Patients suffering from fatty liver disease are at a lower risk of liver disease and heart disease after bariatric surgery.

A Cleveland Clinic study found that patients with advanced liver disease caused by fatty tissue and overweight had a significantly lower risk of developing liver disease and serious cardiovascular complications than patients who didn’t have bariatric weight reduction surgery.

Furthermore 88% lower risk of developing cirrhosis or liver cancer after bariatric surgery during the study period. 70% less chance of developing serious cardiovascular diseases like stroke or heart attack, was also linked to bariatric surgery. The study was published online by JAMA.

There is currently no FDA-approved medication for fat liver. This study offers solid proof that bariatric surgery is an effective treatment option for patients suffering from advanced obesity and fatty liver disease.

Ali Aminian M.D., director of Cleveland Clinic’s Bariatric & Metabolic Institute, and lead investigator for the study

Obesity is a significant risk factor in the development of nonalcoholic steatohepatitis, a severe form of fatty liver disease. The accumulation of fat in the liver can cause inflammation and damages to the organ. The liver disease worsens and scar tissue is formed in the liver. This blocks the liver from working properly. Cirrhosis can cause permanent damage to the liver. This increases the risk of developing liver cancer. A liver that is permanently damaged could require a liver transplant to be able to live.

In addition to complications related to liver disease NASH and fatty liver are closely linked to cardiovascular diseases and diabetes, such as heart attack and heart failure.

In the beginning, patients who suffer from fatty livers may not show any obvious signs. A liver biopsy is necessary for certain patients to identify the disease and determine the severity. Multidisciplinary treatment is essential to treat NASH. This will prevent the same liver injury from happening again and decrease the risk of suffering from serious cardiovascular events. There are currently no approved treatments for NASH. Additionally there is no treatment proven in NASH patients to reduce the risk of a progression of liver disease or serious cardiovascular events.

The SPLENDOR (Surgical Procedures & Long-term Effectiveness In NASH Disease and Obesity Risk Study) was designed to examine the relationship between bariatric surgery, future risk of developing serious cardiovascular events and the development of cirrhosis among patients with NASH and obesity.

Researchers followed 1,158 patients with biopsy-proven NASH through March 2021. They were able to have their livers removed between 2004 between 2004 and 2016. A comparison was conducted between 650 patients in the bariatric surgery program and 508 patients who did not undergo any surgical procedures. The study participants shared the same characteristics such as severity of liver disease at baseline liver biopsy.

Ten years after enrolling in the study, advanced liver disease (progression to cirrhosis, liver cancer, need for a liver transplant, or death from liver disease) occurred in 2.3 percent of the surgical group versus 9.6 percent in the control group. In addition, at the conclusion of the study 8.5 percent of the surgical group and 15.7 percent in the nonsurgical group experienced major adverse cardiovascular events such as heart attack, failure, stroke, or death from heart disease.

At 10 years the body weight was reduced by 22.4% in the surgical group and by 4.6 percent in the nonsurgical group. Patients with diabetes also saw significant reductions in blood sugar after bariatric surgery. These findings support the longevity of the health benefits of bariatric surgery, as shown in the Cleveland Clinic-led STAMPEDE clinical trial.

“The SPLENDOR study shows that for patients with obesity and NASH, substantial and sustained weight loss that is achieved through bariatric surgery can safeguard the heart and lower the chance of developing end-stage liver disease,” said the study’s principal investigator, Steven Nissen, M.D. Chief Academic Officer of the Heart, Vascular and Thoracic Institute at Cleveland Clinic. “This is the first medical study to report a treatment method that is associated with a lower risk of major adverse events in patients with biopsy-proven NASH.

Journal reference:

Aminian, A., and al. (2021). Association of Bariatric Surgery with major adverse Liver or Cardiovascular Outcomes for Patients with Biopsy-Proven Nonalcoholic Hepatitis. JAMA.

Content Source:

Gemma Wilson

Gemma is a journalism graduate with keen interest in covering business news – specifically startups. She has as a keen eye for technologies and has predicted quite a few successful startups over the last couple of years.

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