Journal article
Authors list: Hempel, Felix; Roderfeld, Martin; Muentnich, Lucas John; Albrecht, Jens; Oruc, Ziya; Arneth, Borros; Karrasch, Thomas; Pons-Kuehnemann, Joern; Padberg, Winfried; Renz, Harald; Schaeffler, Andreas; Roeb, Elke
Publication year: 2021
Journal: Journal of Clinical Medicine
Volume number: 10
Issue number: 6
eISSN: 2077-0383
Open access status: Gold
DOI Link: https://doi.org/10.3390/jcm10061233
Publisher: MDPI
Abstract:
Bariatric surgery has emerged as an effective treatment option in morbidly obese patients with non-alcoholic fatty liver disease (NAFLD). However, worsening or new onset of non-alcoholic steatohepatitis (NASH) and fibrosis have been observed. Caspase-cleaved keratin 18 (ccK18) has been established as a marker of hepatocyte apoptosis, a key event in NASH development. Thus, ccK18 measurements might be feasible to monitor bariatric surgery patients. Clinical data and laboratory parameters were collected from 39 patients undergoing laparoscopic Roux-en-Y gastric bypass at six timepoints, prior to surgery until one year after the procedure. ccK18 levels were measured and a high-throughput analysis of serum adipokines and cytokines was carried out. Half of the cohort's patients (20/39) presented with ccK18 levels indicative of progressed liver disease. 21% had a NAFLD-fibrosis score greater than 0.676, suggesting significant fibrosis. One year after surgery, a mean weight loss of 36.87% was achieved. Six and twelve months after surgery, ccK18 fragments were significantly reduced compared to preoperative levels (p < 0.001). Yet nine patients did not show a decline in ccK18 levels >= 10% within one year postoperatively, which was considered a response to treatment. While no significant differences in laboratory parameters or ccK18 could be observed, they presented with a greater expression of leptin and fibrinogen before surgery. Consecutive ccK18 measurements monitored the resolution of NAFLD and identified non-responders to bariatric surgery with ongoing liver injury. Further studies are needed to elicit the pathological mechanisms in non-responders and study the potential of adipokines as prognostic markers.
Citation Styles
Harvard Citation style: Hempel, F., Roderfeld, M., Muentnich, L., Albrecht, J., Oruc, Z., Arneth, B., et al. (2021) Caspase-Cleaved Keratin 18 Measurements Identified Ongoing Liver Injury after Bariatric Surgery, Journal of Clinical Medicine, 10(6), Article 1233. https://doi.org/10.3390/jcm10061233
APA Citation style: Hempel, F., Roderfeld, M., Muentnich, L., Albrecht, J., Oruc, Z., Arneth, B., Karrasch, T., Pons-Kuehnemann, J., Padberg, W., Renz, H., Schaeffler, A., & Roeb, E. (2021). Caspase-Cleaved Keratin 18 Measurements Identified Ongoing Liver Injury after Bariatric Surgery. Journal of Clinical Medicine. 10(6), Article 1233. https://doi.org/10.3390/jcm10061233
