Bariatric surgery improves adverse outcomes in mash-related cirrhosis patients

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Observational studies published in Natural Medicine We demonstrated that bariatric surgery significantly reduces the adverse outcomes and long-term risk of decompensation in patients with steatohepatitis (MASH)-related cirrhosis associated with obesity and compensated metabolic dysfunction. Due to a lack of medical treatment for compensated mash-related cirrhosis, the authors say metabolic surgery could be a safe and effective treatment option for patients.¹

This observational study is to eliminate compensated cirrhosis during long-term (spec) advancements via surgical procedures, and to compensate for mash-related obesity and histologically proven cirrhosis in patients. We compared the effects of metabolic surgery and nonsurgical treatment options. The authors noted that previous studies reported the benefits of metabolic surgery in mash patients, but that these patients did not have cirrhosis.^1,2

A total of 62 patients (68% female) who underwent metabolic surgery (roux-en-y gastric bypass: n = 37; sleeve gastrectomy: n = 25, and 106 nonsurgical controls (71% Female patients) were enrolled. Study (mean age: 54.4 years).^1,2

The findings show that the 15-year cumulative incidence of major adverse liver outcomes in patients undergoing bariatric surgery was approximately 20.1% (95% CI 25.6% to 61.3%) compared to 46.4% (95% CI 25.6% to 61.3%) in controls. %CI 2.5%–35.9%). Patients (HR 0.28, 95% CI 0.12-0.64, p = .003). Furthermore, compared with the nonsurgical group (30.7%; 95% CI, 12.9%–44.8%; HR 0.20, 955, late cirrhosis was also significantly lower in the surgical group (15.6%; 95% CI 0%– 31.3%) %CI 0.06-0.68, p = .01).¹ Furthermore, the authors suggested that bariatric surgery could help patients with mash, obesity, and decompensated cirrhosis ultimately obtain liver transplants where necessary.²

“Currently, lifestyle interventions are the only therapeutic recommendation for compensated mash-related cirrhosis,” Dr. Steven Nissen, of Cleveland Clinic, said in a news release. Risk of liver complications in this patient population. Special studies have shown that bariatric surgery is an effective treatment that can affect the trajectory of progression of liver cirrhosis in selected patients. ”²

Furthermore, an important limitation of this study is the inability to use data on physical activity, dietary habits, alcohol use and smoking status. Furthermore, approximately 90% of study patients are white, limiting the generalizability of the outcome to other racial and ethnic groups. The authors point out that patients who underwent metabolic surgery may have adopted a healthier lifestyle than the non-surgical group, which could lead to healthy user bias.²

The findings show that this surgery is a safe and effective treatment option that affects the patient's cirrhosis trajectory. Nevertheless, experts point out that there is still need to be careful, such as in small hospitals.^1,2

“[In my practice,] In a news release, Wajahat Mehall, Maryland, of Yale School of Medicine in New Haven, said: .²

reference

1. AminianA, Aljabri A, Wang S, et al.. Long-term liver results after metabolic surgery for compensating liver cirrhosis due to metabolic dysfunction-associated steatohepatitis. The night with. 2025. doi:10.1038/s41591-024-03480-y

2. Today's Med Page. Bariatric surgery in mash patients improved long-term outcomes. News release. January 27th, 2025. Accessed February 4th, 2025. https://bit.ly/3cdit1s

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