Liver Fibrosis, Liver Steatosis, NAFLD, Obesity
Conditions
Keywords
Obesity, NAFLD, liver steatosis, liver fibrosis, bariatric endoscopy, weight lose
Brief summary
Find out how bariatric endocopy will influence clinical course of non alcoholic fatty liver disease.
Detailed description
The study will test and investigate the impact of bariatric endoscopy (various types of intragastric balloons, endoscopic sleeve gastroplasty, aspiration therapy) on components of the metabolic syndrome in obese patients, especially on influencing non-alcoholic steatosis and steatohepatitis and signs of liver fibrotization and weight reduction. The method consists in performing a mini-invasive endoscopic procedure and, as a result, in reduced food intake. Current state of knowledge: Based on data evaluated according to EBM (Evidence Based Medicine), it is an indisputable fact that bariatric methods have a demonstrable effect not only on improving the parameters and regression of many metabolic syndromes, but also improve the course of non-alcoholic fatty liver disease (NAFLD). It is this nosological unit that is becoming the dominant cause of liver disease in developed countries and has two subunits, where simple hepatic steatosis (NAFL) is considered a benign disease, while the second, where fat accumulation in the liver is associated with the inflammatory process called non-alcoholic steatohepatitis (NASH). ) has serious consequences for the liver with the development of fibrotization leading to cirrhosis with all its adverse effects. Recently, however, it has been shown that even simple steatosis is not as benign as it seemed, but carries an independent risk for the patient due to an increased incidence of cardiovascular diseases, oncological manifestations and a higher incidence of metabolic syndrome manifestations. Classical bariatric endoscopy carries a number of risks associated with the patient for the surgical procedure, however, we also have less invasive methods of gradually more and more developing endoscopy and dreams of associated bariatric procedures with many times lower risk for the patient.
Interventions
PROCEDUREbariatric endoscopy, mainly intragastric baloons, plication of stomach too
bariatric endoscopy, mainly intragastric baloons, plication of stomach too
Sponsors
University Hospital Olomouc
University Hospital Ostrava
Palacky University
University of Ostrava
Study design
Allocation
NON_RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
To be eligible for participation in this study, subjects must conform to the following inclusion criteria: 1. Age between 21-64 years; 2. BMI \>30 Kg/m2 3. Must be able to comply with all study requirements for the duration of the study as outlined in the protocol. This includes complying with the visit schedule as well as study specific procedures such as: clinical assessment , endoscopy, radiography, as well as laboratory investigations. 4. Must be able to understand and be willing to provide written informed consent.
Exclusion criteria
* Subjects meeting any of the following exclusionary criteria cannot be enrolled in the study: 1. Achalasia and any other esophageal motility disorders 2. Heart diseases: unstable angina, myocardial infarction within the past year, or heart disease classified within the New York Heart Association's Class III or IV functional capacity. 3. Hypertension: uncontrolled hypertension during last 3 month 4. Severe renal, hepatic, pulmonary disease or cancer; 5. GIT stenosis or obstruction 6. Pregnancy or breastfeeding 7. Impending gastric surgery 60 days post intervention; 8. Currently participating in other study 9. Celiac disease 10. History of bariatric surgery 11. Chronic or recent acute pancreatitis 12. Type 2 diabetes with insuline medication or type 1 diabetes 13. Hematologic disease or disease with impairment of hemocoagulation 14. Decompensated psychiatric disease 15. Autoimmune disease with chronic glucocorticoid or imunosupressive medications 16. Uncontroled disease of thyroid gland 17. Excesive abuse of addictive substances such alcohol or other
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Amount of patients with NAFLD with degree of fibrosis of the liver amog patients undergoing bariatric endoscopy and determine influence of bariatric endoscopy on clinical course of NAFLD and liver fibrosis | 24 months | Amount of patients with NAFLD with degree of fibrosis of the liver amog patients undergoing bariatric endoscopy and determine influence of bariatric endoscopy on clinical course of NAFLD and liver fibrosis |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Influence of bariatric endoscopy on improvements of weight, antropometric, improvements in components of metabolic syndrome | 24 months | Influence of bariatric endoscopy on improvements of weight, antropometric, improvements in components of metabolic syndrome |
Countries
Czechia
Contacts
Primary ContactAdam Vasura
Outcome results
None listed