Ankita Srivastava1, Matthew Stevenson1, Jenny Lee1, Christopher Hall1, Thomas Palaia1, Chaohui Lisa Zhao2, Raymond Lau1,3, Collin Brathwaite1,4, Louis Ragolia5,6. 1. Biomedical Research, NYU Long Island School of Medicine, NYU Langone Hospital-Long Island, 101 Mineola Blvd. Suite 4-003, Mineola, NY, 11501, USA. 2. Department of Pathology, NYU Langone Hospital-Long Island, 222 Station Plaza, Mineola, NY, 11501, USA. 3. Department of Endocrinology, NYU Langone Hospital-Long Island, 101 Mineola Blvd. Suite 2-009, Mineola, NY, 11501, USA. 4. Department of Surgery, Langone Hospital-Long Island, 222 Station Plaza, Suite 300, Mineola, NYNY, 11501, USA. 5. Biomedical Research, NYU Long Island School of Medicine, NYU Langone Hospital-Long Island, 101 Mineola Blvd. Suite 4-003, Mineola, NY, 11501, USA. Louis.Ragolia@NYULangone.org. 6. Department of Foundations of Medicine, NYU Long Island School of Medicine, NYU Langone Hospital-Long Island, 101 Mineola Blvd, Mineola, NY, 11501, USA. Louis.Ragolia@NYULangone.org.
Abstract
PURPOSE: Bariatric surgery is emerging as an effective treatment for obesity and the metabolic syndrome. Recently, we demonstrated that Roux-en-Y gastric bypass (RYGB), but not vertical sleeve gastrectomy (VSG), resulted in improvements to white adipose physiology and enhanced brown adipose functioning. Since beneficial alterations to liver health are also expected after bariatric surgery, comparing the post-operative effects of RYGB and VSG on liver physiology is essential to their application in the treatment of non-alcoholic fatty liver disease (NAFLD). MATERIALS AND METHODS: The effects of RYGB and VSG on liver physiology were compared using diet induced mouse model of obesity. High-fat diet (HFD) was administered for 12 weeks after surgery and alterations to liver physiology were assessed. RESULTS: Both RYGB and VSG showed decreased liver weight as well as reductions to hepatic cholesterol and triglyceride levels. There were demonstrable improvements to NAFLD activity score (NAS) and fibrosis stage scoring after both surgeries. In RYGB, these beneficial changes to liver function resulted from the downregulation of pro-fibrotic and upregulation anti-fibrotic genes, as well as increased fatty acid oxidation and bile acid flux. For VSG, though similar alterations were observed, they were less potent. However, VSG did significantly downregulate pro-fibrotic genes and showed increased glycogen content paralleled by decreased glycogenolysis which may have contributed to the resolution of NAFLD. CONCLUSION: RYGB and VSG improve liver physiology and function, but RYGB is more efficacious. Resolutions of NAFLD in RYGB and VSG are achieved through different processes, independent of weight loss.
PURPOSE: Bariatric surgery is emerging as an effective treatment for obesity and the metabolic syndrome. Recently, we demonstrated that Roux-en-Y gastric bypass (RYGB), but not vertical sleeve gastrectomy (VSG), resulted in improvements to white adipose physiology and enhanced brown adipose functioning. Since beneficial alterations to liver health are also expected after bariatric surgery, comparing the post-operative effects of RYGB and VSG on liver physiology is essential to their application in the treatment of non-alcoholic fatty liver disease (NAFLD). MATERIALS AND METHODS: The effects of RYGB and VSG on liver physiology were compared using diet induced mouse model of obesity. High-fat diet (HFD) was administered for 12 weeks after surgery and alterations to liver physiology were assessed. RESULTS: Both RYGB and VSG showed decreased liver weight as well as reductions to hepatic cholesterol and triglyceride levels. There were demonstrable improvements to NAFLD activity score (NAS) and fibrosis stage scoring after both surgeries. In RYGB, these beneficial changes to liver function resulted from the downregulation of pro-fibrotic and upregulation anti-fibrotic genes, as well as increased fatty acid oxidation and bile acid flux. For VSG, though similar alterations were observed, they were less potent. However, VSG did significantly downregulate pro-fibrotic genes and showed increased glycogen content paralleled by decreased glycogenolysis which may have contributed to the resolution of NAFLD. CONCLUSION: RYGB and VSG improve liver physiology and function, but RYGB is more efficacious. Resolutions of NAFLD in RYGB and VSG are achieved through different processes, independent of weight loss.
Authors: Matthew Stevenson; Ankita Srivastava; Jenny Lee; Christopher Hall; Thomas Palaia; Raymond Lau; Collin Brathwaite; Louis Ragolia Journal: Obes Surg Date: 2021-04-15 Impact factor: 4.129
Authors: Sherene Shalhub; Anna Parsee; Scott F Gallagher; Krista L Haines; Chris Willkomm; Stephen G Brantley; Haim Pinkas; Lisa Saff-Koche; Michel M Murr Journal: Obes Surg Date: 2004-01 Impact factor: 4.129