Bariatric surgery shows promise in resolving nonalcoholic steatohepatitis and improving liver health
Metabolic/bariatric surgery (MBS) has demonstrated significant effectiveness in treating individuals with obesity-associated nonalcoholic steatohepatitis (NASH), according to a study.
The study, conducted at a tertiary referral university hospital, found that MBS led to a substantial resolution of steatohepatitis without worsening fibrosis in a majority of patients.
The retrospective analysis, based on data from a prospectively held database, included 37 patients who underwent MBS. All patients underwent a liver biopsy at the time of MBS, and a second biopsy was conducted in cases of further surgery or for NASH follow-up, especially in the presence of NASH in the initial biopsy.
The primary endpoint of the study was the resolution of steatohepatitis without worsening of fibrosis on the second liver biopsy. Overall, 83.3% of patients experienced a significant resolution of steatohepatitis without fibrosis worsening.
The secondary endpoints included the evaluation of liver steatosis, hepatocyte ballooning, Nonalcoholic Fatty Liver Disease Activity Score (NAFLD), and various biochemical parameters. The study revealed a statistically significant improvement in all blood tests, except for low-density lipoprotein, alkaline phosphatases, and bilirubinemia.
Moreover, the Homeostatic Model Assessment (HOMA) index showed a significant improvement after MBS, indicating positive changes in insulin resistance. Circulating insulin and leptin concentrations were also found to be significantly reduced, suggesting a positive impact on metabolic health.
The results demonstrated a mean weight loss of 47 kg, with a reduction of 16.6 kg/m2 in body mass index (BMI) and a % of total weight loss (%TWL) of 40.3 ±14% from the time of MBS to the last follow-up.
Reference
Drai C, Chierici A, Pavone G, et al. Remission of nonalcoholic steatohepatitis after bariatric surgery: a single referral center cohort study. Surg Obes Relat Dis. 2023;S1550-7289(23)00758-X. doi: 10.1016/j.soard.2023.10.015. Epub ahead of print. PMID: 38195314.
