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Cited by 26Bariatric Surgery and OutcomesLiver Disease Diagnosis and TreatmentMinimally Invasive Surgical Techniques

Endoscopic Bariatric Treatment with Duodenal-Jejunal Bypass Liner Improves Non-invasive Markers of Non-alcoholic Steatohepatitis

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Karlas, Thomas, Petroff, David, Feisthammel, Jürgen, Beer, Sebastian, Blüher, Matthias, Schütz, Tatjana, Lichtinghagen, Ralf, Hoffmeister, Albrecht +1 more·2022·Obesity Surgery
DOI 10.1007/s11695-022-06150-5PMC PMC9273553
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Abstract

PURPOSE: People with obesity often develop non-alcoholic fatty liver disease (NAFLD) and are at high risk of progression to non-alcoholic steatohepatitis (NASH). Few therapies are effective other than bariatric surgery. We therefore analyzed data from duodenal-jejunal bypass liner (DJBL) patients regarding steatosis, fibrosis, and NASH. METHODS: Consecutive DJBL patients with type 2 diabetes underwent standardized assessments up to device removal at 48 weeks. These included aspartate and alanine transaminase (AST, ALT), controlled attenuation parameter (CAP, for steatosis), and liver stiffness measurement (LSM, for fibrosis). The NAFLD fibrosis score (NFS), fibrosis-4 score (FIB4), and enhanced liver fibrosis (ELF) test were also used to assess fibrosis and the Fibroscan-AST (FAST) score to assess NASH. Mixed models were used and missing data were accounted for with multiple imputation. RESULTS: ) were included. After 48 weeks, the change compared to baseline with 95% CI was a factor 0.74 (0.65 to 0.84) for AST, 0.63 (0.53 to 0.75) for ALT, and a difference of - 0.21 (- 0.28 to - 0.13) for FAST, all with p < 0.001. Fibrosis based on LSM, NFS, and ELF did not change whereas FIB4 exhibited slight improvement. Eight DJBL were explanted early due to device-related complications and eight complications led to hospitalization. CONCLUSIONS: One year of DJBL therapy is associated with relevant improvements in non-invasive markers of steatosis and NASH, but not fibrosis, and is accompanied by a substantial number of complications. Given the lack of alternatives, DJBL deserves further attention.

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Cited by

Sorted by citations

Authors
Karlas, T., Petroff, D., Feisthammel, J., Beer, S., Blüher, M., Schütz, T., Lichtinghagen, R., Hoffmeister, A., & Wiegand, J.
Affiliations
  • University Hospital Leipzig (DE)
  • IFB Adiposity Diseases (DE)
  • Helmholtz Munich (DE)
  • Medizinische Hochschule Hannover (DE)
Corresponding author
Karlas, Thomas
ORCID
Venue
Obesity Surgery
Publisher
Springer Science and Business Media LLC
Published
2022-06-17
Volume
32
Issue
8
Pages
2495-2503
ISSN
  • 0960-8923 (ISSN-L)
  • 1708-0428
DOI
10.1007/s11695-022-06150-5
PMC
PMC9273553
OpenAlex
W4283076487
Cited by
26
References
5
Citations by year
2026: 3 · 2025: 9 · 2024: 8 · 2023: 4 · 2022: 2
FWCI
5.50
Type
journal article
Language
en
Open access
Licence
Locations
  • Obesity Surgery (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Qucosa (Saxon State and University Library Dresden) (submittedVersion, cc-by)
  • Site cant be reached (submittedVersion, cc-by)
  • PuSH - Publication Server of Helmholtz Zentrum München (submittedVersion, cc-by)
Funders
  • Echosens
  • Siemens Healthineers
  • Universität Leipzig
Topics
  • Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
  • Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
  • Health Sciences › Medicine › Surgery › Minimally Invasive Surgical Techniques
Keywords
duodenal-jejunal bypass liner, endoscopic bariatric therapy
MeSH terms
Aspartate Aminotransferases, Diabetes Mellitus, Type 2, Female, Fibrosis, Humans, Liver Cirrhosis, Middle Aged, Obesity, Morbid, Biomarkers, Bariatric Surgery, Elasticity Imaging Techniques, Non-alcoholic Fatty Liver Disease

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