A Cleveland Clinic study shows that patients with obesity and fatty liver-related problems had lower chances of liver complications post bariatric surgery
Scientists at Cleveland Clinic have found that obese patients with cirrhosis have lower risk of liver complications if they have undergone weight loss surgery. They reported their findings in the Nature Medicine journal.
Lead investigator Ali Aminian, M.D., director of Cleveland Clinic’s Bariatric & Metabolic Institute said that the results opened up avenues for bariatric surgery to become a treatment option in patients with cirrhosis and obesity. “Bariatric surgery was associated with a 72% lower risk of developing serious complications of liver disease and an 80% lower risk of progression to decompensated stage among patients with compensated cirrhosis and obesity,” he said.
Obesity and diabetes are the leading causes of metabolic dysfunction-associated steatohepatitis (MASH). Accumulation of fat within liver cells triggers a cascade of events ultimately leading to liver scarring. About 20% of people with MASH can progress to late-stage liver scarring which is called cirrhosis.
“Patients with MASH-related cirrhosis have extremely limited treatment options. Currently, no therapeutic interventions have demonstrated efficacy in mitigating the risk of severe liver complications within this patient population,” said Sobia Laique, M.D., a transplant hepatologist and the study coinvestigator at Cleveland Clinic. “This underscores a critical unmet need for the development of effective therapies specifically targeting patients with compensated MASH-related cirrhosis.”
The aim of the SPECCIAL (Surgical Procedures Eliminate Compensated Cirrhosis In Advancing Long-term) study was to examine the long-term outcomes of bariatric surgery on the risk of developing major liver complications in patients with obesity and compensated MASH-related cirrhosis, compared with nonsurgical management.
A group of 62 Cleveland Clinic’s patients with compensated MASH-related cirrhosis and obesity who had bariatric surgery were compared with a control group of 106 nonsurgical patients and followed for 15 years. Study participants had similar characteristics such as severity of liver disease at their baseline liver biopsy.
Fifteen years after enrollment, study results show that 20.9% in the surgical group and 46.4% in the nonsurgical group developed one of the major complications of liver disease including liver cancer and death.
