Hormonal
Bariatric surgery (BS) improves NAFLD outcomes by altering bile acid bioavailability, which activates the Fxr-Glp-1 axis, improves glucose homeostasis, and reestablishes normal ghrelin responses.
For obese patients with NAFLD, bariatric surgery is a viable treatment option that not only reduces weight but also improves liver health through hormonal changes. It reestablishes normal ghrelin responses and activates pathways that improve glucose homeostasis. If you are considering surgery, discuss how it might specifically benefit your liver health beyond weight loss.
The Fxr-Glp-1 axis improves glucose homeostasis through the bile diversion to ileum caused by BS; this has demonstrated to mediate metabolic changes, depending on bile acids bioavailability... As to the abnormal response to Ghr in obese patients, it seems to be reestablished after a Roux-en-Y gastric bypass procedure.
Why this rating
The paper cites studies showing metabolic changes and reestablished ghrelin response, but notes the complexity of bile acid bioavailability.
Source
Hunger & satiety signals: another key mechanism involved in the NAFLD pathway
Iván López-Méndez et al. · Frontiers in Endocrinology · 2023
DOI 10.3389/fendo.2023.1213372
More from this paper
- GLP-1 receptor agonists (specifically semaglutide and liraglutide) significantly reduce hepatic fat content and resolve NASH in patients with NAFLD, primarily through delayed gastric emptying and direct metabolic effects on the liver.Good
- Ghrelin levels, specifically the ratio of unacylated to acylated ghrelin, are altered in NAFLD patients, with decreased plasma unacylated/acylated ghrelin ratio and increased hypothalamic acylated ghrelin expression correlating with insulin resistance and NAFLD severity.Moderate
Related findings · Hormonal
- Initial treatment for type 2 diabetes should be a combination of metformin and either an SGLT-2 inhibitor or a GLP-1 receptor agonist to achieve cardiorenal protection, rather than monotherapy or older agents like sulfonylureas.Strong
- For patients with specific monogenic obesity syndromes (leptin deficiency, POMC/PCSK1/LEPR mutations), targeted pharmacotherapy (recombinant leptin or setmelanotide) is highly effective and should be prioritized, unlike in polygenic obesity.Strong
- Continued weekly administration of 2.4 mg subcutaneous semaglutide prevents weight regain and promotes further weight loss in adults with overweight or obesity, whereas switching to placebo results in significant weight regain.Strong
This is one finding among thousands. Every one is graded and traced to its source, so you can see what the evidence actually supports. Browse the research →