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Cited by 371Bariatric Surgery and OutcomesLiver Disease Diagnosis and TreatmentOrgan Transplantation Techniques and Outcomes

The DOI matches its Crossref record; 70 of the 70 references it cites were found in a registry or an index.

Complete Resolution of Nonalcoholic Fatty Liver Disease After Bariatric Surgery: A Systematic Review and Meta-analysis

Lee, Yung, Doumouras, Aristithes G., Yu, James, Brar, Karanbir, Banfield, Laura, Gmora, Scott, Anvari, Mehran, Hong, Dennis·2019·Clinical Gastroenterology and Hepatology
DOI 10.1016/j.cgh.2018.10.017
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Abstract

Background & aims Bariatric surgery has been reported to lead to complete resolution of nonalcoholic fatty liver disease (NAFLD) following the sustained weight loss induced in obese patients. We performed a systematic review and meta-analysis to evaluate the effects of bariatric surgery on NAFLD in obese patients. Methods We searched MEDLINE, EMBASE, CENTRAL, and Web of Science databases through May 2018 for studies that compared liver biopsy results before and after bariatric surgery in obese patients. Primary outcomes were biopsy-confirmed resolution of NAFLD and NAFLD activity score. Secondary outcomes were worsening of NAFLD after surgery and liver volume. The Grading of Recommendations, Assessment, Development, and Evidence approach was conducted to assess overall quality of evidence. Results We analyzed data from 32 cohort studies comprising 3093 biopsy specimens. Bariatric surgery resulted in a biopsy-confirmed resolution of steatosis in 66% of patients (95% CI, 56%-75%), inflammation in 50% (95% CI, 35%-64%), ballooning degeneration in 76% (95% CI, 64%-86%), and fibrosis in 40% (95% CI, 29%-51%). Patients' mean NAFLD activity score was reduced significantly after bariatric surgery (mean difference, 2.39; 95% CI, 1.58-3.20; P < .001). However, bariatric surgery resulted in new or worsening features of NAFLD, such as fibrosis, in 12% of patients (95% CI, 5%-20%). The overall Grading of Recommendations, Assessment, Development, and Evidence quality of evidence was very low. Conclusions Through this systematic review and meta-analysis, we found that bariatric surgery leads to complete resolution of NAFLD in obese patients. However, some patients develop new or worsened features of NAFLD. Randomized controlled trials are needed to further examine the therapeutic benefits of bariatric surgery for patients with NAFLD.

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Crossref · 10.1016/j.cgh.2018.10.017

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Research works printed but not linked: 3

  1. Haskins, 2018, US economic burden of fatty liver disease is $32 billion annually, Bariatric News
  2. Singh, 2017, Treatment options for alcoholic and non-alcoholic fatty liver, World J Clin Cases, 16, 258
  3. 2017, GRADEpro GDT, Cochrane Community

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Metadata

Authors
Lee, Y., Doumouras, A. G., Yu, J., Brar, K., Banfield, L., Gmora, S., Anvari, M., & Hong, D.
Affiliations
  • McMaster University (CA)
  • University of Toronto (CA)
Corresponding author
Hong, Dennis
ORCID
Venue
Clinical Gastroenterology and Hepatology
Publisher
Elsevier BV
Published
2019-05
Volume
17
Issue
6
Pages
1040-1060.e11
ISSN
1542-3565 (ISSN-L)
DOI
10.1016/j.cgh.2018.10.017
OpenAlex
W2896985838
Cited by
371
References
70
Citations by year
2026: 28 · 2025: 40 · 2024: 54 · 2023: 44 · 2022: 60 · 2021: 73 · 2020: 46 · 2019: 24
FWCI
8.01
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Clinical Gastroenterology and Hepatology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
  • Health Sciences › Medicine › Hepatology › Liver Disease Diagnosis and Treatment
  • Health Sciences › Medicine › Surgery › Organ Transplantation Techniques and Outcomes
Keywords
bariatric surgery, non-alcoholic fatty liver disease, obesity, weight loss, liver biopsy, NAFLD activity score, hepatic steatosis, liver fibrosis, liver inflammation, ballooning degeneration, liver volume
MeSH terms
Humans, Obesity, Body Mass Index, Bariatric Surgery, Non-alcoholic Fatty Liver Disease

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