Bariatric surgery improves nonalcoholic fatty liver disease: systematic review and meta-analysis
Abstract
Purpose Bariatric surgery has been uncovered to relieve nonalcoholic fatty liver disease (NAFLD) in patients with obesity, while current studies have neutral or opposite results. This systematic review and meta-analysis aimed to evaluate the effects of bariatric surgery on NAFLD in patients with obesity.Materials and methods PubMed, Embase, Cochrane Central, and Web of Science databases were performed to obtain publications containing comparison results of liver biopsy before and after bariatric surgery in obesity. Primary outcomes were biopsy-confirmed remission of NAFLD and NAFLD activity scores. Secondary outcomes were liver function. This study was registered with PROSPERO, CRD42021240346.Results Thirty-seven studies were included. After bariatric surgery, a biopsy-confirmed resolution of steatosis was improved in 56% of patients, ballooning degeneration in 49%, inflammation in 45%, and fibrosis in 25%. Bariatric surgery significantly decreased mean NAFLD activity scores. RYGB achieved the most obviously improvements in steatosis, and SG attained the most notably ameliorations in fibrosis. The percentage of patients with improved steatosis and hepatic fibrosis in Asian countries was higher than non-Asian countries. The reduction of ALT and AST was 11.95U/L and 6.44 U/L after surgery.Conclusion Our study has revealed that bariatric surgery brought out significantly resolution of NAFLD in individuals with obesity. RYGB and SG have been proved to be of benefit to many hepatic parameters, and the improvement of liver steatosis and fibrosis, particularly in Asian countries. It is strongly suggested that bariatric surgery should be considered as a novel treatment for NAFLD.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Two meta-analyses including more than 30 studies and more than 3,700 individuals with MASLD/MASH undergoing bariatric surgery showed that Roux-en-Y gastric bypass was associated with the most individuals achieving improvement in steatohepatitis, and had a greater impact on MASLD histology compared with other procedures.
“Two meta-analyses that included more than 30 studies and enrolled more than 3,700 individuals with MASLD/MASH undergoing bariatric surgery showed that Roux-en-Y gastric bypass was associated with the most individuals achieving improvement in steatohepatitis, and had a greater impact on MASLD histology compared with other procedures.”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [441]
Cites
Measuring inconsistency in meta-analyses
Higgins, J. P. T., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003) · BMJ · doi:10.1136/bmj.327.7414.557 · Cited by 63,139 · see citing works
GRADE: an emerging consensus on rating quality of evidence and strength of recommendations
Guyatt, G. H., Oxman, A. D., Vist, G. E., Kunz, R., Falck-Ytter, Y., Alonso-Coello, P., & Schünemann, H. J. (2008) · BMJ · doi:10.1136/bmj.39489.470347.ad · Cited by 23,305 · cited 2× · see citing works
“Quality of evidence for estimates derived from meta-analyses was evaluated according to Grading of Recommendations, Assessment, Development and Evaluation (GRADE) [20].”
MethodSlim, K., Nini, E., Forestier, D., Kwiatkowski, F., Panis, Y., & Chipponi, J. (2003) · ANZ Journal of Surgery · doi:10.1046/j.1445-2197.2003.02748.x · Cited by 7,603 · see citing works
Chalasani, N., Younossi, Z., Lavine, J. E., Charlton, M., Cusi, K., Rinella, M., Harrison, S. A., Brunt, E. M., & Sanyal, A. J. (2018) · Hepatology · doi:10.1002/hep.29367 · Cited by 7,239 · see citing works
Global burden of NAFLD and NASH: trends, predictions, risk factors and prevention
Younossi, Z., Anstee, Q. M., Marietti, M., Hardy, T., Henry, L., Eslam, M., George, J., & Bugianesi, E. (2018) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/nrgastro.2017.109 · Cited by 5,249 · see citing works
EASL–EASD–EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease
(2016) · Journal of Hepatology · doi:10.1016/j.jhep.2015.11.004 · Cited by 4,836 · see citing works
Ludwig, J., Viggiano, T. R., McGill, D. B., & Ott, B. J. (1980) · Mayo Clinic Proceedings · doi:10.1016/s0025-6196(24)00530-5 · Cited by 2,903 · see citing works
Mofrad, P., Contos, M., Haque, M., Sargeant, C. C., Fisher, R., Luketic, V., Sterling, R., Shiffman, M., Stravitz, R., & Sanyal, A. (2003) · Hepatology · doi:10.1053/jhep.2003.50229 · Cited by 1,221 · see citing works
Salminen, P., Helmiö, M., Ovaska, J., Juuti, A., Leivonen, M., Peromaa-Haavisto, P., Hurme, S., Soinio, M., Nuutila, P., & Victorzon, M. (2018) · JAMA · doi:10.1001/jama.2017.20313 · Cited by 946 · see citing works
Eslam, M., Sarin, S. K., Wong, V. W., Fan, J.-G., Kawaguchi, T., Ahn, S. H., Zheng, M., Shiha, G. E.-S., Yilmaz, Y. N., Gani, R. A., et al. (2020) · Hepatology International · doi:10.1007/s12072-020-10094-2 · Cited by 837 · see citing works
Bariatric Surgery Reduces Features of Nonalcoholic Steatohepatitis in Morbidly Obese Patients
Lassailly, G., Caiazzo, R., Buob, D., Pigeyre, M., Verkindt, H., Labreuche, J., Raverdy, V., Leteurtre, E., Dharancy, S., Louvet, A., et al. (2015) · Gastroenterology · doi:10.1053/j.gastro.2015.04.014 · Cited by 762 · see citing works
Nonalcoholic fatty liver disease: Improvement in liver histological analysis with weight loss
Dixon, J. B., Bhathal, P. S., Hughes, N. R., & O'Brien, P. E. (2004) · Hepatology · doi:10.1002/hep.20251 · Cited by 727 · see citing works
Lassailly, G., Caiazzo, R., Ntandja-Wandji, L.-C., Gnemmi, V., Baud, G., Verkindt, H., Ningarhari, M., Louvet, A., Leteurtre, E., Raverdy, V., et al. (2020) · Gastroenterology · doi:10.1053/j.gastro.2020.06.006 · Cited by 622 · see citing works
Effect of bariatric surgery on nonalcoholic fatty liver disease: Systematic review and meta-analysis
Mummadi, R. R., Kasturi, K. S., Chennareddygari, S., & Sood, G. K. (2008) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2008.08.012 · Cited by 511 · see citing works
Mathurin, P., Hollebecque, A., Arnalsteen, L., Buob, D., Leteurtre, E., Caiazzo, R. J., Pigeyre, M., Verkindt, H., Dharancy, S., Louvet, A., et al. (2009) · Gastroenterology · doi:10.1053/j.gastro.2009.04.052 · Cited by 483 · see citing works
Lim, K.-C., Ini, E. M. N., Orestier, D. A. F., Wiatkowski, F. A. K., & Anis, Y. V. P. (2003) · Cited by 436 · see citing works
Lee, Y., Doumouras, A. G., Yu, J., Brar, K., Banfield, L., Gmora, S., Anvari, M., & Hong, D. (2019) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2018.10.017 · Cited by 371 · see citing works
Mattar, S. G., Velcu, L. M., Rabinovitz, M., Demetris, A. J., Krasinskas, A. M., Barinas‐Mitchell, E., Eid, G. M., Ramanathan, R. C., Taylor, D. S., & Schauer, P. R. (2005) · Annals of Surgery · doi:10.1097/01.sla.0000179652.07502.3f · Cited by 341 · see citing works
Effects of surgical treatment of the metabolic syndrome on liver fibrosis and cirrhosis
Kral, J. G., Thung, S. N., Biron, S., Hould, F.-S., Lebel, S., Marceau, S., Simard, S., & Marceau, P. (2004) · Surgery · doi:10.1016/j.surg.2003.10.003 · Cited by 322 · see citing works
De Luca, M., Angrisani, L., Himpens, J., Busetto, L., Scopinaro, N., Weiner, R., Sartori, A., Stier, C., Lakdawala, M., Bhasker, A. G., et al. (2016) · Obesity Surgery · doi:10.1007/s11695-016-2271-4 · Cited by 296 · see citing works
Metabolic Effects of Bariatric Surgery in Patients With Moderate Obesity and Type 2 Diabetes
Kashyap, S. R., Bhatt, D. L., Wolski, K., Watanabe, R. M., Abdul‐Ghani, M. A., Abood, B., Pothier, C. E., Brethauer, S. A., Nissen, S. E., Gupta, M. K., et al. (2013) · Diabetes Care · doi:10.2337/dc12-1596 · Cited by 286 · see citing works
Katsagoni, C. N., Georgoulis, M., Papatheodoridis, G. V., Panagiotakos, D. B., & Kontogianni, M. D. (2017) · Metabolism · doi:10.1016/j.metabol.2016.12.006 · Cited by 270 · see citing works
Fakhry, T. K., Mhaskar, R., Schwitalla, T., Muradova, E., Gonzalvo, J. P., & Murr, M. M. (2019) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2018.12.002 · Cited by 259 · see citing works
Non‐alcoholic fatty liver disease: a review of epidemiology, risk factors, diagnosis and management
Huang, T. (., Behary, J., & Zekry, A. (2020) · Internal Medicine Journal · doi:10.1111/imj.14709 · Cited by 227 · see citing works
Caiazzo, R., Lassailly, G., Leteurtre, E., Baud, G., Verkindt, H., Raverdy, V., Buob, D., Pigeyre, M., Mathurin, P., & Pattou, F. (2014) · Annals of Surgery · doi:10.1097/sla.0000000000000945 · Cited by 226 · see citing works
Non-alcoholic steatohepatitis: effect of Roux-en-Y gastric bypass surgery
Barker, K. B., Palekar, N. A., Bowers, S. P., Goldberg, J. E., Pulcini, J. P., & Harrison, S. A. (2006) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2006.00419.x · Cited by 218 · see citing works
Effects of bariatric surgery on nonalcoholic fatty liver disease: Preliminary findings after 2 years
Furuya, C. K., De Oliveira, C. P. M. S., De Mello, E. S., Faintuch, J., Raskovski, A., Matsuda, M., Vezozzo, D. C. P., Halpern, A., Garrido, A. B., Alves, V. A. F., et al. (2007) · Journal of Gastroenterology and Hepatology · doi:10.1111/j.1440-1746.2007.04833.x · Cited by 193 · see citing works
Roux‐en‐Y Gastric Bypass Improves Liver Histology in Patients with Non‐Alcoholic Fatty Liver Disease
Clark, J. M., Al-Khuraishi, A., Solga, S. F., Alli, P. M., Diehl, A. M., & Magnuson, T. H. (2005) · Obesity Research · doi:10.1038/oby.2005.140 · Cited by 184 · see citing works
Management of non-alcoholic fatty liver disease
Petroni, M. L., Brodosi, L., Bugianesi, E., & Marchesini, G. (2021) · BMJ · doi:10.1136/bmj.m4747 · Cited by 181 · see citing works
Regression of Hepatic Steatosis in Morbidly Obese Persons After Gastric Bypass
Silverman, E. M., Sapala, J. A., & Appelman, H. D. (1995) · American Journal of Clinical Pathology · doi:10.1093/ajcp/104.1.23 · Cited by 164 · see citing works
Resolution of nonalcoholic steatohepatits after gastric bypass surgery
Liu, X., Lazenby, A. J., Clements, R. H., Jhala, N., & Abrams, G. A. (2007) · Obesity Surgery · doi:10.1007/s11695-007-9086-2 · Cited by 149 · see citing works
Effects of weight loss induced by bariatric surgery on hepatic adipocytokine expression
Moschen, A. R., Molnar, C., Wolf, A. M., Weiss, H. G., Graziadei, I. W., Kaser, S., Ebenbichler, C. F., Stadlmann, S., Moser, P. L., & Tilg, H. (2009) · Journal of Hepatology · doi:10.1016/j.jhep.2009.06.016 · Cited by 136 · see citing works
Manco, M., Mosca, A., PEPPO, F. D., Caccamo, R., Cutrera, R., Giordano, U., Stefanis, C. D., Alisi, A., Baumann, U., Silecchia, G., et al. (2016) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2016.08.101 · Cited by 128 · see citing works
Changes in Liver Histology Accompanying Massive Weight Loss after Gastroplasty for Morbid Obesity
Stratopoulos, C., Papakonstantinou, A., Terzis, I., Spiliadi, C., Dimitriades, G., Komesidou, V., Kitsanta, P., Argyrakos, T., & Hadjiyannakis, E. J. (2005) · Obesity Surgery · doi:10.1381/0960892055002239 · Cited by 123 · see citing works
Ignat, M., Vix, M., Imad, I., D’Urso, A., Perretta, S., Marescaux, J., & Mutter, D. (2016) · British journal of surgery · doi:10.1002/bjs.10400 · Cited by 123 · see citing works
Taitano, A. A., Markow, M., Finan, J. E., Wheeler, D. E., Gonzalvo, J. P., & Murr, M. M. (2014) · Journal of Gastrointestinal Surgery · doi:10.1007/s11605-014-2678-y · Cited by 112 · see citing works
Effect of Bariatric Surgery on Liver Fibrosis
Moretto, M., Kupski, C., da Silva, V. D., Padoin, A. V., & Mottin, C. C. (2012) · Obesity Surgery · doi:10.1007/s11695-011-0559-y · Cited by 110 · see citing works
Roux-en-Y Gastric Bypass Improves the Nonalcoholic Steatohepatitis (NASH) of Morbid Obesity
Sanches, S. R. D. A., Rocha, P. S., Sanches, M. D., Leite, V. R., Pinto-Silva, R. A., Diniz, M. T. C., Diniz, M. D. F. H. S., & Rocha, A. S. (2006) · Obesity Surgery · doi:10.1381/096089206776116462 · Cited by 107 · see citing works
Inoue, M., Hayashi, A., Taguchi, T., Arai, R., Sasaki, S., Takano, K., Inoue, Y., & Shichiri, M. (2018) · Journal of Diabetes Investigation · doi:10.1111/jdi.12980 · Cited by 105 · see citing works
Nickel, F., Tapking, C., Benner, L., Sollors, J., Billeter, A. T., Kenngott, H. G., Bokhary, L., Schmid, M., von Frankenberg, M., Fischer, L., et al. (2018) · Obesity Surgery · doi:10.1007/s11695-017-3012-z · Cited by 100 · see citing works
Tai, C.-M., Huang, C.-K., Hwang, J.-C., Chiang, H., Chang, C.-Y., Lee, C.-T., Yu, M.-L., & Lin, J.-T. (2012) · Obesity Surgery · doi:10.1007/s11695-011-0579-7 · Cited by 91 · see citing works
Naveau, S., Lamouri, K., Pourcher, G., Njiké‐Nakseu, M., Ferretti, S., Courie, R., Tranchart, H., Ghinoiu, M., Balian, A., Prevot, S., et al. (2014) · Obesity Surgery · doi:10.1007/s11695-014-1235-9 · Cited by 88 · see citing works
Froylich, D., Corcelles, R., Daigle, C. R., Boules, M., Brethauer, S. A., & Schauer, P. R. (2015) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2015.04.004 · Cited by 83 · see citing works
Raj, P., Gomes, R. M., Kumar, S. S., Senthilnathan, P., Karthikeyan, P., Annapoorni, S., & Palanivelu, C. (2015) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2015.02.006 · Cited by 80 · see citing works
Ofosu, A. (2018) · Annals of Gastroenterology · doi:10.20524/aog.2018.0240 · Cited by 80 · see citing works
Cazzo, E., Jimenez, L. S., Pareja, J. C., & Chaim, E. A. (2015) · Obesity Surgery · doi:10.1007/s11695-014-1489-2 · Cited by 72 · see citing works
Vargas, V., Allende, H., Lecube, A., Salcedo, M. T., Baena-Fustegueras, J. A., Fort, J. M., Rivero, J., Ferrer, R., Catalán, R., Pardina, E., et al. (2012) · World Journal of Hepatology · doi:10.4254/wjh.v4.i12.382 · Cited by 69 · see citing works
Laparoscopic Sleeve Gastrectomy Resolves NAFLD: Another Formal Indication for Bariatric Surgery?
Esquivel, C. M., Garcia, M., Armando, L., Ortiz, G., Lascano, F. M., & Foscarini, J. M. (2018) · Obesity Surgery · doi:10.1007/s11695-018-3466-7 · Cited by 51 · see citing works
Nobili, V., Carpino, G., PEPPO, F. D., Caccamo, R., Mosca, A., Romito, I., Overi, D., Franchitto, A., Onori, P., Alisi, A., et al. (2017) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2017.10.036 · Cited by 44 · see citing works
Agarwal, L., Aggarwal, S., Shalimar, S., Yadav, R., DATTAGUPTA, S., Garg, H., & Agarwal, S. (2020) · Obesity Surgery · doi:10.1007/s11695-020-04977-4 · Cited by 42 · see citing works
Loy, J. J., Youn, H. A., Schwack, B., Kurian, M., Ren Fielding, C., & Fielding, G. A. (2015) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2014.11.010 · Cited by 39 · see citing works
Schneck, A., Anty, R., Patouraux, S., Bonnafous, S., Rousseau, D., Lebeaupin, C., Bailly-maitre, B., Sans, A., Tran, A., Gugenheim, J., et al. (2016) · Frontiers in Physiology · doi:10.3389/fphys.2016.00344 · Cited by 37 · see citing works
Schwenger, K. J. P., Fischer, S. E., Jackson, T., Okrainec, A., & Allard, J. P. (2018) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2018.06.007 · Cited by 36 · see citing works
Yeo, C., Ong, W. M., Cheng, K. S. A., & Tan, C. H. (2019) · Obesity Surgery · doi:10.1007/s11695-018-03676-5 · Cited by 36 · see citing works
Chaim, F. D. M., Pascoal, L. B., Chaim, F. H. M., Palma, B. B., Damázio, T. A., da Costa, L. B. E., de Carvalho, R. B., Cazzo, E., Gestic, M. A., Utrini, M. P., et al. (2020) · Scientific Reports · doi:10.1038/s41598-020-65556-2 · Cited by 35 · see citing works
Reversal of fibrosis in patients with nonalcoholic steatohepatosis after gastric bypass surgery
Parker, B., Wu, J., You, J., Barnes, D., Yerian, L., Kirwan, J., Schauer, P., & Sessler, D. (2017) · BMC Obesity · doi:10.1186/s40608-017-0168-y · Cited by 34 · see citing works
Laparoscopic Sleeve Gastrectomy on the Horizon as a Promising Treatment Modality for NAFLD
Salman, M. A., Salman, A., Abdelsalam, A., Atallah, M., Shaaban, H. E., El-Mikkawy, A., Omar, M. G., & Elshenoufy, M. G. (2019) · Obesity Surgery · doi:10.1007/s11695-019-04118-6 · Cited by 32 · see citing works
Hepatic Outcomes after Jejunoileal Bypass: Is There a Publication Bias?
Meinhardt, N. G., Souto, K., Ulbrich-Kulczynski, J., & Stein, A. (2006) · Obesity Surgery · doi:10.1381/096089206778392239 · Cited by 23 · see citing works
Fatty liver, cardiometabolic disease and mortality
Bedogni, G., Gastaldelli, A., & Foschi, F. G. (2019) · Current Opinion in Lipidology · doi:10.1097/mol.0000000000000652 · Cited by 20 · see citing works
Taitano, A. A., Markow, M., Finan, J. E., Wheeler, D. E., Gonzalvo, J. P., & Murr, M. M. (2014) · Gastroenterology · doi:10.1016/s0016-5085(14)63678-7 · Cited by 15 · see citing works
de BARROS, F., & Fonseca, A. B. M. (2020) · Clinical Obesity · doi:10.1111/cob.12393 · Cited by 15 · see citing works
Aksoy, E. K., Göktaş, Z., Albuz, Ö., AKPINAR, M. Y., Öztürk, D., Buluş, H., & Uzman, M. (2019) · Journal of Laboratory Medicine · doi:10.1515/labmed-2018-0181 · Cited by 10 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Tacke, F., Horn, P., Wai-Sun Wong, V., Ratziu, V., Bugianesi, E., Francque, S., Zelber-Sagi, S., Valenti, L., Roden, M., Schick, F., et al. (2024) · Journal of Hepatology · doi:10.1016/j.jhep.2024.04.031 · Cited by 2,210 · see citing works
(2024) · Obesity Facts · doi:10.1159/000539371 · Cited by 510 · see citing works
Pathogenesis and treatment of non-alcoholic steatohepatitis and its fibrosis
Lee, K., Wu, P.-S., & Lin, H. (2022) · Clinical and Molecular Hepatology · doi:10.3350/cmh.2022.0237 · Cited by 260 · see citing works
NAFLD and NASH: etiology, targets and emerging therapies
Wei, S., Wang, L., Evans, P. C., & Xu, S. (2024) · Drug Discovery Today · doi:10.1016/j.drudis.2024.103910 · Cited by 216 · see citing works
Eslam, M., Fan, J., Yu, M., Wong, V. W., Cua, I. H., Liu, C., Tanwandee, T., Gani, R. A., Seto, W., Alam, S., et al. (2025) · Hepatology International · doi:10.1007/s12072-024-10774-3 · Cited by 186 · see citing works
Xanthakos, S. A., Ibrahim, S. H., Adams, K. H., Kohli, R., Sathya, P., Sundaram, S. S., Vos, M. B., Dhawan, A., Caprio, S., Behling, C. A., et al. (2025) · Hepatology · doi:10.1097/hep.0000000000001368 · Cited by 86 · see citing works
Hwang, J., Hwang, H., Shin, H., Kim, B. H., Kang, S. H., Yoo, J., Choi, M. Y., Lee, D. E., Jun, D. W., & Cho, Y. (2024) · Clinical and Molecular Hepatology · doi:10.3350/cmh.2023.0384 · Cited by 54 · see citing works
A roadmap for clinical trials in MASH-related compensated cirrhosis
Pericàs, J. M., Anstee, Q. M., Augustín, S., Bataller, R. A., Berzigotti, A., Ciudin, A., Francque, S., Abraldeṣ, J. G., Hernández–Gea, V., Pons, M., et al. (2024) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/s41575-024-00955-8 · Cited by 37 · see citing works
Practical Lifestyle Management of Nonalcoholic Fatty Liver Disease for Busy Clinicians
Zelber‐Sagi, S., & Moore, J. B. (2024) · Diabetes Spectrum · doi:10.2337/dsi23-0009 · Cited by 34 · see citing works
Giannakogeorgou, A., & Roden, M. (2024) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.17848 · Cited by 30 · see citing works
Liver fat as risk factor of hepatic and cardiometabolic diseases
Demir, M., Bornstein, S. R., Mantzoros, C. S., & Perakakis, N. (2023) · Obesity Reviews · doi:10.1111/obr.13612 · Cited by 29 · see citing works
Begriche, K., Penhoat, C., Bernabeu-Gentey, P., Massart, J., & Fromenty, B. (2023) · Livers · doi:10.3390/livers3010003 · Cited by 27 · see citing works
Nixdorf, L., Hartl, L., Ströhl, S., Felsenreich, D. M., Mairinger, M., Jedamzik, J., Richwien, P., Mozayani, B., Semmler, G., Balcar, L., et al. (2024) · Scientific Reports · doi:10.1038/s41598-024-67415-w · Cited by 26 · see citing works
HFpEF and MASLD: converging mechanisms and clinical implications
Capone, F., Häseli, S. P., Liu, L., Strocchi, S., Langenberg, C., Lusis, A. J., Pietzner, M., Muoio, D. M., Rider, O. J., Raman, B., et al. (2026) · Nature Reviews Cardiology · doi:10.1038/s41569-026-01257-z · Cited by 32 · see citing works
Fernández-Sáez, E. M., Losarcos, M., Becerril, S., Valentí, V., Moncada, R., Martín, M., Burrell, M. A., Catalán, V., Gómez‐Ambrosi, J., Mugueta, C., et al. (2023) · Metabolism · doi:10.1016/j.metabol.2023.155663 · Cited by 25 · see citing works
Ivashkin, V. T., Drapkina, O. M., Maevskaya, M. V., Raikhelson, K. L., Okovityi, S. V., Жаркова, М. С., Grechishnikova, V. R., Abdulganieva, D. I., Alekseenko, S. A., Ardatskaya, M. D., et al. (2025) · Russian Journal of Gastroenterology Hepatology Coloproctology · doi:10.22416/1382-4376-2025-35-1-94-152 · Cited by 23 · see citing works
Theel, W. B., Klerk, B. M. B., Dirksmeier-Harinck, F., van Rossum, E. F. C., Kanhai, D. A., Apers, J. A., van Dalen, B. M., de Knegt, R. J., Holleboom, A. G., Tushuizen, M. E., et al. (2022) · Obesity Reviews · doi:10.1111/obr.13481 · Cited by 19 · see citing works
Hany, M., Abouelnasr, A. A., Abdelkhalek, M. H., Ibrahim, M., Aboelsoud, M. R., Hozien, A. I., & Torensma, B. (2023) · International Journal of Obesity · doi:10.1038/s41366-023-01378-2 · Cited by 20 · see citing works
Therapeutic Targets and Approaches to Manage Inflammation of NAFLD
Geng, W., Liao, W., Cao, X., & Yang, Y. (2025) · Biomedicines · doi:10.3390/biomedicines13020393 · Cited by 20 · see citing works
Obesity and Metabolic Dysfunction-associated Fatty Liver Disease: Understanding the Intricate Link
Vulchi, J., Suryadevara, V., Mohan, P., Kamalanathan, S., Sahoo, J., Naik, D., & Selvarajan, S. (2023) · Journal of Translational Gastroenterology · doi:10.14218/jtg.2023.00043 · Cited by 15 · see citing works
Hany, M., Shafei, M. E., Ibrahim, M., Agayby, A. S. S., Abouelnasr, A. A., Aboelsoud, M. R., Elmongui, E., & Torensma, B. (2024) · Obesity Surgery · doi:10.1007/s11695-024-07433-9 · Cited by 14 · see citing works
Kamrul-Hasan, A. B. M., Pappachan, J. M., Nagendra, L., Ashraf, H., Dutta, D., Bhattacharya, S., & Kapoor, N. (2025) · Clinical Obesity · doi:10.1111/cob.70008 · Cited by 13 · see citing works
Wu, J., Lin, Y., Hsu, W., Liu, T., Tsai, Y., Huang, P., Chuang, M., Yu, T., & Lai, C. (2025) · Hepatology International · doi:10.1007/s12072-025-10857-9 · Cited by 12 · see citing works
Breakthrough in the Treatment of Metabolic Associated Steatotic Liver Disease: Is it all over?
Petroni, M. L., Perazza, F., & Marchesini, G. (2024) · Digestive and Liver Disease · doi:10.1016/j.dld.2024.04.021 · Cited by 13 · see citing works
Castellano‐Castillo, D., Núñez‐Sánchez, M. Á., Román, A. B., Martínez‐Sánchez, M. A., Fernández-Ruiz, V. E., Ferrer‐Gómez, M., Martínez, C. M., Frutos, M. D., Queipo‐Ortuño, M. I., Cardona, F., et al. (2024) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2024.01.017 · Cited by 11 · see citing works
Voermans, B., Gerdes, V. E. A., & Nieuwdorp, M. (2025) · Expert Review of Endocrinology & Metabolism · doi:10.1080/17446651.2025.2512551 · Cited by 11 · see citing works
Sandvik, E. C. S., Aasarød, K. M., Johnsen, G., Hoff, D. A. L., Kulseng, B. E., Hyldmo, Å. A., Græslie, H., Nymo, S., Sandvik, J., & Fossmark, R. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11164910 · Cited by 11 · see citing works
Yang, C., Zhu, D., Liu, C., Wang, W., He, Y., Wang, B., & Li, M. (2024) · BMC Medicine · doi:10.1186/s12916-024-03377-0 · Cited by 10 · see citing works
Hu, R., Wu, B., Wang, C., Wu, Z., Zhang, X., Chen, X., Lu, G., & Yuan, K. (2024) · International Journal of Surgery · doi:10.1097/js9.0000000000001078 · Cited by 10 · see citing works
Navarro‐Masip, È., Petit, N. M., Zorzano-Martínez, M., Salinas‐Roca, B., Sánchez, E., López‐Cano, C., Herrerías, F., de la Fuente, M. C., Santamaría, M., León, J., et al. (2024) · Obesity Surgery · doi:10.1007/s11695-024-07071-1 · Cited by 10 · see citing works
Grueso-Navarro, E., & Lucendo, A. J. (2025) · Expert Review of Clinical Immunology · doi:10.1080/1744666x.2025.2514605 · Cited by 9 · see citing works
Widmer, J. D., Eden, J., Abbassi, F., Angelico, R., Rössler, F., Müllhaupt, B., Dutkowski, P., Bueter, M., & Schlegel, A. A. (2023) · Liver International · doi:10.1111/liv.15791 · Cited by 9 · see citing works
Juárez-Hernández, E., Velázquez-Alemán, A. P., Castro‐Narro, G., Uribe, M., & López-Méndez, I. (2022) · Frontiers in Endocrinology · doi:10.3389/fendo.2022.1026444 · Cited by 9 · see citing works
Transient Elastography and Fibroscan: Stethoscope of a Hepatologist in Today’s World
Jalil, S., Pagadala, M. R., Dunn, N., Blaney, H. L., Elfeki, M. A., Thakral, N., & Singal, A. K. (2025) · Current Hepatology Reports · doi:10.1007/s11901-025-00713-7 · Cited by 8 · see citing works
Anastasiou, I. A., Kounatidis, D. C., Honka, M., Vallianou, N. G., Rebelos, E., Karamanolis, N. N., Dalamaga, Μ., Pantos, C. I., & Mourouzis, I. S. (2025) · Metabolites · doi:10.3390/metabo15070434 · Cited by 7 · see citing works
Endoscopic sleeve gastroplasty for metabolic dysfunction-associated steatotic liver disease
Matteo, M. V., Gualtieri, L., Bove, V., Palumbo, G., Pontecorvi, V., Siena, M. D., Barbaro, F., Spada, C., & Boškoski, I. (2024) · Expert Review of Gastroenterology & Hepatology · doi:10.1080/17474124.2024.2387231 · Cited by 7 · see citing works
Impact of Weight Loss on Metabolic Dysfunction Associated Steatohepatitis and Hepatic Fibrosis
Takawy, M., & Abdelmalek, M. F. (2025) · Current Diabetes Reports · doi:10.1007/s11892-025-01579-1 · Cited by 10 · see citing works
The metabolic influence of duodenal mucosal resurfacing for nonalcoholic fatty liver disease
Chuang, T.-J., Ko, C.-W., & Shiu, S. (2023) · Medicine · doi:10.1097/md.0000000000035147 · Cited by 6 · see citing works
Echeverria, L. S., Mounzer, D. L. S., Gestic, M. A., Utrini, M. P., Chaim, F. D. M., Callejas-Neto, F., Chaim, É. A., & Cazzo, E. (2023) · Obesity Surgery · doi:10.1007/s11695-023-06998-1 · Cited by 6 · see citing works
Chen, S., Zhu, B., Luo, Z., Wang, Y., Hu, Q., & Zhou, L. (2024) · Angiology · doi:10.1177/00033197241231051 · Cited by 6 · see citing works
Dobbie, L. J., Birney, S., Breen, C., Bryant, S., Clare, K., Ciudin, A., Felsenreich, D. M., Halford, J. C. G., Heneghan, H., Lorenzo, N. D., et al. (2024) · International Journal of Surgery · doi:10.1097/js9.0000000000002171 · Cited by 5 · see citing works
Short-Term Evolution of MASLD Following Roux-en-Y Gastric Bypass: A Focus on Fibrotic MASH
Matavelli, C. B., Echeverria, L. S., Pereira, L. M., Chrispim, I., Mounzer, D. L. S., Chaim, F. D. M., Chaim, É. A., Utrini, M. P., Gestic, M. A., Callejas-Neto, F., et al. (2025) · Obesity Surgery · doi:10.1007/s11695-025-07688-w · Cited by 5 · see citing works
Obesity management for the hepatologist—What to do, how to do it and why?
Watt, K. D. S., Paul, S., Khan, M. Q., Siddiqui, M. S., Lam, J., Diwan, T. S., & Camilleri, M. (2023) · Hepatology · doi:10.1097/hep.0000000000000598 · Cited by 5 · see citing works
Karagiannakis, D. S., Stefanaki, K., Paschou, S. Α., Papatheodoridi, Μ., Tsiodras, S., & Παπάνας, Ν. (2024) · HORMONES · doi:10.1007/s42000-024-00625-z · Cited by 4 · see citing works
Albor, C., Anyiam, O., Boyle, L., Makaronidis, J., Tan, R. J. L., Iftikhar, S., Burzić, A., Lajeunesse‐Trempe, F., Stanley, M., Bhatti, A. I., et al. (2026) · Current Obesity Reports · doi:10.1007/s13679-026-00707-6 · Cited by 5 · see citing works
Frey, S., Ayer, A., Sotin, T., Lorant, V., Louis-Gaubert, C., Arnaud, L., Billon‐Crossouard, S., Croyal, M., Prieur, X., Hadjadj, S., et al. (2023) · Obesity · doi:10.1002/oby.23916 · Cited by 4 · see citing works
Longsomboon, R., Kachornvitaya, P., Prasoppokakorn, T., Treeprasertsuk, S., Boonchaya‐anant, P., Klaikaew, N., & Udomsawaengsup, S. (2025) · BMC Gastroenterology · doi:10.1186/s12876-025-04482-x · Cited by 3 · see citing works
Shi, X., Liu, Y., Chen, Y., Jiang, Z., Ye, M. S., & Wang, J. (2025) · Pediatric Obesity · doi:10.1111/ijpo.70017 · Cited by 3 · see citing works
Barajas-Gamboa, J. S., Khan, M. S. I., Dang, J. T., Romero-Vélez, G., Gobbo, G. D. D., Abdallah, M., Pantoja, J. P., Abril, C. M., Guerron, A. D., John, T. L. S., et al. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13051264 · Cited by 2 · see citing works
Tuffs, C., Delistamatis, M., Hauenschild, A., Sauerbier, L., Amin, D., Kosovic, A., Amati, A., Albrecht, J. U., Askevold, I. H., Sprenger, T., et al. (2026) · Journal of Robotic Surgery · doi:10.1007/s11701-026-03462-x · Cited by 2 · see citing works
Rathnayake, D. W., Sooriyaarachchi, P., Niriella, M. A., Ediriweera, D. S., & Perera, J. A. (2024) · Advances in Integrative Medicine · doi:10.1016/j.aimed.2024.08.016 · Cited by 2 · see citing works
Reducing complications of metabolic dysfunction–associated steatotic liver disease
Wada, N., Iwaki, M., Kobayashi, T., Nakajima, A., & Yoneda, M. (2025) · Expert Review of Gastroenterology & Hepatology · doi:10.1080/17474124.2025.2502549 · Cited by 1 · see citing works
Progression of liver fibrosis after metabolic bariatric surgery in a MASLD rat model
Mairinger, M., Richwien, P., Eichelter, J., Mölzer, C., Jedamzik, J., Felsenreich, D. M., Sarocchi, F., Büchi, I., Wöran, K., Staufer, K., et al. (2025) · Clinical Nutrition · doi:10.1016/j.clnu.2025.07.019 · Cited by 1 · see citing works
Kalapala, R., Jagtap, N., Rughwani, H., Asif, S., Sekaran, A., Sharma, M., Kulkarni, A., Rao, P. N., Tyagi, A., & Reddy, D. N. (2025) · Journal of Clinical and Experimental Hepatology · doi:10.1016/j.jceh.2025.103152 · Cited by 1 · see citing works
Surgical and interventional approaches for the treatment of obesity
Gant, L., & Myerson, M. L. (2026) · Journal of clinical lipidology · doi:10.1016/j.jacl.2025.11.003 · Cited by 1 · see citing works
Consensus statement on obesity management in liver transplantation candidates
Pacheco, D., Vinaixa, C., de Gordejuela, A. G. R., Alcázar, C. F., Seoane, R. M. Á., Delgado, J. B., Mizrahi, D. C., Díaz‐Zorita, B., Santiago, R. F., Suárez, Y. J. F., et al. (2026) · Updates in Surgery · doi:10.1007/s13304-025-02473-x · Cited by 1 · see citing works
Metabolic dysfunction-associated steatotic liver disease in Asia: implications on management
Lai, K. N., & Wong, V. W. (2026) · Singapore Medical Journal · doi:10.4103/singaporemedj.smj-2025-167 · Cited by 1 · see citing works
Voermans, B., Prange, K. H. M., Bruin, S. C., Acherman, Y. I. Z., Zaura, E., Nieuwdorp, M., & Gerdes, V. E. A. (2026) · Gut Microbes Reports · doi:10.1080/29933935.2026.2693432 · Cited by 1 · see citing works
Metabolic health and strategies for a Healthier SG
Khoo, J. J. C., Lim, R. L. C., Ng, L. P., Phoon, I. K. Y., Gani, L. U., Puar, T. H. K., How, C. H., & Loh, W. J. (2025) · Singapore Medical Journal · doi:10.4103/singaporemedj.smj-2025-157 · Cited by 1 · see citing works
Impact of Metabolic and Bariatric Surgery on Liver Diseases
Agarwal, L., Chekuri, R., Singla, V., Kumar, A., Shalimar, S., & Aggarwal, S. (2022) · Journal of Bariatric Surgery · doi:10.4103/jbs.jbs_9_22
Li, Z., Shu, X., Liu, F., Liu, X., Tong, Y. A., Lv, Q., Liu, X., Zhang, W., & Peng, D. (2024) · Metabolic Syndrome and Related Disorders · doi:10.1089/met.2023.0232
Bidares, M., Melali, H., Aziz, M., & Salehi, M. (2024) · Hepatitis Monthly · doi:10.5812/hepatmon-141884
Barajas-Gamboa, J. S., Khan, M. S. I., Gobbo, G. D. D., Rivas, H., Pantoja, J. P., Abril, C. M., Moreno, C., Raza, J., Khan, F., Ghazanfar, R., et al. (2024) · Research Square · doi:10.21203/rs.3.rs-5240706/v1
Current Standards in Therapeutic Management
Pustjens, J., & Brouwer, W. P. (2024) · Springer eBooks · doi:10.1007/978-981-97-9519-2_9
Nikoupour, H., Sheikhbahaei, E., Shamsaeefar, A., Kazemi, K., Eslamian, M., Zefreh, H., Malek-Hosseini, S. A., & Nikeghbalian, S. (2025) · Obesity Surgery · doi:10.1007/s11695-025-07852-2
INNOVATIONS IN OBESITY TREATMENT – GLP – 1 PHARMACOTHERAPY AND BARIATRIC SURGERY
Bartnik, P., Palmi, J., Bebrysz, E., Dębek-Kalinowska, K., Baran, J., Dunder, I., Koss, M., Biszewski, M., Drabik, A., & Ziomek, W. (2025) · International Journal of Innovative Technologies in Social Science · doi:10.31435/ijitss.3(47).2025.3682
Ospanov, O. B., Duysenov, G., Yelembayev, B., & Sultanov, K. (2025) · F1000Research · doi:10.12688/f1000research.169898.1
Yang, C., Zhu, D., Liu, C., Wang, W., He, Y., Wang, B., & Li, M. (2024) · Figshare · doi:10.6084/m9.figshare.26708273
Yang, C., Zhu, D., Liu, C., Wang, W., He, Y., Wang, B., & Li, M. (2024) · Figshare · doi:10.6084/m9.figshare.26708270
Yang, C., Zhu, D., Liu, C., Wang, W., He, Y., Wang, B., & Li, M. (2024) · Figshare · doi:10.6084/m9.figshare.25633062
Yang, C., Zhu, D., Liu, C., Wang, W., He, Y., Wang, B., & Li, M. (2024) · Figshare · doi:10.6084/m9.figshare.25632969
Esparham, A., Phillippe, S., & Khorgami, Z. (2026) · Surgical Endoscopy · doi:10.1007/s00464-025-12497-4
Association between nonalcoholic fatty liver disease and stroke: a cross-sectional study
Zhou, S., Mang, G., Zhou, H., Zhang, S., Dmytriw, A. A., Gao, B., Huang, S., Yang, S., Jin, L., Zhang, Y., et al. (2026) · International Journal of Surgery · doi:10.1097/js9.0000000000004936
Self-citationOzeki, Y., Masaki, T., Imaishi, N., Yonezu, C., Morita, M., Mori, Y., Noguchi, T., Miyamoto, S., Yoshida, Y., Gotoh, K., et al. (2026) · Livers · doi:10.3390/livers6020026
Hepatic steatosis: A pandemic disease causing serious secondary diseases
Canbay, A., Figge, A., Patsalis, P., Baars, T., Özcürümez, M. K., & Götze, O. (2026) · Deutsches Ärzteblatt international · doi:10.3238/arztebl.m2026.0074
Liu, C., Lu, R., Tang, W., Zhou, J., Liu, Y., & Zhang, Z. (2026) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2026.05.033
Gagal, S., Rath, B. K., Khan, W. F., Baksi, A., Arumugaswamy, P. R., Singh, A., Yadav, R., Shalimar, Aggarwal, S., & Bhattacharjee, H. K. (2026) · Surgical Endoscopy · doi:10.1007/s00464-026-13152-2
Xu, Y., Gong, F., Cao, T., Chen, R., Zhuo, N., Wei, Y., & Yang, Y. (2026) · Journal of the Renin-Angiotensin-Aldosterone System · doi:10.1177/14703203261477614
Kehar, M., Ramji, A. S., Swain, M., Singer, A. G., IVERS, N., Schaufert, W., Betel, M., Dasgupta, K., Sebastiani, G., & Patel, K. (2026) · Canadian Liver Journal · doi:10.3138/canlivj-2026-9-3-guidelines
Reytor-González, C., Román-Galeano, N. M., Gavilanes, D. J., Rossetti, G., Cobellis, L., Pilone, V., Simancas‐Racines, D., & Schiavo, L. (2026) · Obesity Pillars · doi:10.1016/j.obpill.2026.100348
Cheng, P., Lu, C., Lin, C. L., Chiang, C., Yang, H., Kao, H., Wang, C., Chou, T.-J., Chang, M., Hsiao, T.-J., et al. (2026) · Liver International · doi:10.1111/liv.70926
Navigating MASLD heterogeneity: from metabolic risk to precision stratification
Yan, C., Zhang, G., Liang, L., & He, H. (2026) · Frontiers in Medicine · doi:10.3389/fmed.2026.1966460
- Authors
- Zhou, H., Luo, P., Li, P., wang, G., Yi, X., Fu, Z., Sun, X., Cui, B., Zhu, L., & Zhu, S.
- Affiliations
- Central South University (CN)
- Corresponding author
- Zhu, Liyong
- Zhu, Shaihong
- Venue
- Obesity Surgery
- Published
- 2022-04-06
- Volume
- 32
- Issue
- 6
- Pages
- 1872-1883
- ISSN
- 0960-8923 (ISSN-L)
- 1708-0428
- OpenAlex
- W4225371992
- Cited by
- 79
- References
- 63
- Citations by year
- 2026: 17 · 2025: 21 · 2024: 26 · 2023: 10 · 2022: 5
- FWCI
- 3.80
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Obesity Surgery (publishedVersion)
- PubMed (publishedVersion)
- Funders
- the Wisdom Accumulation and Talent Cultivation Project of the Third xiangya hosipital of Central South University
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Surgery › Organ Transplantation Techniques and Outcomes
- Keywords
- bariatric surgery, non-alcoholic fatty liver disease
- MeSH terms
- Humans, Liver, Liver Cirrhosis, Obesity, Obesity, Morbid, Bariatric Surgery, Non-alcoholic Fatty Liver Disease
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
