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Inicio Medicina Clínica (English Edition) Bariatric surgery and non-alcoholic fatty liver disease
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Vol. 158. Issue 11.
Pages 550-555 (June 2022)
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Vol. 158. Issue 11.
Pages 550-555 (June 2022)
Review
Bariatric surgery and non-alcoholic fatty liver disease
Cirugía bariátrica e hígado graso no alcohólico
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5
Helena Juliàa,b, David Benaigesa,b,c,d,
Corresponding author
96002@parcdesalutmar.cat

Corresponding author.
, Juan Pedro-Boteta,b,c
a Endocrinology Department, Hospital Universitari del Mar, 08003 Barcelona, Spain
b Department of Medicine, Universitat Autònoma de Barcelona, 08139 Barcelona, Spain
c IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain
d Consorci Sanitari de l’Alt Penedès i Garraf, 08720 Vilafranca del Penedès, Spain
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Abstract

Non-alcoholic fatty liver disease (NAFLD) is a chronic disease that may lead to cirrhosis and hepatocellular carcinoma; its close relationship with obesity and the metabolic syndrome involves an increasing prevalence. Invasive liver biopsy is the gold standard diagnosis technique for NAFLD but entails risks. Therefore, transient elastography, a non-invasive technique with high reliability, is frequently used in clinical practice. Bariatric surgery is the only effective treatment for long-term weight loss and obesity-related metabolic conditions improvement. Although studies report encouraging results of bariatric surgery as a valuable therapy for NAFLD, guidelines for its use in NAFLD are ambiguous. Indeed, the mechanisms driving this improvement are largely unknown, but likely involve weight loss-dependent and independent factors including anatomic and hormonal changes. This review aims to update the relationship between NAFLD and bariatric surgery, focusing on the indications for surgery and the mechanisms implied in NAFLD improvement.

Keywords:
Bariatric surgery
Morbid obesity
Obesity
Metabolic syndrome
Non-alcoholic fatty liver disease
Non-alcoholic steatohepatitis
Resumen

El hígado graso no alcohólico (HGNA) es una enfermedad crónica que puede conducir a cirrosis y hepatocarcinoma; su relación con la obesidad y el síndrome metabólico supone un aumento en su prevalencia. La biopsia hepática es la prueba diagnóstica de elección, pero implica riesgos. En consecuencia, la elastografía hepática, una técnica no invasiva con una alta fiabilidad, es utilizada frecuentemente en la práctica clínica. La cirugía bariátrica es el único tratamiento eficaz para la pérdida de peso y la mejoría de las comorbilidades a largo plazo. Aunque los estudios demuestran que la cirugía bariátrica es efectiva para el tratamiento del HGNA, la mayoría de los mecanismos implicados en esta mejoría se desconocen. De hecho, las guías clínicas son ambiguas en cuanto a su indicación. Esta revisión tiene como objetivo actualizar la relación entre el HGNA y la cirugía bariátrica, centrándose en las indicaciones de la cirugía y los mecanismos implicados en la mejoría del HGNA.

Palabras clave:
Cirugía bariátrica
Obesidad mórbida
Obesidad
Síndrome metabólico
Hígado graso no alcohólico
Esteatohepatitis no alcohólica

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