OBJECTIVE: To evaluate the effects of the intragastric balloon (IGB) in patients with metabolic dysfunction-associated fatty liver disease through the assessment of liver enzymes, imaging and several metabolic markers.
METHODS: A comprehensive search was done of multiple electronic databases (MEDLINE, EMBASE, LILACS, Cochrane and Google Scholar) and grey literature from their inception until February 2021. Inclusion criteria involved patients with a body mass index > 25 kg/m2 with evidence or previous diagnosis of hepatic steatosis. Outcomes analyzed before and after 6 mo of IGB removal were alanine aminotransferase (IU/L), gamma-glutamyltransferase (IU/L), glycated hemoglobin (%), triglycerides (mg/dL), systolic blood pressure (mmHg), homeostatic model assessment, abdominal circumference (cm), body mass index (kg/m2) and liver volume (cm3).
RESULTS: Ten retrospective cohort studies evaluating a total of 508 patients were included. After 6 mo of IGB placement, this significantly reduced alanine aminotransferase [mean difference (MD): 10.2, 95% confidence interval (CI): 8.12-12.3], gamma-glutamyltransferase (MD: 9.41, 95%CI: 6.94-11.88), glycated hemoglobin (MD: 0.17%, 95%CI: 0.03-0.31), triglycerides (MD: 38.58, 95%CI: 26.65-50.51), systolic pressure (MD: 7.27, 95%CI: 4.79-9.76), homeostatic model assessment (MD: 2.23%, 95%CI: 1.41-3.04), abdominal circumference (MD: 12.12, 95%CI: 9.82-14.41) and body mass index (MD: 5.07, 95%CI: 4.21-5.94).
CONCLUSIONS: IGB placement showed significant efficacy in improving alanine aminotransferase and gamma-glutamyltransferase levels in patients with metabolic dysfunction-associated fatty liver disease as well as improving metabolic markers related to disease progression.
目的:通过肝酶评估评估胃球囊(IGB)在代谢功能障碍相关脂肪肝患者中的作用,影像学和几种代谢标志物。
方法:对多个电子数据库进行了全面搜索(MEDLINE,EMBASE,LILACS,Cochrane和GoogleScholar)和灰色文学从成立到2021年2月。纳入标准涉及体重指数>25kg/m2的患者,有证据或先前诊断为肝性脂肪变性。IGB去除6个月前后分析的结果是丙氨酸转氨酶(IU/L),γ-谷氨酰转移酶(IU/L),糖化血红蛋白(%),甘油三酯(mg/dL),收缩压(mmHg),稳态模型评估,腹围(cm),体重指数(kg/m2)和肝脏体积(cm3)。
结果:共纳入了10项回顾性队列研究,评估了508例患者。IGB放置6个月后,这显着降低了丙氨酸氨基转移酶[平均差异(MD):10.2,95%置信区间(CI):8.12-12.3],γ-谷氨酰转移酶(MD:9.41,95CI:6.94-11.88),糖化血红蛋白(MD:0.17%,95CI:0.03-0.31),甘油三酯(MD:38.58,95CI:26.65-50.51),收缩压(MD:7.27,95CI:4.79-9.76),稳态模型评估(MD:2.23%,95CI:1.41-3.04),腹围(MD:12.12,95CI:9.82-14.41)和体重指数(MD:5.07,95CI:4.21-5.94)。
结论:IGB在改善代谢功能障碍相关脂肪肝患者的丙氨酸转氨酶和γ-谷氨酰转移酶水平以及改善与疾病进展相关的代谢指标方面显示出显著疗效。