Year 2019 / Volume 111 / Number 4
Original
An assessment of bacterial overgrowth and translocation in the non-alcoholic fatty liver of patients with morbid obesity

294-300

DOI: 10.17235/reed.2019.5942/2018

Francisco Domper Bardají, Aurora Gil Rendo, Soledad Illescas Fernández-Bermejo, Roberto Patón Arenas, Alicia Hernández Albújar, Francisco Martín Dávila, Cristina Murillo Lázaro, Mónica Sánchez Alonso, Maite Serrano Dueñas, Ana Sobrino López, Fernando Ramírez Esteso, Jesús Martín Fernández,

Abstract
Background: small intestinal bacterial overgrowth (SIBO) and bacterial translocation across the intestinal wall have been allegedly associated with non-alcoholic fatty liver (NAFL). Our goal was to study such alleged association in morbidly obese patients. Patients and methods: patients with morbid obesity were consecutively included prior to bariatric surgery. Exclusion criteria included normal liver biopsy, other causes of liver disease, and duodenal mucosal atrophy. A gastroscopy was performed for duodenal aspirate culture and duodenal biopsy, and peripheral venous blood was drawn to assess lipopolysaccharide (LPS) and LPS-binding protein (LBP) levels. A liver biopsy was carried out during surgery. Results: seventy-one patients were included; 26 were excluded because of normal liver biopsy. Forty-five had NAFL. Eighteen were male, mean age was 45.8 years (22-69), and BMI was 47.8 kg/m2 (37-58). A total of 25% had SIBO in their duodenal aspirate culture. There was statistical significance for the association of LBP levels and SIBO with steatosis grade (p < 0.05 and p = 0.077, respectively). There was no statistical association with non-alcoholic steatohepatitis (NASH) index, but a trend towards association was found. LPS levels were not associated with steatosis grade or NASH index. Conclusions: the higher the grade of liver steatosis, the higher were the circulating LBP levels and SIBO rates seen in patients with morbid obesity and NAFL.
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Domper Bardají F, Gil Rendo A, Illescas Fernández-Bermejo S, Patón Arenas R, Hernández Albújar A, Martín Dávila F, et all. An assessment of bacterial overgrowth and translocation in the non-alcoholic fatty liver of patients with morbid obesity. 5942/2018


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Publication history

Received: 27/09/2018

Accepted: 08/02/2019

Online First: 21/03/2019

Published: 04/04/2019

Article revision time: 130 days

Article Online First time: 175 days

Article editing time: 189 days


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