Risk for adverse liver and cardiovascular outcomes lower among patients with obesity and advanced fatty liver who undergo bariatric surgery
THURSDAY, Nov. 18, 2021 (HealthDay News) — Among patients with nonalcoholic steatohepatitis (NASH) and obesity, bariatric surgery is associated with a significantly lower risk for adverse liver and cardiovascular outcomes, according to a study published online Nov. 11 in the Journal of the American Medical Association.
Ali Aminian, M.D., from the Cleveland Clinic, and colleagues investigated the long-term relationship between bariatric surgery and incident major adverse liver outcomes and major adverse cardiovascular events (MACE) in patients with obesity and biopsy-proven fibrotic NASH without cirrhosis. The analysis included 1,158 adult patients, including 650 patients who underwent bariatric surgery and 508 patients in the nonsurgical control group (2004 to 2016), who were followed for a median of seven years.
The researchers identified five patients in the bariatric surgery group and 40 patients in the nonsurgical control group who experienced major adverse liver outcomes and 39 patients in the bariatric surgery group and 60 patients in the nonsurgical group who experienced MACE. The cumulative incidence of major adverse liver outcomes at 10 years was 2.3 percent in the bariatric surgery group and 9.6 percent in the nonsurgical group (adjusted absolute risk difference, 12.4 percent; adjusted hazard ratio, 0.12). At 10 years, the cumulative incidence of MACE was 8.5 percent in the bariatric surgery group and 15.7 percent in the nonsurgical group (adjusted absolute risk difference, 13.9 percent; adjusted hazard ratio, 0.30). Within the first year after bariatric surgery, there were four patient deaths from surgical complications (0.6 percent), including two gastrointestinal leaks and two respiratory failures.
“There is currently no U.S. Food and Drug Administration-approved medication for fatty liver,” Aminian said in a statement. “The striking findings of this study provide strong evidence that bariatric surgery should be considered as an effective therapeutic option for patients with advanced fatty liver and obesity.”
Several authors disclosed financial ties to the medical technology and pharmaceutical industries.
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