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
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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In the citing paper
“However, 12% of patients developed new or worsening liver disease, particularly fibrosis [87].”
From Precision obesity medicine: A phenotype-guided framework for pharmacologic therapy across the lifespan (2025) · cites this paper as [87]
In the citing paper
“The overall NAFLD activity score notably decreased (mean difference − 2.39; 95% CI, − 3.20 to − 1.58; P < 0.001), supporting the capacity of surgery-induced Weight loss to reverse key pathological features of NAFLD.”
From Precision obesity medicine: A phenotype-guided framework for pharmacologic therapy across the lifespan (2025) · cites this paper as [87]
In the citing paper
“A comprehensive systematic review and meta-analysis assessed the histological effects of bariatric surgery on nonalcoholic fatty liver disease (NAFLD) in patients, analyzing 3,093 paired liver biopsies from 32 cohort studies. Bariatric surgery was associated with significant improvements in hepatic histology: steatosis resolved in 66% of cases, lobular inflammation in 50%, hepatocellular Ballooni”
From Precision obesity medicine: A phenotype-guided framework for pharmacologic therapy across the lifespan (2025) · cites this paper as [87]
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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)
- 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
- 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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