Endoscopic duodenal-jejunal bypass liner rapidly improves plasma parameters of nonalcoholic fatty liver disease

C. de Jonge, S.S. Rensen, G.H. Koek, M.F. Joosten, W.A. Buurman, N. Bouvy, J.W. Greve

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

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), gamma-glutamyltransferase (gamma-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 +/- 4 IU/L), ALT (54 +/- 5 IU/L), and gamma-GT (66 +/- 14 IU/L), compared with healthy individuals; subjects' mean concentrations of caspase-cleaved CK-18 and L-FABP were 214.4 +/- 35.6 U/L and 29.3 +/- 2.6 ng/mL, respectively. Three months after implantation of DJBL, all NAFLD-related parameters had decreased from baseline (AST, 28 +/- 3 IU/L; ALT, 32 +/- 2 IU/L; gamma-GT, 44 +/-7 IU/L; caspase-cleaved CK-18, 140.6 +/- 16.3U/L; and L-FABP, 18.2 +/- 1.5 ng/mL; all P < .05). After 6 months, levels of ALT and gamma-GT had further decreased (ALT, 28 +/- 2 IU/L and gamma-GT, 35 +/- 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 +/- 3 IU/L), gamma-GT (42 +/- 5 IU/L), and caspase-cleaved CK-18 (124.5 +/- 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. ClinicalTrials.gov, Number: NCT00985114.
Original languageEnglish
Pages (from-to)1517-1520
Number of pages4
JournalClinical gastroenterology and hepatology
Volume11
Issue number11
DOIs
Publication statusPublished - Nov 2013

Keywords

  • Insulin Resistance
  • Intestine
  • Stomach
  • Steatosis
  • WEIGHT-LOSS
  • BARIATRIC SURGERY
  • NONINVASIVE DIAGNOSIS
  • STEATOHEPATITIS
  • APOPTOSIS
  • BIOMARKER

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