Published in:
01-09-2016 | Review
Effect of Intragastric Balloons on Liver Enzymes: A Systematic Review and Meta-Analysis
Published in: Digestive Diseases and Sciences | Issue 9/2016
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Background
Intragastric balloons (IGBs) are safe and effective in inducing weight loss in obese patients. The objective of this study was to review and analyze the available data of the effect of IGB on markers of nonalcoholic fatty liver disease (NAFLD) and liver enzymes.
Methods
Searches were performed of MEDLINE and Embase databases from inception through January 2016. Study inclusion criteria were the following: ≥5 overweight or obese adult patients undergoing intragastric balloon placement, with liver tests [alanine aminotransferase (ALT) or gamma-glutamyl transpeptidase (GGT)] or markers of NAFLD (e.g., imaging, biopsy) reported before balloon insertion and after balloon removal at 6 months.
Results
Nine observational studies and one randomized trial were identified. ALT decreased by −10.02 U/l (95 % CI, −13.2, −6.8), GGT decreased by −9.82 U/l (95 % CI, −12.9, −6.8), and BMI decreased by −4.98 kg/m2 (−5.6, −4.4) with IGB therapy. Hepatic steatosis improved from baseline after 6 months of balloon therapy by magnetic resonance imaging (fat fraction, 16.7 ± 10.9–7.6 ± 9.8, p = 0.003), ultrasound (severe liver steatosis, 52–4 %, p < 0.0001). Histological NAFLD activity score was lower after 6 months of IGB versus control with sham endoscopy and diet (2 ± 0.75 vs. 4 ± 2.25, p = 0.03).
Conclusion
The use of intragastric balloon decreases liver enzymes and is potentially an effective short-term treatment for NAFLD as part of a multidisciplinary approach. Larger, more rigorous trials are needed to confirm the effect of IGBs on NAFLD.