News release

From: American College of Physicians

Bariatric surgery highly effective for reducing fatty liver disease in patients with obesity and diabetes
Abstract: https://www.acpjournals.org/doi/10.7326/M21-1962
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A randomized controlled trial found that both gastric bypass and gastric sleeve surgery were highly effective in reducing nonalcoholic fatty liver disease in patients with type 2 diabetes and obesity. Both procedures led to substantial reduction in liver fat 5 weeks after surgery and almost complete clearance of liver fat 1 year after surgery. The effect of bariatric surgery on liver scarring, or cirrhosis, was not clear. The findings are published in Annals of Internal Medicine.

Nonalcoholic fatty liver disease is a significant problem because it leads to inflammation in the liver and cirrhosis, which may progress to liver failure or liver cancer. The condition is more commonly seen in people with diabetes or obesity, and moderate weight loss is the first-line treatment. The most common weight loss surgeries are Roux-en-Y gastric bypass and sleeve gastrectomy. Gastric bypass is more complicated and riskier than sleeve surgery, but some low-quality studies suggest that gastric bypass may be superior to gastric sleeve surgery in improving liver fat content.

Researchers from Vestfold Hospital Trust, Tønsberg, Norway recruited 109 patients with type 2 diabetes and obesity who were scheduled to undergo weight loss surgery to their study. Patients in the trial were randomly assigned to undergo either gastric bypass (54 patients) or gastric sleeve surgery (55 patients). The researchers followed the study patients for 1 year after weight loss surgery and compared changes in liver fat content and the amount of liver scarring between the groups. The researchers found that both procedures effectively reduced liver fat. Bariatric surgery had less influence on degree of scarring in the short term, but researchers plan to follow participants for 5 more years to gather further insights about the comparative effectiveness of the two procedures.