Background And Aim: It is recognized that nonalcoholic fatty liver disease (NAFLD), including nonalcoholic steatohepatitis (NASH), may develop after pancreaticoduodenectomy (PD). However, the mechanism of NASH development remains unclear. This study aimed to examine the changes in gene expression associated with NASH occurrence following PD.
Methods: The expression of genes related to fatty acid/triglyceride (FA/TG) metabolism and inflammatory signaling was examined using liver samples obtained from 7 post-PD NASH patients and compared with 6 healthy individuals and 32 conventional NASH patients.
Results: The livers of post-PD NASH patients demonstrated significant up-regulation of the genes encoding CD36, FA-binding proteins 1 and 4, acetyl-coenzyme A carboxylase α, diacylglycerol acyltransferase 2, and peroxisome proliferator-activated receptor (PPAR) γ compared with normal and conventional NASH livers. Although serum apolipoprotein B (ApoB) and TG were decreased in post-PD NASH patients, the mRNAs of ApoB and microsomal TG transfer protein were robustly increased, indicating impaired TG export from the liver as very-low-density lipoprotein (VLDL). Additionally, elevated mRNA levels of myeloid differentiation primary response 88 and superoxide dismutases in post-PD NASH livers suggested significant activation of innate immune response and augmentation of oxidative stress generation.
Conclusions: Enhanced FA uptake into hepatocytes and lipogenesis, up-regulation of PPARγ, and disruption of VLDL excretion into the circulation are possible mechanisms of steatogenesis after PD.
General Significance: These results provide a basis for understanding the pathogenesis of NAFLD/NASH following PD.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4661550 | PMC |
http://dx.doi.org/10.1016/j.bbacli.2015.02.001 | DOI Listing |
Surg Today
August 2024
Department of Hepatobiliary Pancreatic and Transplant Surgery, Graduate School of Medicine, Mie University, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.
Purpose: Predicting nonalcoholic fatty liver disease (NAFLD) following pancreaticoduodenectomy (PD) is challenging, which delays therapeutic intervention and makes its prevention difficult. We conducted this study to assess the potential application of preoperative computed tomography (CT) radiomics for predicting NAFLD.
Methods: The subjects of this retrospective study were 186 patients with PD from a single institution.
Clin J Gastroenterol
October 2023
Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.
Surg Today
February 2020
Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto, Kumamoto, 860-8556, Japan.
Purposes: This study aimed to clarify the impact of postoperative nonalcoholic fatty liver disease (NAFLD) on the clinical course of patients with pancreatic ductal adenocarcinoma (PDAC).
Methods: One hundred and eight patients with pancreatic cancer undergoing pancreaticoduodenectomy (PD) with curative intent in between 2005 and 2016 were enrolled in this study. Post-PD NAFLD was assessed by computed tomography (CT), which was routinely performed at 3 months, 6 months, and 1 year after surgery.
BBA Clin
June 2015
Department of Gastroenterology, Shinshu University School of Medicine, Matsumoto, Japan.
J Gastroenterol
January 2016
Department of Digestive Surgery, Nihon University School of Medicine, 30-1 Ohyaguchikami-machi, Itabashi-ku, Tokyo, 173-8610, Japan.
Background: To investigate the efficacy of the early administration of pancreatic enzymes combined with an elemental diet of branched-chain amino acids (BCAA) for nonalcoholic fatty liver disease (NAFLD) after pancreaticoduodenectomy (PD).
Methods: Data were obtained for 122 consecutive patients who underwent PD. High-titer pancrelipase and a BCAA-rich solution was administered via a feeding tube beginning on postoperative day (POD) 4 (PB group: n = 31).
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