Intragastric Balloon as a New Approach for Metabolic Dysfunction-Associated Fatty Liver Disease (Mafld): A Systematic Review and Meta-Analysis

Aims Metabolic dysfunction-associated fatty liver disease (MAFLD) is a new definition for non-alcoholic fatty liver disease and corresponds to the accumulation of fat in the liver caused by metabolic dysregulation. It is estimated the condition affects a quarter of the adult world population and it will be the main cause of liver transplantation by 2030. This is the first systematic review and meta-analysis to evaluate the effects of the intragastric balloon (IGB) placement in patients with MAFLD through liver enzymes, imaging, and metabolic parameters.

Methods The search was conducted in the MEDLINE, EMBASE, and gray literature databases in August 2020. Study criteria inclusion were patients with a BMI> 25 kg/m2 with evidence or previous diagnosis of hepatic steatosis. The outcomes analyzed before and after 6 months of IGB insertion were alanine aminotransferase (ALT), gamma-glutamyltransferase (GGT), glycosylated hemoglobin (Hb1Ac), Homeostatic model assessment (HOMA-IR), triglycerides, systolic pressure, abdominal circumference, and body mass index (BMI), and liver volume.

Results Ten retrospective cohort studies including 508 patients were included in the statistical analysis. After 6 months IGB reduced ALT (MD: 10.2, 95 % IC [8.12, 12.3], p < 0,01); GGT (MD: 9.41, 95 % IC [6.94, 11.88], p < 0,01); Hb1Ac (MD: 0.17 %, 95 % IC [0.03, 0.31], p = 0,02); HOMA-IR (MD: 2.23, 95 % IC [1.41, 3.04], p < 0,01); triglycerides (MD: 38.58, 95 % IC [26.65, 50.51], p < 0.01); systolic pressure (MD: 7.27 95 % IC [4.79, 9.76], p < 0.01); abdominal circumference (MD: 12.12, 95 % IC [9.82, 14.41], p < 0.01) and BMI (MD: 5.07, 95 % IC [4.21,5.94], p < 0.01). No statistical significance was found in the reduction in liver volume (MD: 303 cm³, 95 % IC [-56.6; 663.15]; p = 0.1).

Outcome	MD (mean difference)	95 %CI	p (value indicating level of statistical significance)	Heterogeneity (I2 %)
ALT (IU/L)	10.2	8.12 - 12.3	< 0,01	<50
GGT (IU/L)	9.41	6.94 - 11.88	< 0,01	0
HOMA-IR	2.23	1.41 - 3.04	< 0,01	>50
BMI (kg/m2)	5.07	4.21 - 5.94	< 0,01	0

Conclusions IGB reduced liver enzymes in patients with MAFLD as well as improved metabolic parameters related to disease progression.

Citation: de Freitas Junior JR, Sagae VMT, de Oliveira GHP et al. OP42 INTRAGASTRIC BALLOON AS A NEW APPROACH FOR METABOLIC DYSFUNCTION-ASSOCIATED FATTY LIVER DISEASE (MAFLD): A SYSTEMATIC REVIEW AND META-ANALYSIS. Endoscopy 2021; 53: S19.

Publication History

Article published online:
19 March 2021