Skip to main content
Erschienen in: Obesity Surgery 8/2017

10.03.2017 | Original Contributions

Adipokine Levels Versus Hepatic Histopathology in Bariatric Surgery Patients

verfasst von: Rafael Bergesch D’Incao, Cristiane Valle Tovo, Vanessa Suñé Mattevi, Diego Olschowsky Borges, Jane Maria Ulbrich, Gabriela Perdomo Coral, Mauricio Jacques Ramos, Nelson Guardiola Meinhardt

Erschienen in: Obesity Surgery | Ausgabe 8/2017

Einloggen, um Zugang zu erhalten

Abstract

Background

Obesity is a worldwide prevalent disease and is an underlying factor of non-alcoholic fatty liver disease (NAFLD). It has been understood as a chronic inflammatory state, being associated with the production of adipokines. The aim of this study was to analyze the levels of adipokines in the serum, visceral, and subcutaneous fat and to compare them with hepatic histopathology in morbidly obese patients.

Methods

This is a cross-sectional observational study, which analyzed the findings of liver biopsy in patients undergoing bariatric surgery and who had performed analysis of adipokines mRNA expression (adiponectin—ADIPOQ, leptin—LEP, and resistin—RETN) in subcutaneous and visceral adipose tissue and circulating adipokines in serum. Liver biopsies performed were evaluated according to Kleiner criteria.

Results

The study analyzed 25 patients undergoing bariatric surgery. The sample was composed exclusively of women. There was a predominance of NAFLD, with 21 patients (84%) with intrahepatic fat accumulation. Twelve patients presented non-alcoholic steatohepatitis (NASH). Glycated hemoglobin levels (HbA1c) were elevated in NASH patients. ADIPOQ levels were directly correlated with high-density lipoprotein (HDL) cholesterol levels and inversely correlated with triglycerides and total cholesterol. LEP levels showed an inverse relationship with the degree of steatosis, and RETN levels showed an inverse relationship with fibrosis stages.

Conclusion

Serum LEP levels were reduced in the presence of increased levels of intrahepatic fat, and serum levels of RETN were diminished in the presence of NASH. HbA1c levels were higher in the presence of NASH, indirectly reflecting insulin resistance. Moreover, ADIPOQ levels were related to blood lipid profile.
Literatur
1.
Zurück zum Zitat Lau DCW, Douketis JD, Morrison KM, et al. 2006 Canadian clinical practice guidelines on the management and prevention of obesity in adults and children. Can Med Assoc J. 2007;176(8):S1–13.CrossRef Lau DCW, Douketis JD, Morrison KM, et al. 2006 Canadian clinical practice guidelines on the management and prevention of obesity in adults and children. Can Med Assoc J. 2007;176(8):S1–13.CrossRef
2.
Zurück zum Zitat Vernon G, Baranova A, Younossi ZM. Systematic review: the epidemiology and natural history of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in adults. Aliment Pharmacol Ther. 2011;34(3):274–85.CrossRefPubMed Vernon G, Baranova A, Younossi ZM. Systematic review: the epidemiology and natural history of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in adults. Aliment Pharmacol Ther. 2011;34(3):274–85.CrossRefPubMed
3.
Zurück zum Zitat WGO Global Guidelines. Nonalcoholic fatty liver disease and nonalcoholic steatohepatitis. World Gastroenterol Organ Guidel. 2012. WGO Global Guidelines. Nonalcoholic fatty liver disease and nonalcoholic steatohepatitis. World Gastroenterol Organ Guidel. 2012.
4.
Zurück zum Zitat Losekann A, Weston A, de Mattos A, et al. Non-alcoholic steatohepatitis (NASH): risk factors in morbidly obese patients. Int J Mol Sci. 2015;16(10):25552–9.CrossRefPubMedPubMedCentral Losekann A, Weston A, de Mattos A, et al. Non-alcoholic steatohepatitis (NASH): risk factors in morbidly obese patients. Int J Mol Sci. 2015;16(10):25552–9.CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat Losekann A, Weston AC, Carli LA, et al. Nonalcoholic fatty liver disease in severe obese patients, subjected to bariatric surgery. Arq Gastroenterol. 2013;50(4):285–9.CrossRefPubMed Losekann A, Weston AC, Carli LA, et al. Nonalcoholic fatty liver disease in severe obese patients, subjected to bariatric surgery. Arq Gastroenterol. 2013;50(4):285–9.CrossRefPubMed
6.
Zurück zum Zitat Rinella ME. Nonalcoholic fatty liver disease a systematic review. JAMA. 2015;169(2):170. Rinella ME. Nonalcoholic fatty liver disease a systematic review. JAMA. 2015;169(2):170.
7.
Zurück zum Zitat Frayn KN, Arner P, Yki-Jarvinen H. Fatty acid metabolism in adipose tissue, muscle and liver in health and disease. Essays Biochem. 2006;42:89–103.CrossRefPubMed Frayn KN, Arner P, Yki-Jarvinen H. Fatty acid metabolism in adipose tissue, muscle and liver in health and disease. Essays Biochem. 2006;42:89–103.CrossRefPubMed
8.
Zurück zum Zitat Deng Y, Scherer PE. Adipokines as novel biomarkers and regulators of the metabolic syndrome. Ann N Y Acad Sci. 2010;1212:1–25.CrossRef Deng Y, Scherer PE. Adipokines as novel biomarkers and regulators of the metabolic syndrome. Ann N Y Acad Sci. 2010;1212:1–25.CrossRef
9.
Zurück zum Zitat Petta S, Gastaldelli A, Rebelos E, et al. Pathophysiology of non alcoholic fatty liver disease. Int J Mol Sci. 2016;17(12):2082.CrossRefPubMedCentral Petta S, Gastaldelli A, Rebelos E, et al. Pathophysiology of non alcoholic fatty liver disease. Int J Mol Sci. 2016;17(12):2082.CrossRefPubMedCentral
10.
Zurück zum Zitat Li X-L, Sui J-Q, Lu L-L, et al. Gene polymorphisms associated with non-alcoholic fatty liver disease and coronary artery disease: a concise review. Lipids Health Dis Lipids in Health and Disease. 2016;15(1):53.CrossRefPubMed Li X-L, Sui J-Q, Lu L-L, et al. Gene polymorphisms associated with non-alcoholic fatty liver disease and coronary artery disease: a concise review. Lipids Health Dis Lipids in Health and Disease. 2016;15(1):53.CrossRefPubMed
11.
Zurück zum Zitat Jarrar MH, Baranova A, Collantes R, et al. Adipokines and cytokines in non-alcoholic fatty liver disease. Aliment Pharmacol Ther. 2008;27(5):412–21.CrossRefPubMed Jarrar MH, Baranova A, Collantes R, et al. Adipokines and cytokines in non-alcoholic fatty liver disease. Aliment Pharmacol Ther. 2008;27(5):412–21.CrossRefPubMed
12.
Zurück zum Zitat Abenavoli L, Peta V. Role of adipokines and cytokines in non-alcoholic fatty liver disease. Rev Recent Clin Trials. 2014;9(3):134–40.CrossRefPubMed Abenavoli L, Peta V. Role of adipokines and cytokines in non-alcoholic fatty liver disease. Rev Recent Clin Trials. 2014;9(3):134–40.CrossRefPubMed
13.
Zurück zum Zitat Buechler C, Wanninger J, Neumeier M. Adiponectin, a key adipokine in obesity related liver diseases. World J Gastroenterol. 2011;17(23):2801–11.PubMedPubMedCentral Buechler C, Wanninger J, Neumeier M. Adiponectin, a key adipokine in obesity related liver diseases. World J Gastroenterol. 2011;17(23):2801–11.PubMedPubMedCentral
14.
Zurück zum Zitat Stojsavljević S, Gomerčić Palčić M, Virović Jukić L, et al. Adipokines and proinflammatory cytokines, the key mediators in the pathogenesis of nonalcoholic fatty liver disease. World J Gastroenterol. 2014;20(48):18070–91.CrossRefPubMedPubMedCentral Stojsavljević S, Gomerčić Palčić M, Virović Jukić L, et al. Adipokines and proinflammatory cytokines, the key mediators in the pathogenesis of nonalcoholic fatty liver disease. World J Gastroenterol. 2014;20(48):18070–91.CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Tsochatzis EA, Papatheodoridis GV, Archimandritis AJ. Adipokines in nonalcoholic steatohepatitis: from pathogenesis to implications in diagnosis and therapy. Mediat Inflamm. 2009;2009:831670.CrossRef Tsochatzis EA, Papatheodoridis GV, Archimandritis AJ. Adipokines in nonalcoholic steatohepatitis: from pathogenesis to implications in diagnosis and therapy. Mediat Inflamm. 2009;2009:831670.CrossRef
16.
Zurück zum Zitat Kleiner DE, Brunt EM, Van Natta M, et al. Design and validation of a histological scoring system for nonalcoholic fatty liver disease. Hepatology. 2005;41(6):1313–21.CrossRefPubMed Kleiner DE, Brunt EM, Van Natta M, et al. Design and validation of a histological scoring system for nonalcoholic fatty liver disease. Hepatology. 2005;41(6):1313–21.CrossRefPubMed
17.
Zurück zum Zitat Targher G, Bertolini L, Rodella S, et al. Associations between plasma adiponectin concentrations and liver histology in patients with nonalcoholic fatty liver disease. Clin Endocrinol. 2006;64(6):679–83.CrossRef Targher G, Bertolini L, Rodella S, et al. Associations between plasma adiponectin concentrations and liver histology in patients with nonalcoholic fatty liver disease. Clin Endocrinol. 2006;64(6):679–83.CrossRef
18.
Zurück zum Zitat Karbowska J, Kochan Z. Role of adiponectin in the regulation of carbohydrate and lipid metabolism. In: J Physiol Pharmacol. 2006. p. 103–13. Karbowska J, Kochan Z. Role of adiponectin in the regulation of carbohydrate and lipid metabolism. In: J Physiol Pharmacol. 2006. p. 103–13.
19.
Zurück zum Zitat Lee B, Shao J. Adiponectin and lipid metabolism in skeletal muscle. Acta Pharm Sin B. 2012;2(4):335–40.CrossRef Lee B, Shao J. Adiponectin and lipid metabolism in skeletal muscle. Acta Pharm Sin B. 2012;2(4):335–40.CrossRef
20.
Zurück zum Zitat Baratta R, Amato S, Degano C, Farina MG, Patanè G, Vigneri R, et al. Adiponectin relationship with lipid metabolism is independent of body fat mass: evidence from both cross-sectional and intervention studies. In: J Clin Endocrinol Metabol. 2004. p. 2665–71. Baratta R, Amato S, Degano C, Farina MG, Patanè G, Vigneri R, et al. Adiponectin relationship with lipid metabolism is independent of body fat mass: evidence from both cross-sectional and intervention studies. In: J Clin Endocrinol Metabol. 2004. p. 2665–71.
21.
Zurück zum Zitat Bugianesi E, Pagotto U, Manini R, et al. Plasma adiponectin in nonalcoholic fatty liver is related to hepatic insulin resistance and hepatic fat content, not to liver disease severity. J Clin Endocrinol Metab. 2005;90(6):3498–504.CrossRefPubMed Bugianesi E, Pagotto U, Manini R, et al. Plasma adiponectin in nonalcoholic fatty liver is related to hepatic insulin resistance and hepatic fat content, not to liver disease severity. J Clin Endocrinol Metab. 2005;90(6):3498–504.CrossRefPubMed
22.
Zurück zum Zitat Pagano C, Soardo G, Esposito W, et al. Plasma adiponectin is decreased in nonalcoholic fatty liver disease. Eur J Endocrinol. 2005;152(1):113–8.CrossRefPubMed Pagano C, Soardo G, Esposito W, et al. Plasma adiponectin is decreased in nonalcoholic fatty liver disease. Eur J Endocrinol. 2005;152(1):113–8.CrossRefPubMed
23.
Zurück zum Zitat Polyzos SA, Mantzoros CS. Adiponectin as a target for the treatment of nonalcoholic steatohepatitis with thiazolidinediones: a systematic review. Metabolism. 2016;65(9):1297–306.CrossRefPubMed Polyzos SA, Mantzoros CS. Adiponectin as a target for the treatment of nonalcoholic steatohepatitis with thiazolidinediones: a systematic review. Metabolism. 2016;65(9):1297–306.CrossRefPubMed
24.
Zurück zum Zitat Spranger J, Kroke A, Möhlig M, et al. Adiponectin and protection against type 2 diabetes mellitus. Lancet. 2003;361(9353):226–8.CrossRefPubMed Spranger J, Kroke A, Möhlig M, et al. Adiponectin and protection against type 2 diabetes mellitus. Lancet. 2003;361(9353):226–8.CrossRefPubMed
25.
Zurück zum Zitat Argentou M, Tiniakos DG, Karanikolas M, et al. Adipokine serum levels are related to liver histology in severely obese patients undergoing bariatric surgery. Obes Surg. 2009;19(9):1313–23.CrossRefPubMed Argentou M, Tiniakos DG, Karanikolas M, et al. Adipokine serum levels are related to liver histology in severely obese patients undergoing bariatric surgery. Obes Surg. 2009;19(9):1313–23.CrossRefPubMed
26.
Zurück zum Zitat Abenavoli L, DI Renzo L, Guzzi PH, et al. Non-alcoholic fatty liver disease severity, central fat mass and adinopectin: a close relationship. Clujul Med. 2015;88(4):489–93.CrossRefPubMedPubMedCentral Abenavoli L, DI Renzo L, Guzzi PH, et al. Non-alcoholic fatty liver disease severity, central fat mass and adinopectin: a close relationship. Clujul Med. 2015;88(4):489–93.CrossRefPubMedPubMedCentral
27.
Zurück zum Zitat Baranova A, Gowder SJ, Schlauch K, et al. Gene expression of leptin, resistin, and adiponectin in the white adipose tissue of obese patients with non-alcoholic fatty liver disease and insulin resistance. Obes Surg. 2006;16(9):1118–25.CrossRefPubMed Baranova A, Gowder SJ, Schlauch K, et al. Gene expression of leptin, resistin, and adiponectin in the white adipose tissue of obese patients with non-alcoholic fatty liver disease and insulin resistance. Obes Surg. 2006;16(9):1118–25.CrossRefPubMed
28.
Zurück zum Zitat Jamali R, Arj A, Razavizade M, et al. Prediction of nonalcoholic fatty liver disease via a novel panel of serum adipokines. Medicine (Baltimore). 2016a;95(5):e2630.CrossRef Jamali R, Arj A, Razavizade M, et al. Prediction of nonalcoholic fatty liver disease via a novel panel of serum adipokines. Medicine (Baltimore). 2016a;95(5):e2630.CrossRef
29.
Zurück zum Zitat Considine RV, Sinha MK, Heiman ML, et al. Serum immunoreactive-leptin concentrations in normal-weight and obese humans. N Engl J Med. 1996;334(5):292–5.CrossRefPubMed Considine RV, Sinha MK, Heiman ML, et al. Serum immunoreactive-leptin concentrations in normal-weight and obese humans. N Engl J Med. 1996;334(5):292–5.CrossRefPubMed
30.
Zurück zum Zitat Lönnqvist F, Arner P, Nordfors L, et al. Overexpression of the obese (Ob) gene in adipose tissue of human obese subjects. Nat Med. 1995;1(9):950–3.CrossRefPubMed Lönnqvist F, Arner P, Nordfors L, et al. Overexpression of the obese (Ob) gene in adipose tissue of human obese subjects. Nat Med. 1995;1(9):950–3.CrossRefPubMed
31.
Zurück zum Zitat Tsochatzis E, Papatheodoridis GV, Archimandritis AJ. The evolving role of leptin and adiponectin in chronic liver diseases. Am J Gastroenterol. 2006;101(11):2629–40.CrossRefPubMed Tsochatzis E, Papatheodoridis GV, Archimandritis AJ. The evolving role of leptin and adiponectin in chronic liver diseases. Am J Gastroenterol. 2006;101(11):2629–40.CrossRefPubMed
32.
Zurück zum Zitat Ikejima K, Takei Y, Honda H, et al. Leptin receptor-mediated signaling regulates hepatic fibrogenesis and remodeling of extracellular matrix in the rat. Gastroenterology. 2002;122(5):1399–410.CrossRefPubMed Ikejima K, Takei Y, Honda H, et al. Leptin receptor-mediated signaling regulates hepatic fibrogenesis and remodeling of extracellular matrix in the rat. Gastroenterology. 2002;122(5):1399–410.CrossRefPubMed
33.
Zurück zum Zitat Ikejima K, Honda H, Yoshikawa M, et al. Leptin augments inflammatory and profibrogenic responses in the murine liver induced by hepatotoxic chemicals. Hepatology. 2001;34(2):288–97.CrossRefPubMed Ikejima K, Honda H, Yoshikawa M, et al. Leptin augments inflammatory and profibrogenic responses in the murine liver induced by hepatotoxic chemicals. Hepatology. 2001;34(2):288–97.CrossRefPubMed
34.
Zurück zum Zitat Chitturi S, Farrell G, Frost L, et al. Serum leptin in NASH correlates with hepatic steatosis but not fibrosis: a manifestation of lipotoxicity? Hepatology. 2002;36(2):403–9.CrossRefPubMed Chitturi S, Farrell G, Frost L, et al. Serum leptin in NASH correlates with hepatic steatosis but not fibrosis: a manifestation of lipotoxicity? Hepatology. 2002;36(2):403–9.CrossRefPubMed
35.
Zurück zum Zitat Tsochatzis E, Papatheodoridis GV, Hadziyannis E, et al. Serum adipokine levels in chronic liver diseases: association of resistin levels with fibrosis severity. Scand J Gastroenterol. 2008;43(9):1128–36.CrossRefPubMed Tsochatzis E, Papatheodoridis GV, Hadziyannis E, et al. Serum adipokine levels in chronic liver diseases: association of resistin levels with fibrosis severity. Scand J Gastroenterol. 2008;43(9):1128–36.CrossRefPubMed
36.
Zurück zum Zitat Polyzos SA, Aronis KN, Kountouras J, et al. Circulating leptin in non-alcoholic fatty liver disease: a systematic review and meta-analysis. Diabetologia. 2016;59(1):30–43.CrossRefPubMed Polyzos SA, Aronis KN, Kountouras J, et al. Circulating leptin in non-alcoholic fatty liver disease: a systematic review and meta-analysis. Diabetologia. 2016;59(1):30–43.CrossRefPubMed
37.
Zurück zum Zitat Polyzos SA, Kountouras J, Mantzoros CS. Leptin in nonalcoholic fatty liver disease: a narrative review. Metab Clin Exp. 2015;64:60–78.CrossRefPubMed Polyzos SA, Kountouras J, Mantzoros CS. Leptin in nonalcoholic fatty liver disease: a narrative review. Metab Clin Exp. 2015;64:60–78.CrossRefPubMed
38.
Zurück zum Zitat Steppan CM, Bailey ST, Bhat S, et al. The hormone resistin links obesity to diabetes. Nature. 2001;409(6818):307–12.CrossRefPubMed Steppan CM, Bailey ST, Bhat S, et al. The hormone resistin links obesity to diabetes. Nature. 2001;409(6818):307–12.CrossRefPubMed
39.
Zurück zum Zitat De Luis DA, Terroba MC, Cuellar L, et al. Resistin levels in morbid obese patients following the biliopancreatic diversion surgery. Horm Metab Res. 2011;43(3):205–8.CrossRefPubMed De Luis DA, Terroba MC, Cuellar L, et al. Resistin levels in morbid obese patients following the biliopancreatic diversion surgery. Horm Metab Res. 2011;43(3):205–8.CrossRefPubMed
40.
Zurück zum Zitat Aller R, de Luis D, Fernandez L, et al. Influence of insulin resistance and adipokines in the grade of steatosis of nonalcoholic fatty liver disease. Dig Dis Sci. 2008;53(4):1088–92.CrossRefPubMed Aller R, de Luis D, Fernandez L, et al. Influence of insulin resistance and adipokines in the grade of steatosis of nonalcoholic fatty liver disease. Dig Dis Sci. 2008;53(4):1088–92.CrossRefPubMed
41.
Zurück zum Zitat Pagano C, Soardo G, Pilon C, et al. Increased serum resistin in nonalcoholic fatty liver disease is related to liver disease severity and not to insulin resistance. J Clin Endocrinol Metab. 2006;91(3):1081–6.CrossRefPubMed Pagano C, Soardo G, Pilon C, et al. Increased serum resistin in nonalcoholic fatty liver disease is related to liver disease severity and not to insulin resistance. J Clin Endocrinol Metab. 2006;91(3):1081–6.CrossRefPubMed
42.
Zurück zum Zitat Senates E, Çolak Y, Yesil A, et al. Circulating resistin is elevated in patients with non-alcoholic fatty liver disease and its associated with steatosis, portal inflammation, insulin resistance and no alcoholic steatohepatitis scores. Minerva Med. 2012;53(9):1689–99. Senates E, Çolak Y, Yesil A, et al. Circulating resistin is elevated in patients with non-alcoholic fatty liver disease and its associated with steatosis, portal inflammation, insulin resistance and no alcoholic steatohepatitis scores. Minerva Med. 2012;53(9):1689–99.
43.
Zurück zum Zitat Cengiz C, Ardicoglu Y, Bulut S, et al. Serum retinol-binding protein 4 in patients with nonalcoholic fatty liver disease: does it have a significant impact on pathogenesis? Eur J Gastroenterol Hepatol. 2010;22(7):813–9.CrossRefPubMed Cengiz C, Ardicoglu Y, Bulut S, et al. Serum retinol-binding protein 4 in patients with nonalcoholic fatty liver disease: does it have a significant impact on pathogenesis? Eur J Gastroenterol Hepatol. 2010;22(7):813–9.CrossRefPubMed
44.
Zurück zum Zitat Jamali R, Razavizade M, Arj A, et al. Serum adipokines might predict liver histology findings in non-alcoholic fatty liver disease. World J Gastroenterol. 2016b;22(21):5096–103.CrossRefPubMedPubMedCentral Jamali R, Razavizade M, Arj A, et al. Serum adipokines might predict liver histology findings in non-alcoholic fatty liver disease. World J Gastroenterol. 2016b;22(21):5096–103.CrossRefPubMedPubMedCentral
45.
Zurück zum Zitat Perseghin G, Lattuada G, De Cobelli F, et al. Serum resistin and hepatic fat content in nondiabetic individuals. J Clin Endocrinol Metab. 2006;91(12):5122–5.CrossRefPubMed Perseghin G, Lattuada G, De Cobelli F, et al. Serum resistin and hepatic fat content in nondiabetic individuals. J Clin Endocrinol Metab. 2006;91(12):5122–5.CrossRefPubMed
46.
Zurück zum Zitat Bekaert M, Verhelst X, Geerts A, et al. Association of recently described adipokines with liver histology in biopsy-proven non-alcoholic fatty liver disease: a systematic review. Obes Rev. 2016;17(1):68–80.CrossRefPubMed Bekaert M, Verhelst X, Geerts A, et al. Association of recently described adipokines with liver histology in biopsy-proven non-alcoholic fatty liver disease: a systematic review. Obes Rev. 2016;17(1):68–80.CrossRefPubMed
47.
Zurück zum Zitat Samaras K, Botelho NK, Chisholm DJ, et al. Subcutaneous and visceral adipose tissue gene expression of serum adipokines that predict type 2 diabetes. Obesity (silver spring). Nat Publ Group. 2010;18(5):884–9. Samaras K, Botelho NK, Chisholm DJ, et al. Subcutaneous and visceral adipose tissue gene expression of serum adipokines that predict type 2 diabetes. Obesity (silver spring). Nat Publ Group. 2010;18(5):884–9.
48.
Zurück zum Zitat Blüher M, Fasshauer M, Kralisch S, et al. Regulation of adiponectin receptor R1 and R2 gene expression in adipocytes of C57BL/6 mice. Biochem Biophys Res Commun. 2005;329(3):1127–32.CrossRefPubMed Blüher M, Fasshauer M, Kralisch S, et al. Regulation of adiponectin receptor R1 and R2 gene expression in adipocytes of C57BL/6 mice. Biochem Biophys Res Commun. 2005;329(3):1127–32.CrossRefPubMed
Metadaten
Titel
Adipokine Levels Versus Hepatic Histopathology in Bariatric Surgery Patients
verfasst von
Rafael Bergesch D’Incao
Cristiane Valle Tovo
Vanessa Suñé Mattevi
Diego Olschowsky Borges
Jane Maria Ulbrich
Gabriela Perdomo Coral
Mauricio Jacques Ramos
Nelson Guardiola Meinhardt
Publikationsdatum
10.03.2017
Verlag
Springer US
Erschienen in
Obesity Surgery / Ausgabe 8/2017
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-017-2627-4

Weitere Artikel der Ausgabe 8/2017

Obesity Surgery 8/2017 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.