Effect of Endoscopic Bariatric and Metabolic Therapies on Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-analysis
Abstract
Background & aims Weight loss via lifestyle intervention remains the mainstay of treatment for nonalcoholic fatty liver disease (NAFLD). Endoscopic bariatric and metabolic therapies (EBMTs) have recently been developed as an alternative treatment option for obesity. This study aimed to assess the effect of FDA-approved EBMTs on NAFLD. Methods We searched MEDLINE, EMBASE, Web of Science and Cochrane Central through December 2020 for studies that assessed changes in liver outcomes following EBMT. Primary Outcomes: Liver fibrosis. Secondary outcomes Liver biochemistry, steatosis, NAFLD histological changes and insulin sensitivity. The Grading of Recommendations, Assessment, Development, and Evidence (GRADE) approach was conducted to assess quality of evidence. Results Of 4994 potential studies, 18 studies with 863 patients were included. Average weight loss was 14.5% of initial weight at a 6-month follow-up. Primary outcomes: Following EBMT, liver fibrosis significantly reduced by standardized mean difference (SMD) of 0.7 (95% CI, 0.1, 1.3; P = .02). Secondary outcomes There were significant improvements in other NAFLD surrogates including alanine aminotransferase (-9.0 U/L; 95% CI, -11.6, -6.4; P Conclusions EBMTs appear effective at treating NAFLD with significant improvement in liver fibrosis. Given the worsening NAFLD pandemic and limitations of currently available therapies, EBMTs should be further investigated as a potential treatment option for this patient population.
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A recent meta-analysis found complete resolution of steatosis, inflammation, ballooning and fibrosis in 66%, 50%, 76% and 40% of people, respectively, after bariatric surgery and a median follow-up period of 15 months.
“A recent meta-analysis found complete resolution of steatosis, inflammation, ballooning and fibrosis in 66 %, 50 %, 76 % and 40 % of people, respectively, after bariatric surgery and a median followup period of 15 months [86].”
From Obesity and MASLD: Is weight loss the (only) key to treat metabolic liver disease? (2024) · cites this paper as [86]
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- Authors
- Jirapinyo, P., McCarty, T. R., Dolan, R. D., Shah, R., & Thompson, C. C.
- Affiliations
- Brigham and Women's Hospital (US)
- University Hospitals Cleveland Medical Center (US)
- Corresponding author
- Thompson, Christopher C.
- Venue
- Clinical Gastroenterology and Hepatology
- Publisher
- Elsevier BV
- Published
- 2022-03
- Volume
- 20
- Issue
- 3
- Pages
- 511-524.e1
- ISSN
- 1542-3565 (ISSN-L)
- OpenAlex
- W3137033928
- Cited by
- 86
- References
- 5
- Citations by year
- 2026: 11 · 2025: 20 · 2024: 20 · 2023: 15 · 2022: 15 · 2021: 5
- FWCI
- 2.10
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Gastroenterology and Hepatology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Hepatology › Liver Disease and Transplantation
- Keywords
- endoscopic bariatric therapy, non-alcoholic fatty liver disease, liver fibrosis, hepatic steatosis, insulin resistance, weight loss, obesity, alanine aminotransferase, waist circumference
- MeSH terms
- Humans, Liver, Weight Loss, Bariatrics, Bariatric Surgery, Non-alcoholic Fatty Liver Disease
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