*EMBARGOED All research presented at the 2022 ACG Annual Scientific Meeting and Postgraduate Course is strictly embargoed until Sunday, October 23, 2022, at 12:00 pm EDT.
Wednesday, October 26, 2022 | 8:40 AM – 8:50 AM ET | Location: Hall C1
Author Insight from Arunkumar Krishnan, MBBS, West Virginia University School of Medicine
What’s new here and important for clinicians?
Obesity and nonalcoholic fatty liver disease (NAFLD) are associated with significant morbidity and mortality. The global prevalence of NAFLD has reached 25.2% and is projected to be 33.5% by 2030. Notably, NAFLD is becoming a leading cause of cirrhosis, with the burden of NAFLD-related complications projected to become the leading indication for orthotopic liver transplantation globally. Furthermore, NAFLD was responsible for a higher frequency of simultaneous liver-kidney transplantation than any other liver disease. However, despite the increasing prevalence of NAFLD and ongoing research, there is no US Food and Drug Administration (FDA)–approved treatment for NAFLD, and weight loss is optional as a first-line treatment for NAFLD.
Bariatric surgery is an efficient weight-loss intervention in patients with obesity. It may be indicated in patients with obesity and NAFLD to achieve and maintain 7-10% weight loss which is needed to improve NAFLD. However, research on the effects of bariatric surgery among patients with NAFLD on adverse renal-related outcomes has not been well explored, and there is a paucity of data on adverse liver-related outcomes.
Our study findings indicate that bariatric surgery was associated with lower incidences of adverse liver outcomes such as developing cirrhosis, hepatocellular carcinoma, and cholangiocarcinoma. Similarly, it also incidences the risks of adverse renal outcomes, such as the development of various stages of chronic kidney disease, including end-stage renal disease and the need for dialysis. Furthermore, bariatric surgery patients had a lower risk of renal cell carcinoma. These findings strengthen previously reported associations and add new data to the current literature.
What do patients need to know?
Our findings indicate bariatric surgery lowers the incidences of developing cirrhosis, hepatocellular carcinoma, and cholangiocarcinoma. Similarly, it reduces the incidences of developing various stages of chronic kidney disease, the need for dialysis, and renal cell cancer among patients with NAFLD and obesity.
Although bariatric surgery is not a specific indication nor recommended treatment for NAFLD, however, it may improve obesity-related comorbidities such as type 2 diabetes mellitus, insulin resistance, dyslipidemia, and hypertension, as well as NAFLD itself.
More studies with longer-follow-up are still needed to confirm our findings, and it could increase our understanding of the effects of bariatric surgery on the adverse liver and renal outcomes.
Author Contact
Arunkumar Krishnan, MBBS, West Virginia University School of Medicine
dr.arunkumar.krishnan [at] gmail.com
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