We therefore investigated the effect of Endobarrier treatment on hepatic parameters in obese uncontrolled type 2 diabetes mellitus patients with NAFLD. The Endobarrier device was implanted for 12 months in the duodenum via an endo-scopic procedure in 44 uncontrolled diabetic, obese, NAFLD subjects (age 52.3±9.3y, 52.2% male, BMI 37.5±4.6 m2/kg). BMI, waist circumference, serum liver enzyme levels, glucose, HBA1c and lipid profile were performed as well as shear wave elastography (SWE) (Aixplorer SuperSonic Imagine, PD98059 purchase France) and Fibromax (FibroTest, ActiTest, SteatoTest, and NashTest) (BioPredictive, France) for the noninvasive evaluation of hepatic injury before, 3 and 6 months

during the implantation of the Endobarrier device and when removing the device (12 months). At 3 and 6 months after implantation of the Endo-barrier (interim results, n=29), the BMI, waist circumference, serum liver enzyme levels, glucose, HBA1c and lipid profile decreased significantly (from baseline and from 3 to 6 months). The fibrosis stage (evaluated by SWE) and the: SteatoTest (fat liver content),

and NashTest (steatohepatitis score) (evaluated by Fibromax) also improved significantly from baseline and from 3 to 6 months. In 9 subjects (20.4%) the Endobarrier was endoscopically explanted early. Conclusion: Endobarrier, a minimally invasive bariatric technique, achieved significant improvement Gefitinib purchase in hepatic injury, fat liver content, steatohepatitis score and fibrosis stage in advanced uncontrolled obese, diabetic, NAFLD patients.

This device may be suitable for the treatment of morbid obesity and its related comorbidities including NAFLD. Disclosures: The following people have nothing to disclose: Oranit Cohen-Ezra, Gabriella Segal-Lieberman, Alon Lang, Maor Lahav, Yeroham Kleinbaum, Sima Katshergin-sky, Keren Tsaraf, Ziv Ben Ari Background & Aims: Recent investigations demonstrated that circulating secreted factors, such as adiponectin, leptin, tumor necrosis factor-α (TNF-α), and fetuin-A significantly affect pathophysiological Protein tyrosine phosphatase progression in NAFLD. Fetuin-A (a2HS-gly-coprotein) is a liver glycoprotein secreted into the circulation at high concentrations. Fetuin-A is known as a transforming growth factor (TGF)-1 signaling inhibitor. Serum fetuin-A concentration is associated with nonalcoholic fatty liver disease (NAFLD) and cardiovascular disease. However, the usefulness of the serum fetuin-A level as a predictive fibrosis biomarker in NAFLD patients is unclear. In this study, we investigated the relationship between circulating fetuin-A levels and fibrosis related markers [platelet count, NAFLD fibrosis score, and carotid intima media thickness (IMT)] in subjects with NAFLD. We also investigated the effects of fetuin-A on hepatic stellate cells (HSCs), which play a pivotal role in the progression of hepatic fibrosis.