caa a22 4500 445887826 CHVBK 20180317145605.0 cr unu---uuuuu 170323e20110601xx s 000 0 eng 10.1007/s00535-011-0370-5 doi (NATIONALLICENCE)springer-10.1007/s00535-011-0370-5 Clinical characteristics of de novo nonalcoholic fatty liver disease following pancreaticoduodenectomy [Elektronische Daten] [Naoki Tanaka, Akira Horiuchi, Takahide Yokoyama, Gengo Kaneko, Naoto Horigome, Takahiro Yamaura, Tadanobu Nagaya, Michiharu Komatsu, Kenji Sano, Shin-ichi Miyagawa, Toshifumi Aoyama, Eiji Tanaka] Background: Hepatic steatosis may develop after pancreatic resection, but its clinicopathological features remain unclear. We explored the clinical characteristics of newly appearing nonalcoholic fatty liver disease (NAFLD) after pancreaticoduodenectomy (PD), designated as de novo NAFLD after PD. Methods: Of 83 patients who underwent PD between 2001 and 2006, the patients with regular alcohol consumption after PD (n=3), those who were unavailable for regular abdominal computed tomography follow-up (n=12), and those who died within 6months of PD (n=8) were excluded from the study. In the remaining 60 patients, the prevalence and clinical features of de novo NAFLD after PD were examined. Results: NAFLD developed after PD in 14 (23%) patients in our cohort. Liver biopsy was performed in 8 patients and all showed typical steatohepatitis. Compared with the patients who had conventional nonalcoholic steatohepatitis (NASH), patients with post-PD de novo NASH demonstrated significant decreases in body mass index and lower levels of serum albumin, cholesterol, apolipoprotein B, and homeostasis model assessment for insulin resistance. Multivariate logistic regression analysis revealed that pancreatic head cancer was associated with an increased risk of developing NAFLD after PD (odds ratio 12.0, 95% confidence interval 2.0-71.4, P=0.006). Increased dosage of oral pancreatic enzymes significantly ameliorated the steatosis, as well as leading to the recovery of body weight loss and resolution of the biochemical abnormalities. Conclusions: De novo NAFLD/NASH after PD is characterized by non-obesity and lack of hyperlipidemia and insulin resistance and is associated with pancreatic exocrine insufficiency. In such patients, intensifying pancreatic enzyme supplementation may be useful. Springer, 2011 Nonalcoholic steatohepatitis nationallicence Pancreatic exocrine insufficiency nationallicence Albumin nationallicence Pancreatic head cancer nationallicence Apolipoprotein B nationallicence ALT : Alanine aminotransferase nationallicence apoB : Apolipoprotein B nationallicence AST : Aspartate aminotransferase nationallicence BMI : Body mass index nationallicence CT : Computed tomography nationallicence γGT : Gamma-glutamyltransferase nationallicence HbA1c : Hemoglobin A1c nationallicence HBV : Hepatitis B virus nationallicence HCV : Hepatitis C virus nationallicence HDL : High-density lipoprotein nationallicence HOMA-IR : Homeostasis model assessment for insulin resistance nationallicence MCD : Methionine- and choline-deficient diet nationallicence NAFLD : Nonalcoholic fatty liver disease nationallicence NAS : NAFLD activity score nationallicence NASH : Nonalcoholic steatohepatitis nationallicence PD : Pancreaticoduodenectomy nationallicence VLDL : Very-low-density lipoprotein nationallicence Tanaka Naoki Department of Metabolic Regulation, Institute on Aging and Adaptation, Shinshu University Graduate School of Medicine, Asahi 3-1-1, 390-8621, Matsumoto, Japan aut Horiuchi Akira Department of Gastroenterology, Showa Inan General Hospital, Komegane, Japan aut Yokoyama Takahide Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan aut Kaneko Gengo Department of Surgery, Iida Municipal Hospital, Iida, Japan aut Horigome Naoto Department of Surgery, Iida Municipal Hospital, Iida, Japan aut Yamaura Takahiro Department of Gastroenterology, Iida Municipal Hospital, Iida, Japan aut Nagaya Tadanobu Department of Gastroenterology, Shinshu University School of Medicine, Matsumoto, Japan aut Komatsu Michiharu Department of Gastroenterology, Shinshu University School of Medicine, Matsumoto, Japan aut Sano Kenji Department of Laboratory Medicine, Shinshu University Hospital, Matsumoto, Japan aut Miyagawa Shin-ichi Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan aut Aoyama Toshifumi Department of Metabolic Regulation, Institute on Aging and Adaptation, Shinshu University Graduate School of Medicine, Asahi 3-1-1, 390-8621, Matsumoto, Japan aut Tanaka Eiji Department of Gastroenterology, Shinshu University School of Medicine, Matsumoto, Japan aut Journal of Gastroenterology Springer Japan 46/6(2011-06-01), 758-768 0944-1174 46:6<758 2011 46 535 https://doi.org/10.1007/s00535-011-0370-5 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00535-011-0370-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Tanaka Naoki Department of Metabolic Regulation, Institute on Aging and Adaptation, Shinshu University Graduate School of Medicine, Asahi 3-1-1, 390-8621, Matsumoto, Japan aut NATIONALLICENCE 700 1- Horiuchi Akira Department of Gastroenterology, Showa Inan General Hospital, Komegane, Japan aut NATIONALLICENCE 700 1- Yokoyama Takahide Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan aut NATIONALLICENCE 700 1- Kaneko Gengo Department of Surgery, Iida Municipal Hospital, Iida, Japan aut NATIONALLICENCE 700 1- Horigome Naoto Department of Surgery, Iida Municipal Hospital, Iida, Japan aut NATIONALLICENCE 700 1- Yamaura Takahiro Department of Gastroenterology, Iida Municipal Hospital, Iida, Japan aut NATIONALLICENCE 700 1- Nagaya Tadanobu Department of Gastroenterology, Shinshu University School of Medicine, Matsumoto, Japan aut NATIONALLICENCE 700 1- Komatsu Michiharu Department of Gastroenterology, Shinshu University School of Medicine, Matsumoto, Japan aut NATIONALLICENCE 700 1- Sano Kenji Department of Laboratory Medicine, Shinshu University Hospital, Matsumoto, Japan aut NATIONALLICENCE 700 1- Miyagawa Shin-ichi Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan aut NATIONALLICENCE 700 1- Aoyama Toshifumi Department of Metabolic Regulation, Institute on Aging and Adaptation, Shinshu University Graduate School of Medicine, Asahi 3-1-1, 390-8621, Matsumoto, Japan aut NATIONALLICENCE 700 1- Tanaka Eiji Department of Gastroenterology, Shinshu University School of Medicine, Matsumoto, Japan aut NATIONALLICENCE 773 0- Journal of Gastroenterology Springer Japan 46/6(2011-06-01), 758-768 0944-1174 46:6<758 2011 46 535 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer