Bariatric Surgery in NAFLD

Currently, there are no approved medications to treat patients with nonalcoholic steatohepatitis (NASH) with fibrosis or cirrhosis. Although the management goal in these patients is weight reduction by 7–10% with lifestyle modifications, only less than 10% of patients achieve this target at 1-year,...

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Bibliographic Details
Published in:Digestive diseases and sciences 2022-02, Vol.67 (2), p.408-422
Main Authors: Chauhan, Mahak, Singh, Kuldeep, Thuluvath, Paul J.
Format: Article
Language:English
Subjects:
Acids
Bariatric Surgery
Bile
Biochemistry
Body mass index
Diabetes
Diabetes Mellitus, Type 2 - complications
Diabetes Mellitus, Type 2 - metabolism
Diabetes Mellitus, Type 2 - surgery
Disease Progression
Eating behavior
Food
Gastroenterology
Gastrointestinal surgery
Glucagon
Glucose
Health aspects
Hepatology
Histology
Hormones
Humans
Insulin resistance
Invited Review
Laparoscopy
Life Style
Lifestyles
Liver
Liver cancer
Liver cirrhosis
Liver diseases
Liver transplants
Medicine
Medicine & Public Health
Metabolism
Microbiota
Mortality
Non-alcoholic Fatty Liver Disease - complications
Non-alcoholic Fatty Liver Disease - pathology
Non-alcoholic Fatty Liver Disease - surgery
Obesity
Obesity - complications
Obesity - metabolism
Obesity - surgery
Oncology
Surgery
Transplant Surgery
Type 2 diabetes
Weight control
Weight Loss
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Summary:Currently, there are no approved medications to treat patients with nonalcoholic steatohepatitis (NASH) with fibrosis or cirrhosis. Although the management goal in these patients is weight reduction by 7–10% with lifestyle modifications, only less than 10% of patients achieve this target at 1-year, and fewer maintain the weight loss at 5 years. Bariatric surgery is an option that may be considered in those who fail to lose weight by lifestyle changes. Bariatric surgery has been shown to improve liver histology including fibrosis secondary to NASH, in addition to other benefits including an improvement or resolution of type 2 diabetes mellitus, dyslipidemia, and hypertension, and a reduction of cardiovascular morbidity or mortality. There are no guidelines of bariatric surgery indications for the management of NASH. The purpose of this review is to critically appraise the current knowledge of the role of bariatric surgery and the potential mechanisms for its perceived benefits in the management of patients with NASH-related liver disease.
ISSN:0163-2116
1573-2568
DOI:10.1007/s10620-021-07317-3