About this Journal Submit a Manuscript Table of Contents
Journal of Obesity
Volume 2013 (2013), Article ID 839275, 11 pages
http://dx.doi.org/10.1155/2013/839275
Review Article

Bariatric Surgery as Potential Treatment for Nonalcoholic Fatty Liver Disease: A Future Treatment by Choice or by Chance?

1Department of Emergency Medicine, The James Cook University Hospital, Middlesbrough TS4 3BW, UK
2Department of Medicine, Wexham Park Hospital, Slough, Berkshire SL2 4HL, UK

Received 1 November 2012; Accepted 20 December 2012

Academic Editor: Ahmed Almobarak

Copyright © 2013 Shuja Hafeez and Mohamed H. Ahmed. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Linked References

  1. L. A. Adams and P. Angulo, “Treatment of non-alcoholic fatty liver disease,” Postgraduate Medical Journal, vol. 82, no. 967, pp. 315–322, 2006. View at Publisher · View at Google Scholar · View at Scopus
  2. L. H. Newburgh and J. W. Conn, “A new interpretation of hyperglycemia in obese middle aged persons,” The Journal of the American Medical Association, vol. 112, pp. 7–11, 1939.
  3. S. Zelman, “The liver in obesity,” A.M.A. Archives of Internal Medicine, vol. 90, pp. 141–156, 1952.
  4. J. Ludwig, T. R. Viggiano, D. B. McGill, and B. J. Ott, “Nonalcoholic steatohepatitis. Mayo Clinic experiences with a hitherto unnamed disease,” Mayo Clinic Proceedings, vol. 55, no. 7, pp. 434–438, 1980. View at Scopus
  5. M. H. Ahmed and C. D. Byrne, “Non-alcoholic fatty liver disease,” in The Metabolic Syndrome, C. D. Byrne and S. H. Wild, Eds., pp. 245–277, Wiley-Blackwell, Oxford, UK, 2nd edition, 2011. View at Publisher · View at Google Scholar
  6. P. Angulo, “Medical progress: nonalcoholic fatty liver disease,” The New England Journal of Medicine, vol. 346, no. 16, pp. 1221–1231, 2002. View at Publisher · View at Google Scholar · View at Scopus
  7. D. A. Sass, P. Chang, and K. B. Chopra, “Nonalcoholic fatty liver disease: a clinical review,” Digestive Diseases and Sciences, vol. 50, no. 1, pp. 171–180, 2005. View at Publisher · View at Google Scholar · View at Scopus
  8. M. R. Teli, O. F. W. James, A. D. Burt, M. K. Bennett, and C. P. Day, “The natural history of nonalcoholic fatty liver: a follow-up study,” Hepatology, vol. 22, no. 6, pp. 1714–1719, 1995. View at Scopus
  9. L. M. Alba and K. Lindor, “Review article: non-alcoholic fatty liver disease,” Alimentary Pharmacology and Therapeutics, vol. 17, no. 8, pp. 977–986, 2003. View at Publisher · View at Google Scholar · View at Scopus
  10. Q. M. Anstee, S. McPherson, and C. P. Day, “How big a problem is non-alcoholic fatty liver disease?” British Medical Journal, vol. 343, no. 7816, article d3897, 2011. View at Publisher · View at Google Scholar · View at Scopus
  11. J. Edmison and A. J. McCullough, “Pathogenesis of non-alcoholic steatohepatitis: human data,” Clinics in Liver Disease, vol. 11, no. 1, pp. 75–104, 2007. View at Publisher · View at Google Scholar · View at Scopus
  12. E. Bugianesi, N. Leone, E. Vanni et al., “Expanding the natural history of nonalcoholic steatohepatitis: from cryptogenic cirrhosis to hepatocellular carcinoma,” Gastroenterology, vol. 123, no. 1, pp. 134–140, 2002. View at Publisher · View at Google Scholar · View at Scopus
  13. C. P. Day, “Non-alcoholic fatty liver disease: current concepts and management strategies,” Clinical Medicine, vol. 6, no. 1, pp. 19–25, 2006. View at Scopus
  14. C. M. Oneta and J. F. Dufour, “Non-alcoholic fatty liver disease: treatment options based on pathogenic considerations,” Swiss Medical Weekly, vol. 132, no. 35-36, pp. 493–505, 2002. View at Scopus
  15. D. Preiss and N. Sattar, “Non-alcoholic fatty liver disease: an overview of prevalence, diagnosis, pathogenesis and treatment considerations,” Clinical Science, vol. 115, no. 5-6, pp. 141–150, 2008. View at Publisher · View at Google Scholar · View at Scopus
  16. D. Sorbi, J. Boynton, and K. D. Lindor, “The ratio of aspartate aminotransferase to alanine aminotransferase: potential value in differentiating nonalcoholic steatohepatitis from alcoholic liver disease,” The American Journal of Gastroenterology, vol. 94, no. 4, pp. 1018–1022, 1999. View at Publisher · View at Google Scholar · View at Scopus
  17. B. A. Neuschwander-Tetri and S. H. Caldwell, “Nonalcoholic steatohepatitis: summary of an AASLD Single Topic Conference,” Hepatology, vol. 37, no. 5, pp. 1202–1219, 2003. View at Publisher · View at Google Scholar · View at Scopus
  18. T. L. Setji, N. D. Holland, L. L. Sanders, K. C. Pereira, A. M. Diehl, and A. J. Brown, “Nonalcoholic steatohepatitis and nonalcoholic fatty liver disease in young women with polycystic ovary syndrome,” Journal of Clinical Endocrinology and Metabolism, vol. 91, no. 5, pp. 1741–1747, 2006. View at Publisher · View at Google Scholar · View at Scopus
  19. N. Stefan, K. Kantartzis, and H. U. Häring, “Causes and metabolic consequences of fatty liver,” Endocrine Reviews, vol. 29, no. 7, pp. 939–960, 2008. View at Publisher · View at Google Scholar · View at Scopus
  20. E. M. Silverman, J. A. Sapala, and H. D. Appelman, “Regression of hepatic steatosis in morbidly obese persons after gastric bypass,” American Journal of Clinical Pathology, vol. 104, no. 1, pp. 23–31, 1995. View at Scopus
  21. J. M. Clark, A. R. A. Alkhuraishi, S. F. Solga, P. Alli, A. M. Diehl, and T. H. Magnuson, “Roux-en-Y gastric bypass improves liver histology in patients with non-alcoholic fatty liver disease,” Obesity Research, vol. 13, no. 7, pp. 1180–1186, 2005. View at Scopus
  22. S. G. Mattar, L. M. Velcu, M. Rabinovitz et al., “Surgically-induced weight loss significantly improves nonalcoholic fatty liver disease and the metabolic syndrome,” Annals of Surgery, vol. 242, no. 4, pp. 610–620, 2005. View at Publisher · View at Google Scholar · View at Scopus
  23. C. C. Mottin, M. Moretto, A. V. Padoin et al., “Histological behavior of hepatic steatosis in morbidly obese patients after weight loss induced by bariatric surgery,” Obesity Surgery, vol. 15, no. 6, pp. 788–793, 2005. View at Publisher · View at Google Scholar · View at Scopus
  24. S. Klein, B. Mittendorfer, J. C. Eagon et al., “Gastric bypass surgery improves metabolic and hepatic abnormalities associated with nonalcoholic fatty liver disease,” Gastroenterology, vol. 130, no. 6, pp. 1564–1572, 2006. View at Publisher · View at Google Scholar · View at Scopus
  25. K. B. Barker, N. A. Palekar, S. P. Bowers, J. E. Goldberg, J. P. Pulcini, and S. A. Harrison, “Non-alcoholic steatohepatitis: effect of Roux-en-Y gastric bypass surgery,” The American Journal of Gastroenterology, vol. 101, no. 2, pp. 368–373, 2006. View at Publisher · View at Google Scholar · View at Scopus
  26. A. Csendes, G. Smok, and A. M. Burgos, “Histological findings in the liver before and after gastric bypass,” Obesity Surgery, vol. 16, no. 5, pp. 607–611, 2006. View at Publisher · View at Google Scholar · View at Scopus
  27. S. R. de Almeida, P. R. S. Rocha, M. D. Sanches et al., “Roux-en-Y gastric bypass improves the nonalcoholic steatohepatitis (NASH) of morbid obesity,” Obesity Surgery, vol. 16, no. 3, pp. 270–278, 2006. View at Publisher · View at Google Scholar · View at Scopus
  28. C. K. Furuya Jr., C. P. M. S. de Oliveira, E. S. de Mello et al., “Effects of bariatric surgery on nonalcoholic fatty liver disease: preliminary findings after 2 years,” Journal of Gastroenterology and Hepatology, vol. 22, no. 4, pp. 510–514, 2007. View at Publisher · View at Google Scholar · View at Scopus
  29. X. Liu, A. J. Lazenby, R. H. Clements, N. Jhala, and G. A. Abrams, “Resolution of nonalcoholic steatohepatits after gastric bypass surgery,” Obesity Surgery, vol. 17, no. 4, pp. 486–492, 2007. View at Publisher · View at Google Scholar · View at Scopus
  30. R. A. Weiner, “Surgical treatment of non-alcoholic steatohepatitis and non-alcoholic fatty liver disease,” Digestive Diseases, vol. 28, no. 1, pp. 274–279, 2010. View at Publisher · View at Google Scholar · View at Scopus
  31. M. Moretto, C. Kupski, V. D. da Silva, A. V. Padoin, and C. C. Mottin, “Effect of bariatric surgery on liver fibrosis,” Obesity Surgery, vol. 22, no. 7, pp. 1044–1049, 2012.
  32. I. Ranlov and F. Hardt, “Regression of liver steatosis following gastroplasty or gastric bypass for morbid obesity,” Digestion, vol. 47, no. 4, pp. 208–214, 1990. View at Scopus
  33. K. Jaskiewicz, S. Raczynska, R. Rzepko, and Z. Sledziński, “Nonalcoholic fatty liver disease treated by gastroplasty,” Digestive Diseases and Sciences, vol. 51, no. 1, pp. 21–26, 2006. View at Publisher · View at Google Scholar · View at Scopus
  34. C. Stratopoulos, A. Papakonstantinou, I. Terzis et al., “Changes in liver histology accompanying massive weight loss after gastroplasty for morbid obesity,” Obesity Surgery, vol. 15, no. 8, pp. 1154–1160, 2005. View at Publisher · View at Google Scholar · View at Scopus
  35. J. B. Dixon, P. S. Bhathal, N. R. Hughes, and P. E. O'Brien, “Nonalcoholic fatty liver disease: improvement in liver histological analysis with weight loss,” Hepatology, vol. 39, no. 6, pp. 1647–1654, 2004. View at Publisher · View at Google Scholar · View at Scopus
  36. J. B. Dixon, P. S. Bhathal, and P. E. O'Brien, “Weight loss and non-alcoholic fatty liver disease: falls in gamma-glutamyl transferase concentrations are associated with histologic improvement,” Obesity Surgery, vol. 16, no. 10, pp. 1278–1286, 2006. View at Publisher · View at Google Scholar · View at Scopus
  37. P. Mathurin, A. Hollebecque, L. Arnalsteen et al., “Prospective study of the long term effects of bariatric surgery on liver injury in patients without advanced disease,” Gastroenterology, vol. 137, no. 2, pp. 532–540, 2009. View at Publisher · View at Google Scholar · View at Scopus
  38. J. G. Kral, S. N. Thung, S. Biron et al., “Effects of surgical treatment of the metabolic syndrome on liver fibrosis and cirrhosis,” Surgery, vol. 135, no. 1, pp. 48–58, 2004. View at Publisher · View at Google Scholar · View at Scopus
  39. A. Keshishian, K. Zahriya, and E. B. Willes, “Duodenal switch has no detrimental effects on hepatic function and improves hepatic steatohepatitis after 6 months,” Obesity Surgery, vol. 15, no. 10, pp. 1418–1423, 2005. View at Publisher · View at Google Scholar · View at Scopus
  40. C. C. Mottin, M. Moretto, A. V. Padoin et al., “The role of ultrasound in the diagnosis of hepatic steatosis in morbidly obese patients,” Obesity Surgery, vol. 14, no. 5, pp. 635–637, 2004. View at Publisher · View at Google Scholar · View at Scopus
  41. S. Saadeh, Z. M. Younossi, E. M. Remer et al., “The utility of radiological imaging in nonalcoholic fatty liver disease,” Gastroenterology, vol. 123, no. 3, pp. 745–750, 2002. View at Publisher · View at Google Scholar · View at Scopus
  42. A. J. Sanyal, “AGA technical review on nonalcoholic fatty liver disease,” Gastroenterology, vol. 123, no. 5, pp. 1705–1725, 2002. View at Scopus
  43. S. A. Harrison, “Liver disease in patients with diabetes mellitus,” Journal of Clinical Gastroenterology, vol. 40, no. 1, pp. 68–76, 2006. View at Publisher · View at Google Scholar · View at Scopus
  44. G. Marchesini, E. Bugianesi, G. Forlani et al., “Nonalcoholic fatty liver, steatohepatitis, and the metabolic syndrome,” Hepatology, vol. 37, no. 4, pp. 917–923, 2003. View at Publisher · View at Google Scholar · View at Scopus
  45. N. C. McAvoy, J. W. Ferguson, I. W. Campbell, and P. C. Hayes, “Non-alcoholic fatty liver disease: natural history, pathogenesis and treatment,” British Journal of Diabetes and Vascular Disease, vol. 6, no. 6, pp. 251–260, 2006. View at Publisher · View at Google Scholar · View at Scopus
  46. J. G. Fan, J. Zhu, X. J. Li et al., “Prevalence of and risk factors for fatty liver in a general population of Shanghai, China,” Journal of Hepatology, vol. 43, no. 3, pp. 508–514, 2005. View at Publisher · View at Google Scholar · View at Scopus
  47. S. Bellentani and M. Marino, “Epidemiology and natural history of non-alcoholic fatty liver disease (NAFLD),” Annals of Hepatology, vol. 8, supplement 1, pp. S4–S8, 2009. View at Scopus
  48. F. H. Luyckx, C. Desaive, A. Thiry et al., “Liver abnormalities in severely obese subjects: effect of drastic weight loss after gastroplasty,” International Journal of Obesity, vol. 22, no. 3, pp. 222–226, 1998. View at Scopus
  49. K. Tominaga, J. H. Kurata, Y. K. Chen et al., “Prevalence of fatty liver in Japanese children and relationship to obesity. An epidemiological ultrasonographic survey,” Digestive Diseases and Sciences, vol. 40, no. 9, pp. 2002–2009, 1995. View at Publisher · View at Google Scholar · View at Scopus
  50. A. Franzese, P. Vajro, A. Argenziano et al., “Liver involvement in obese children: ultrasonography and liver enzyme levels at diagnosis and during follow-up in an Italian population,” Digestive Diseases and Sciences, vol. 42, no. 7, pp. 1428–1432, 1997. View at Publisher · View at Google Scholar · View at Scopus
  51. L. A. Adams, J. F. Lymp, J. S. Sauver et al., “The natural history of nonalcoholic fatty liver disease: a population-based cohort study,” Gastroenterology, vol. 129, no. 1, pp. 113–121, 2005. View at Publisher · View at Google Scholar · View at Scopus
  52. B. A. Neuschwander-Tetri, E. M. Brunt, K. R. Wehmeier, D. Oliver, and B. R. Bacon, “Improved nonalcoholic steatohepatitis after 48 weeks of treatment with the PPAR-γ ligand rosiglitazone,” Hepatology, vol. 38, no. 4, pp. 1008–1017, 2003. View at Publisher · View at Google Scholar · View at Scopus
  53. S. Bellentani, F. Scaglioni, M. Marino, and G. Bedogni, “Epidemiology of non-alcoholic fatty liver disease,” Digestive Diseases, vol. 28, no. 1, pp. 155–161, 2010. View at Publisher · View at Google Scholar · View at Scopus
  54. O. Hussein, M. Grosovski, S. Schlesinger, S. Szvalb, and N. Assy, “Orlistat reverse fatty infiltration and improves hepatic fibrosis in obese patients with nonalcoholic steatohepatitis (NASH),” Digestive Diseases and Sciences, vol. 52, no. 10, pp. 2512–2519, 2007. View at Publisher · View at Google Scholar · View at Scopus
  55. I. Lingvay, P. Raskin, and L. S. Szczepaniak, “Effect of insulin-metformin combination on hepatic steatosis in patients with type 2 diabetes,” Journal of Diabetes and its Complications, vol. 21, no. 3, pp. 137–142, 2007. View at Publisher · View at Google Scholar · View at Scopus
  56. E. V. Gomez, A. R. de Miranda, B. G. Oramas et al., “Clinical trial: a nutritional supplement Viusid, in combination with diet and exercise, in patients with nonalcoholic fatty liver disease,” Alimentary Pharmacology and Therapeutics, vol. 30, no. 10, pp. 999–1009, 2009. View at Publisher · View at Google Scholar · View at Scopus
  57. V. Nobili, M. Manco, R. Devito et al., “Lifestyle intervention and antioxidant therapy in children with nonalcoholic fatty liver disease: a randomized, controlled trial,” Hepatology, vol. 48, no. 1, pp. 119–128, 2008. View at Publisher · View at Google Scholar · View at Scopus
  58. T. Andersen, C. Gluud, M. B. Franzmann, and P. Christoffersen, “Hepatic effects of dietary weight loss in morbidly obese subjects,” Journal of Hepatology, vol. 12, no. 2, pp. 224–229, 1991. View at Scopus
  59. L. Sjöström, A. K. Lindroos, M. Peltonen et al., “Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery,” The New England Journal of Medicine, vol. 351, pp. 2683–2693, 2004.
  60. T. D. Adams, R. E. Gress, S. C. Smith et al., “Long-term mortality after gastric bypass surgery,” The New England Journal of Medicine, vol. 357, no. 8, pp. 753–761, 2007. View at Publisher · View at Google Scholar · View at Scopus
  61. L. Sjöström, K. Narbro, C. D. Sjöström et al., “Effects of bariatric surgery on mortality in Swedish obese subjects,” The New England Journal of Medicine, vol. 357, no. 8, pp. 741–752, 2007. View at Publisher · View at Google Scholar · View at Scopus
  62. N. Runkel, M. Colombo-Benkmann, T. P. Hüttl, H. Tigges, O. Mann, and S. Sauerland, “Clinical practice guideline: bariatric surgery,” Deutsches Arzteblatt, vol. 108, no. 20, pp. 341–346, 2011. View at Publisher · View at Google Scholar · View at Scopus
  63. S. A. Brethauer, B. Chand, and P. R. Schauer, “Risks and benefits of bariatric surgery: current evidence,” Cleveland Clinic Journal of Medicine, vol. 73, no. 11, pp. 993–1007, 2006. View at Publisher · View at Google Scholar · View at Scopus
  64. M. R. Ali, W. D. Fuller, M. P. Choi, and B. M. Wolfe, “Bariatric surgical outcomes,” Surgical Clinics of North America, vol. 85, no. 4, pp. 835–852, 2005. View at Publisher · View at Google Scholar · View at Scopus
  65. L. Salem, C. C. Jensen, and D. R. Flum, “Are bariatric surgical outcomes worth their cost? A systematic review,” Journal of the American College of Surgeons, vol. 200, no. 2, pp. 270–278, 2005. View at Publisher · View at Google Scholar · View at Scopus
  66. N. T. Nguyen, C. Goldman, C. J. Rosenquist et al., “Laparoscopic versus open gastric bypass: a randomized study of outcomes, quality of life, and costs,” Annals of Surgery, vol. 234, no. 3, pp. 279–291, 2001. View at Publisher · View at Google Scholar · View at Scopus
  67. H. Buchwald, R. Estok, K. Fahrbach et al., “Weight and type 2 diabetes after bariatric surgery: systematic review and meta-analysis,” The American Journal of Medicine, vol. 122, no. 3, pp. 248.e5–256.e5, 2009. View at Publisher · View at Google Scholar · View at Scopus
  68. S. Karmali, P. Schauer, D. Birch, A. M. Sharma, and V. Sherman, “Laparoscopic sleeve gastrectomy: an innovative new tool in the battle against the obesity epidemic in Canada,” Canadian Journal of Surgery, vol. 53, no. 2, pp. 126–132, 2010. View at Scopus
  69. R. Schouten, D. C. Wiryasaputra, F. M. H. van Dielen, W. G. van Gemert, and J. W. M. Greve, “Long-term results of bariatric restrictive procedures: a prospective study,” Obesity Surgery, vol. 20, no. 12, pp. 1617–1626, 2010. View at Publisher · View at Google Scholar · View at Scopus
  70. C. Rabl and G. M. Campos, “The impact of bariatric surgery on nonalcoholic steatohepatitis,” Seminars in Liver Disease, vol. 32, pp. 80–91, 2012.
  71. P. E. O'Brien, J. B. Dixon, C. Laurie, et al., “Treatment of mild to moderate obesity with laparoscopic adjustable gastric banding or an intensive medical program: a randomised trial,” Annals of Internal Medicine, vol. 144, pp. 625–633, 2006.
  72. V. T. To, T. P. Hüttl, R. Lang, K. Piotrowski, and K. G. Parhofer, “Changes in body weight, glucose homeostasis, lipid profiles, and metabolic syndrome after restrictive bariatric surgery,” Experimental and Clinical Endocrinology & Diabetes, vol. 120, no. 9, pp. 547–552, 2012.
  73. C. Saboya, C. H. Arasaki, D. Matos, and G. J. Lopes-Filho, “Relationship between the preoperative body mass index and the resolution of metabolic syndrome following Roux-en-Y gastric bypass,” Metabolic Syndrome and Related Disorders, vol. 10, no. 4, pp. 292–296, 2012.
  74. F. C. M. Júnior, W. S. Júnior, N. S. Filho et al., “Effects of weight loss induced by bariatric surgery on the prevalence of metabolic syndrome,” Arquivos Brasileiros de Cardiologia, vol. 92, no. 6, pp. 418–422, 435–439, 452–456, 2009.
  75. W. B. Inabnet III, D. A. Winegar, B. Sherif, and M. G. Sarr, “Early outcomes of bariatric surgery in patients with metabolic syndrome: an analysis of the bariatric outcomes longitudinal database,” Journal of the American College of Surgeons, vol. 214, no. 4, pp. 550–557, 2012.
  76. J. O. Bretón, B. García, P. Benito, S. Gimeno, R. García, and P. López, “Effect of gastric bypass on the metabolic syndrome and on cardiovascular risk,” Nutrición Hospitalaria, vol. 25, no. 1, pp. 67–71, 2010.
  77. A. E. Pontiroli, M. Laneri, A. Veronelli et al., “Biliary pancreatic diversion and laparoscopic adjustable gastric banding in morbid obesity: their long-term effects on metabolic syndrome and on cardiovascular parameters,” Cardiovascular Diabetology, vol. 8, article 37, 2009. View at Publisher · View at Google Scholar · View at Scopus
  78. J. A. Batsis, A. Romero-Corral, M. L. Collazo-Clavell, M. G. Sarr, V. K. Somers, and F. Lopez-Jimenez, “Effect of bariatric surgery on the metabolic syndrome: a population-based, long-term controlled study,” Mayo Clinic Proceedings, vol. 83, no. 8, pp. 897–906, 2008. View at Publisher · View at Google Scholar · View at Scopus
  79. C. Nugent, C. Bai, H. Elariny et al., “Metabolic syndrome after laparoscopic bariatric surgery,” Obesity Surgery, vol. 18, no. 10, pp. 1278–1286, 2008. View at Publisher · View at Google Scholar · View at Scopus
  80. A. K. Madan, W. Orth, C. A. Ternovits, and D. S. Tichansky, “Metabolic syndrome: yet another co-morbidity gastric bypass helps cure,” Surgery for Obesity and Related Diseases, vol. 2, no. 1, pp. 48–51, 2006. View at Publisher · View at Google Scholar · View at Scopus
  81. W. J. Lee, M. T. Huang, W. Wang, C. M. Lin, T. C. Chen, and I. R. Lai, “Effects of obesity surgery on the metabolic syndrome,” Archives of Surgery, vol. 139, no. 10, pp. 1088–1092, 2004. View at Publisher · View at Google Scholar · View at Scopus
  82. T. K. Alexandrides, G. Skroubis, and F. Kalfarentzos, “Resolution of diabetes mellitus and metabolic syndrome following Roux-en-Y gastric bypass and a variant of biliopancreatic diversion in patients with morbid obesity,” Obesity Surgery, vol. 17, no. 2, pp. 176–184, 2007. View at Publisher · View at Google Scholar · View at Scopus
  83. G. Skroubis, S. Anesidis, I. Kehagias, N. Mead, K. Vagenas, and F. Kalfarentzos, “Roux-en-Y gastric bypass versus a variant of biliopancreatic diversion in a non-superobese population: prospective comparison of the efficacy and the incidence of metabolic deficiencies,” Obesity Surgery, vol. 16, no. 4, pp. 488–495, 2006. View at Publisher · View at Google Scholar · View at Scopus
  84. L. Angrisani, M. Lorenzo, and V. Borrelli, “Laparoscopic adjustable gastric banding versus Roux-en-Y gastric bypass: 5-year results of a prospective randomized trial,” Surgery for Obesity and Related Diseases, vol. 3, no. 2, pp. 127–132, 2007. View at Publisher · View at Google Scholar · View at Scopus
  85. S. E. Greenway, F. L. Greenway III, and S. Klein, “Effects of obesity surgery on non-insulin-dependent diabetes mellitus,” Archives of Surgery, vol. 137, no. 10, pp. 1109–1117, 2002. View at Scopus
  86. J. L. Carson, M. E. Ruddy, A. E. Duff, N. J. Holmes, R. P. Cody, and R. E. Brolin, “The effect of gastric bypass surgery on hypertension in morbidly obese patients,” Archives of Internal Medicine, vol. 154, no. 2, pp. 193–200, 1994. View at Publisher · View at Google Scholar · View at Scopus
  87. N. T. Nguyen, E. Varela, A. Sabio, C. L. Tran, M. Stamos, and S. E. Wilson, “Resolution of hyperlipidemia after laparoscopic Roux en Y gastric bypass,” Journal of the American College of Surgeons, vol. 203, no. 1, pp. 24–29, 2006. View at Publisher · View at Google Scholar · View at Scopus
  88. R. E. Brolin, L. J. Bradley, A. C. Wilson, and R. P. Cody, “Lipid risk profile and weight stability after gastric resective operations for morbid obesity,” Journal of Gastrointestinal Surgery, vol. 4, no. 5, pp. 464–469, 2000. View at Scopus
  89. M. H. Ahmed and C. D. Byrne, “Ezetimibe as a potential treatment for non-alcoholic fatty liver disease: is the intestine a modulator of hepatic insulin sensitivity and hepatic fat accumulation?” Drug Discovery Today, vol. 15, no. 15-16, pp. 590–595, 2010. View at Publisher · View at Google Scholar · View at Scopus
  90. C. D. Byrne, R. Olufad, K. D. Bruce, F. R. Cagampang, and M. H. Ahmed, “Metabolic disturbances in non-alcoholic fatty liver disease,” Clinical Science, vol. 116, no. 7, pp. 539–564, 2009. View at Publisher · View at Google Scholar · View at Scopus
  91. M. H. Ahmed and C. D. Byrne, “Current treatment of non-alcoholic fatty liver disease,” Diabetes, Obesity and Metabolism, vol. 11, no. 3, pp. 188–195, 2009. View at Publisher · View at Google Scholar · View at Scopus
  92. M. Cnop, P. J. Havel, K. M. Utzschneider et al., “Relationship of adiponectin to body fat distribution, insulin sensitivity and plasma lipoproteins: evidence for independent roles of age and sex,” Diabetologia, vol. 46, no. 4, pp. 459–469, 2003. View at Scopus
  93. M. F. Hivert, L. M. Sullivan, C. S. Fox et al., “Associations of adiponectin, resistin, and tumor necrosis factor-α with insulin resistance,” Journal of Clinical Endocrinology and Metabolism, vol. 93, no. 8, pp. 3165–3172, 2008. View at Publisher · View at Google Scholar · View at Scopus
  94. W. J. Pories, M. S. Swanson, K. G. MacDonald et al., “Who would have thought it? An operation proves to be the most effective therapy for adult-onset diabetes mellitus,” Annals of Surgery, vol. 222, no. 3, pp. 339–350, 1995. View at Scopus
  95. H. Buchwald, Y. Avidor, E. Braunwald et al., “Bariatric surgery: a systematic review and meta-analysis,” The Journal of the American Medical Association, vol. 292, no. 14, pp. 1724–1737, 2004. View at Publisher · View at Google Scholar · View at Scopus
  96. C. Holdstock, L. Lind, B. Eden Engstrom et al., “CRP reduction following gastric bypass surgery is most pronounced in insulin-sensitive subjects,” International Journal of Obesity, vol. 29, no. 10, pp. 1275–1280, 2005. View at Publisher · View at Google Scholar · View at Scopus
  97. N. Vilarrasa, J. Vendrell, R. Sánchez-Santos et al., “Effect of weight loss induced by gastric bypass on proinflammatory interleukin-18, soluble tumour necrosis factor-α receptors, C-reactive protein and adiponectin in morbidly obese patients,” Clinical Endocrinology, vol. 67, no. 5, pp. 679–686, 2007. View at Publisher · View at Google Scholar · View at Scopus
  98. D. J. Drucker, “The role of gut hormones in glucose homeostasis,” Journal of Clinical Investigation, vol. 117, no. 1, pp. 24–32, 2007. View at Publisher · View at Google Scholar · View at Scopus