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. 2023 Nov;18(8):2271-2280.
doi: 10.1007/s11739-023-03417-2. Epub 2023 Sep 12.

Intra-gastric balloon with lifestyle modification: a promising therapeutic option for overweight and obese patients with metabolic dysfunction-associated steatotic liver disease

A M van Dijk  1 , M de Vries  2 , F El-Morabit  3   4 , S T Bac  3 , M W Mundt  5   6 , L E van der Schuit  5 , M M C Hirdes  5 , M Kara  5 , J de Bruijne  3 , S van Meer  3 , H A H Kaasjager  2 , H W de Valk  2 , F P Vleggaar  3 , K J van Erpecum  3
Affiliations

Intra-gastric balloon with lifestyle modification: a promising therapeutic option for overweight and obese patients with metabolic dysfunction-associated steatotic liver disease

A M van Dijk et al. Intern Emerg Med. 2023 Nov.

Abstract

Background: Data on effects of intra-gastric balloon (IGB) on metabolic dysfunction-associated steatotic liver disease (MASLD) are scarce, in part with contradictory results, and mainly obtained in tertiary care patients with diabetes and other comorbidities. We here explore effects of IGB in patients with MASLD referred to a first-line obesity clinic.

Methods: In this prospective cohort study, patients with at least significant fibrosis (≥ F2) and/or severe steatosis (S3) according to screening transient elastography (FibroScan®) were offered a second FibroScan® after 6 months lifestyle modification with or without IGB (based on patient preference).

Results: 50 of 100 consecutively screened patients (generally non-diabetic) qualified for repeated evaluation and 29 (58%) of those had a second FibroScan®. At baseline, at least significant fibrosis was present in 28% and severe steatosis in 91%. IGB was placed in 19 patients (59%), whereas 10 patients (41%) preferred only lifestyle modification (no differences in baseline characteristics between both groups). After 6 months, liver stiffness decreased markedly in the IGB group (median: from 6.0 to 4.9 kPa, p = 0.005), but not in the lifestyle modification only group (median: from 5.5 to 6.9 kPa, p = 0.477). Steatosis improved in both groups, (controlled attenuation parameter values; IGB, mean ± SD: from 328 ± 34 to 272 ± 62 dB/m, p = 0.006: lifestyle modification only, mean ± SD: from 344 ± 33 to 305 ± 43 dB/m: p = 0.006).

Conclusion: Both steatosis and fibrosis improve markedly in overweight/obese patients with MASLD after 6 months IGB combined with lifestyle modification. Our results warrant further research into long-term effect of IGB in these patients.

Keywords: Intra-gastric balloon; Lifestyle modification; Metabolic dysfunction-associated steatotic liver disease; Obese.

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Figures

Fig. 1
Fig. 1
Flowchart of patient inclusion. CAP, controlled attenuation parameter; LSM liver stiffness measurement
Fig. 2
Fig. 2
Effects of 6 months intra-gastric balloon with lifestyle modification or lifestyle modification alone on weight (mean ± SD; a), liver fibrosis (median [range]; b) and steatosis (mean ± SD; c)
See this image and copyright information in PMC

References

    1. Rinella ME, Lazarus J V, Ratziu V, et al (2023) A multi-society Delphi consensus statement on new fatty liver disease nomenclature Authors. Hepatology Publish Ahead of Print. 10.1097/HEP.0000000000000520
    1. Riazi K, Azhari H, Charette JH, et al. The prevalence and incidence of NAFLD worldwide: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2022;7:851–861. doi: 10.1016/S2468-1253(22)00165-0. - DOI - PubMed
    1. Younossi Z, Anstee QM, Marietti M, et al. Global burden of NAFLD and NASH: trends, predictions, risk factors and prevention. Nat Rev Gastroenterol Hepatol. 2018;15:11–20. doi: 10.1038/nrgastro.2017.109. - DOI - PubMed
    1. Younossi Z, Koenig A, Abdelatif D, et al. Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence and outcomes. Hepatology. 2016;64:73–84. doi: 10.1002/hep.28431. - DOI - PubMed
    1. Suzuki A, Lindor K, Saver JS, et al. Effect of changes on body weight and lifestyle in nonalcoholic fatty liver disease. J Hepatol. 2005;43:1060–1066. doi: 10.1016/j.jhep.2005.06.008. - DOI - PubMed