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Bariatric surgery may facilitate complete resolution of NAFLD in obese individuals

06 Nov 2018

Complete resolution of nonalcoholic fatty liver disease (NAFLD) is highly likely to occur following sustained weight loss in obese patients who have undergone bariatric surgery, although there are still some who may develop new or worsened features of NAFLD, a study has shown.

Researchers performed a systematic review and meta-analysis of studies evaluating liver biopsy results before vs after bariatric surgery in obese patients. Primary endpoints included biopsy-confirmed resolution of NAFLD and NAFLD activity score (NAS). Secondary outcomes were worsening of NAFLD after surgery and liver volume.

Pooled data from 32 cohort studies involving 3,093 biopsies revealed that bariatric surgery led to a biopsy-confirmed resolution of steatosis in 66 percent of patients (95 percent CI, 56–75), inflammation in 50 percent (35–64), ballooning degeneration in 76 percent (64–86) and fibrosis in 40 percent (29–51).

Furthermore, mean NAS substantially dropped after bariatric surgery (mean difference, 2.39; 1.58–3.20; p<0.001).

Interestingly, bariatric surgery resulted in new or worsening NAFLD features, such as fibrosis, in 12 percent (5–20) of patients.

Overall quality of evidence, evaluated using the GRADE approach, was very low.

Although the present data yielded positive results, researchers emphasized the need to further investigate the therapeutic benefits of bariatric surgery for patients with NAFLD.

In a previous study investigating potential predictors of resolution of NAFLD after bariatric surgery, weight loss was associated with decreased alanine aminotransferase (ALT) levels by 6 months postsurgery. Other factors independently associated with ALT decline were improved fasting glycaemia, insulin resistance and dyslipidaemia indices. ALT was used as a surrogate marker of NAFLD. [Diabetes 2018;doi:10.2337/db18-341-OR]

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Most Read Articles
Roshini Claire Anthony, 5 days ago

Individuals with moderate-to-severe plaque psoriasis may reap better long-term improvements in the severity of their condition when treated with guselkumab over secukinumab, according to findings of the phase III ECLIPSE* trial presented at the recent Inflammatory Skin Disease Summit (ISDS 2018) held in Vienna, Austria.

Jairia Dela Cruz, 11 Jan 2019
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4 days ago
Discontinuing the use of tyrosine kinase inhibitors (TKIs) in the treatment of patients with chronic myeloid leukaemia appears to be feasible in real-life clinical practice in the context of close molecular monitoring, a study reports.
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There appears to be no clear link between pornography use, even at problematic levels, and erectile dysfunction, a recent US study has shown.