metabolic parameters. The ideal target population for bariatric surgery should be thoroughly addressed, and the underlying risk factors for fibrosis progression need to be controlled before surgery. However, expanded research designed as comprehensive randomized controlled trials are recommended to confirm these findings.

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Acknowledgments

The results described in this paper formed part of a thesis submitted by the first author for a Ph.D. degree in Nutritional Sciences.

Funding

This study was supported by the Vice Chancellor for Research of Mashhad University of Medical Sciences (grant number: 951586).

Author information

Authors and Affiliations

  1. Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

    Tannaz Jamialahmadi, Reza Rezvani, Zeinab Javid Mishamandani & Mohsen Nematy

  2. Surgical Oncology Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

    Ali Jangjoo

  3. Department of Gastroenterology and Hepatology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

    Ladan Goshayeshi

  4. Gastroenterology and Hepatology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

    Ladan Goshayeshi

  5. Cancer Molecular Pathology Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

    Aida Tasbandi

  6. Department of Statistics, Faculty of Mathematical Sciences, Ferdowsi University of Mashhad, Mashhad, Iran

    Mehdi Jabbari Nooghabi

  7. Department of Radiology, Faculty of Medicine, Islamic Azad University-Mashhad Branch, Mashhad, Iran

    Farnood Rajabzadeh

  8. Pathology Department, Education and Research Department, Razavi hospital, Mashhad, Iran

    Kamran Ghaffarzadegan

Authors
  1. Tannaz Jamialahmadi
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  2. Ali Jangjoo
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  3. Reza Rezvani
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  4. Ladan Goshayeshi
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  5. Aida Tasbandi
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  6. Mehdi Jabbari Nooghabi
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  7. Farnood Rajabzadeh
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  8. Kamran Ghaffarzadegan
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  9. Zeinab Javid Mishamandani
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  10. Mohsen Nematy
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Contributions

Conception and design: Nematy M, Jamialahmadi T, Goshayeshi L, Jangjoo A

Analysis and interpretation: Jamialahmadi T, Jabbari Nooghabi M

Data collection: Jamialahmadi T, Jangjoo A, Nematy M, Rajabzadeh F, Tasbandi A, Ghaffarzadegan K

Writing the article: Jamialahmadi T, Goshayeshi L, Tasbandi A

Critical revision: Jamialahmadi T, Jangjoo A, Nematy M, Goshayeshi L, Rezvani R

Final approval: Jamialahmadi T, Nematy M, Goshayeshi L, Jangjoo A, Jabbari Nooghabi M, Rezvani R

Statistical analysis: Jabbari Nooghabi M, Jamialahmadi T

Obtained funding: Nematy M

Overall responsibility: Nematy M

Corresponding author

Correspondence to Mohsen Nematy.

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The authors declare that they have no conflicts of interest.

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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 30, 2251–2258 (2020). https://doi.org/10.1007/s11695-020-04452-0

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  • DOI: https://doi.org/10.1007/s11695-020-04452-0

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