Endoscopic Duodenal-Jejunal Bypass Liner Rapidly Improves Plasma Parameters of Nonalcoholic Fatty Liver Disease
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- 作者：Charlotte de Jonge ; S ; er S. Rensen ; Ger H. Koek ; M ; y F. Joosten ; Wim A. Buurman ; Nicole D. Bouvy ; Jan Willem M. Greve
- 关键词：Insulin Resistance ; Intestine ; Stomach ; Steatosis
- 刊名：Clinical Gastroenterology and Hepatology
- 出版年：2013
- 出版时间：November, 2013
- 年：2013
- 卷：11
- 期：11
- 页码：1517-1520
- 全文大小：359 K
文摘
Bariatric surgery reduces nonalcoholic fatty liver disease (NAFLD). We investigated the effects of duodenal-jejunal bypass liner (DJBL), nonsurgical bariatric device, on plasma parameters of NAFLD. Seventeen obese subjects with type 2 diabetes received the DJBL for 24 weeks. Before, during, and after DJBL implantation, we determined plasma levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), ¦Ã-glutamyltransferase (¦Ã-GT), albumin, caspase-cleaved cytokeratin-18 (CK-18), and liver fatty acid-binding protein (L-FABP). At baseline, subjects had increased levels of AST (35 ¡À 4 IU/L), ALT (54 ¡À 5 IU/L), and ¦Ã-GT (66 ¡À 14 IU/L), compared with healthy individuals; subjects¡¯ mean concentrations of caspase-cleaved CK-18 and L-FABP were 214.4 ¡À 35.6 U/L and 29.3 ¡À 2.6 ng/mL, respectively. Three months after implantation of DJBL, all NAFLD-related parameters had decreased from baseline (AST, 28 ¡À 3 IU/L; ALT, 32 ¡À 2 IU/L; ¦Ã-GT, 44 ¡À7 IU/L; caspase-cleaved CK-18, 140.6 ¡À 16.3U/L; and L-FABP, 18.2 ¡À 1.5 ng/mL; all P < .05). After 6 months, levels of ALT and ¦Ã-GT had further decreased (ALT, 28 ¡À 2 IU/L and ¦Ã-GT, 35 ¡À 5 IU/L), whereas levels of AST, caspase-cleaved CK-18, and L-FABP had stabilized (P?= not significant). Six months after DJBLs were removed, levels of ALT (37 ¡À 3 IU/L), ¦Ã-GT (42 ¡À 5 IU/L), and caspase-cleaved CK-18 (124.5 ¡À 12.5U/L) were still reduced (P < .05), whereas AST and L-FABP had returned to near baseline levels (P?= not significant). Therefore, in obese subjects, DJBL reduces plasma parameters of NAFLD. , Number: .