Reply to correspondence on “Bariatric surgery reduces long-term mortality in patients with metabolic dysfunction-associated steatotic liver disease and cirrhosis” Jing Zeng, Jian-Gao Fan Clinical and Molecular Hepatology.2025; 31(2): e218. CrossRef
Correspondence to editorial on “Bariatric surgery reduces long-term mortality in patients with metabolic dysfunction-associated steatotic liver disease and cirrhosis” Nicholas A. Rouillard, Linda Henry, Mindie H. Nguyen Clinical and Molecular Hepatology.2025; 31(2): e173. CrossRef
Reply to correspondence on “Bariatric surgery reduces long-term mortality in patients with metabolic dysfunction-associated steatotic liver disease and cirrhosis” Jing Zeng, Jian-Gao Fan Clinical and Molecular Hepatology.2025; 31(2): e218. CrossRef
Background/Aims With the obesity pandemic, metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common liver disease and a leading cause of end-stage liver disease and liver-related deaths in the USA. Therefore, we aimed to compare the long-term outcomes of patients with MASLD and cirrhosis with and without bariatric surgery.
Methods Patients were retrospectively identified from the California Department of Healthcare Access and Information database, 2005 to 2019, for a population-based cohort study. Propensity score matching (PSM) was used to balance background risks between patients with cirrhosis who underwent bariatric surgery and those who did not. Overall, liver-related and non-liver-related mortality were analyzed.
Result s: Of 91,708 eligible patients with MASLD and cirrhosis, PSM yielded 2,107 patients who underwent bariatric surgery and 8,428 non-bariatric controls. Compared to matched controls, patients who underwent bariatric surgery had lower 5-year overall (24.9% vs. 37.1%; p<0.0001), liver-related (3.3% vs. 14%; p<0.0001), and non-liver-related mortality (22.3% vs. 26.9%; p=0.046). In multivariable analysis, bariatric surgery was associated with decreased overall mortality (adjusted hazard ratio [aHR]=0.63; p<0.0001), liver-related (aHR=0.24; p<0.0001), and non-liverrelated (aHR=0.81; p=0.0026) mortality. However, only laparoscopic surgeries were associated with lower overall mortality (aHR=0.39; p<0.0001) whereas open surgeries were associated with higher overall mortality (aHR=1.24; p=0.022).
Conclusions Patients with MASLD and cirrhosis who underwent bariatric surgery, specifically laparoscopic approaches, had significantly lower mortality risk than non-surgical counterparts.
Citations
Citations to this article as recorded by
Differential Characteristics and Survival Outcomes of Patients With Cirrhosis According to Underlying Liver Aetiology Yu Shi, Nicholas Chien, Ashley Fong, Vy H. Nguyen, Surya Teja Gudapati, Angela Chau, Sally Tran, Linda Henry, Ramsey Cheung, Changqing Zhao, Minjuan Jin, Mindie H. Nguyen Alimentary Pharmacology & Therapeutics.2025; 61(10): 1622. CrossRef
A leap in the dark: Bariatric surgery for treatment of metabolic dysfunction-associated steatotic liver disease related cirrhosis: Editorial on “Bariatric surgery reduces long-term mortality in patients with metabolic dysfunction-associated steatotic live Jing Zeng, Jian-Gao Fan Clinical and Molecular Hepatology.2025; 31(2): 610. CrossRef
Letter to the editor on “Bariatric surgery reduces long-term mortality in patients with metabolic dysfunction-associated steatotic liver disease and cirrhosis” Wei Wang, Yating Xie, Ailei Xu Clinical and Molecular Hepatology.2025; 31(2): e143. CrossRef
Advancing precision medicine in metabolic dysfunction-associated steatotic liver disease Bryan A. Priego-Parra, Rocío Gallego-Durán, Berenice M. Román-Calleja, José Antonio Velarde-Ruiz Velasco, Manuel Romero-Gómez, Jordi Gracia-Sancho Trends in Endocrinology & Metabolism.2025; 36(11): 1000. CrossRef
Correspondence to editorial on “Bariatric surgery reduces long-term mortality in patients with metabolic dysfunction-associated steatotic liver disease and cirrhosis” Nicholas A. Rouillard, Linda Henry, Mindie H. Nguyen Clinical and Molecular Hepatology.2025; 31(2): e173. CrossRef
Reply to correspondence on “Bariatric surgery reduces long-term mortality in patients with metabolic dysfunction-associated steatotic liver disease and cirrhosis” Jing Zeng, Jian-Gao Fan Clinical and Molecular Hepatology.2025; 31(2): e218. CrossRef
Letter to the editor on “Bariatric surgery reduces long-term mortality in patients with metabolic dysfunction-associated steatotic liver disease and cirrhosis” Weixiong Zhu, Xuefan Zeng, Zengxi Yang, Yusheng Cheng, Wence Zhou Clinical and Molecular Hepatology.2025; 31(3): e252. CrossRef
Association between body roundness index and risks of all-cause and cardiovascular mortality in adults with metabolic dysfunction-associated steatotic liver disease: NHANES 1999–2018 Yanshan Yi, Li Yang Frontiers in Nutrition.2025;[Epub] CrossRef
Letter to the editor on “Bariatric surgery reduces long-term mortality in patients with metabolic dysfunction-associated steatotic liver disease and cirrhosis” Chi-Kuei Hsu, Po-Yu Huang, Chih-Cheng Lai Clinical and Molecular Hepatology.2025; 31(3): e247. CrossRef
Efficacy and Safety of Bariatric Surgery in Well-Compensated Liver Cirrhosis: A Systematic Review and a Single-Arm Meta-analysis Pandora Fonseca, Leonardo Pereira, João Gabriel Braga, Giovanna Macanhã Scremin, Luísa de Araujo, Julia Alves, Gabriel de França, Pedro Bregion, Rafael Rego, Maria Farias, Victor Ivano Obesity Surgery.2025; 35(10): 4246. CrossRef
Metabolic Dysfunction Associated to Steatotic Liver Disease: A Review Janna Vanessa Diaz Torres, Vanessa Rocío Villanueva Guerrero, Jennifer Patricia Vargas Gómez, Fredy Javier Pacheco Miranda, Lorena Rocío Orozco Álvarez, Joseph David León Insignares, Marian Mares, Héctor Mario Rodríguez Ortiz, Evelyn Mendoza-Torres Metabolic Syndrome and Related Disorders.2025; 23(10): 427. CrossRef
Endoscopic Bariatric Therapies for Metabolic Dysfunction-Associated Steatotic Liver Disease: Mechanistic Insights and Metabolic Implications Wissam Ghusn, Mira Sridharan, Rachel Fromer, Muhammet Ozdemir, Madeleine G. Haff, Eric J. Vargas Biomedicines.2025; 13(10): 2437. CrossRef
The prevalence of obesity and metabolic consequences such as nonalcoholic fatty liver diseases (NAFLD) has become a crucial health problem. Lifestyle modifications, especially weight loss, effectively reduces liver injury in NAFLD patients. However, adherence to lifestyle changes is very low in the clinical setting. Bariatric surgery can improve metabolic components and cause long-term weight loss. Therefore, bariatric surgery could serve as an attractive treatment option for NAFLD patients. This review integrates data about the benefits of bariatric surgery on NAFLD but also describes the potential pitfalls.
Citations
Citations to this article as recorded by
Focused Recommendations for the Management of Metabolic Dysfunction-Associated Steatohepatitis (MASH) by Advanced Practice Providers in the United States Brian P. Lam, Jessica Bartholomew, Sherona Bau, HoChong Gilles, Andrea Keller, Ann Moore, Khalil Nader, Lisa Richards, Linda Henry, Zobair M. Younossi Journal of Clinical Gastroenterology.2025; 59(4): 298. CrossRef
Metabolic dysfunction-associated steatotic liver disease (MASLD): a systemic disease with a variable natural history and challenging management Luigi Elio Adinolfi, Aldo Marrone, Luca Rinaldi, Riccardo Nevola, Antonio Izzi, Ferdinando Carlo Sasso Exploration of Medicine.2025;[Epub] CrossRef
Consensus guidelines for the diagnosis and management of metabolic dysfunction-associated steatotic liver disease in adult Asian Indians with type 2 diabetes Anoop Misra, Ashish Kumar, Mohammad Shafi Kuchay, Amerta Ghosh, Seema Gulati, Narendra Singh Choudhary, Deep Dutta, Praveen Sharma, Naval K. Vikram, Ashu Rastogi, Akash Shukla, Alpesh Goyal, Amit Gupta, Anand V. Kulkarni, Anil Chandra Anand, Anil Arora, A Diabetes & Metabolic Syndrome: Clinical Research & Reviews.2025; 19(3): 103209. CrossRef
Reply to correspondence on “Bariatric surgery reduces long-term mortality in patients with metabolic dysfunction-associated steatotic liver disease and cirrhosis” Jing Zeng, Jian-Gao Fan Clinical and Molecular Hepatology.2025; 31(2): e218. CrossRef
Post-Metabolic Bariatric Surgery Cirrhosis and the Role of Liver Transplantation: A Report from a Referral Transplant Center Hamed Nikoupour, Erfan Sheikhbahaei, Alireza Shamsaeefar, Kourosh Kazemi, Mohammad Eslamian, Hamidreza Zefreh, Seyed Ali Malek-Hosseini, Saman Nikeghbalian Obesity Surgery.2025; 35(6): 2111. CrossRef
Comparative Analysis of the Incidence of Post-bariatric Cholelithiasis in Sleeve Gastrectomy and Roux-en-Y Gastric Bypass Fernando de Barros, Enmanuel Compres Guichardo, Ana Beatriz Monteiro Fonseca, Leonardo Halamy Pereira, Daniel Alejandro Reyes Encalada Obesity Surgery.2025; 35(8): 3157. CrossRef
Pathological Evolution and Internal Medicine Management of Nonalcoholic Fatty Liver Disease (NAFLD) in the Era of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) Muhammad Moseeb Ali Hashim, Muhammad Aizaz Mohsin Khan, Muhammad Usama Ashraf, Saniya Mohsin, Kamran Zahoor, Javeria Niazi, Aiza Khan, Sania Muzaffar, Madiha Makhdumi, Omar Ahmed Ibad, Talha Kamran Khan, Sohaib Khalid Cureus.2025;[Epub] CrossRef
Metabolic dysfunction-associated steatotic liver disease management in Saudi Arabia: A modified Delphi-based adaptation of international standards Faisal Abaalkhail, Faisal M. Sanai, Khalid AlSwat, Adnan Alzanbagi, Ahmed Aljedai, Ali Alshehri, Assim Alfadda, Hamdan Alghamdi, Majid Almadi, Mohammad Aleissa, Mona Ismail, Saud Alsifri, Turki Alzahrani, Saleh Alqahtani, Waleed Al Hamoudi Saudi Journal of Gastroenterology.2025;[Epub] CrossRef
Crotonylation of IDH1 alleviates MASLD progression by enhancing the TCA cycle Shanshan Liu, Yu Ji, Luyang Wei, Yiqiao Zhang, Linghang Zeng, Yiyang Min, Danyang Yin, Kun Liu, Chengjian Guan, Shumeng Liu, Huajing Yu, Zhongtao Zhang Nature Communications.2025;[Epub] CrossRef
Metabolic Bariatric Surgery for the Treatment of Metabolic Dysfunction-Associated Steatohepatitis (MASH): A Scoping Review of Biomarker and Histology Changes Aryan Shah, Amirhossein Mohammadi, Adeel Haq, David Walji, Boris Zevin Obesity Surgery.2025; 35(10): 4508. CrossRef
Association of Rapid Early Weight Loss with One-Year Hepatic Steatosis Improvement After Sleeve Gastrectomy: A Retrospective Cohort Study Min Kyoung Jang, Si Yeol Yoon, Jin A. An, Ji Soo Kim, Min-Seon Kim, Jung Ah Lee, Chang Seok Ko, Se Hee Min Journal of Clinical Medicine.2025; 14(20): 7284. CrossRef
Tirzepatide and metabolic surgery: complementary approaches for multimodal management of MASLD Yujia Shi Hepatology International.2025;[Epub] CrossRef
Development and validation of a noninvasive score for at-risk metabolic dysfunction–associated steatohepatitis in individuals with obesity undergoing bariatric surgery Xin Huang, Tao Zhu, Shumin Li, Teng Liu, Shibo Lin, Hui Liang, Mingwei Zhong, Xitai Sun, Liyong Chen, Hao Bai, Zehua Zhao, Shujuan Lin, Xuehui Chu, Zhiyong Dong, Guangyong Zhang, Shaozhuang Liu Hepatology.2025;[Epub] CrossRef
Mid-term Effects of Bariatric Surgery on Metabolic Dysfunction-Associated Fatty Liver Disease Remission and Predictive Factors: A Prospective Study with a Focus on Non-invasive Diagnosis Èlia Navarro-Masip, Núria Mestres, Marta Zorzano-Martínez, Blanca Salinas-Roca, Enric Sánchez, Carolina López-Cano, Fernando Herrerías, Mari Cruz de la Fuente, Maite Santamaría, Josep León-Mengíbar, Ana-Gloria Soler, Marta Bueno, Albert Lecube Obesity Surgery.2024; 34(3): 841. CrossRef
Exploring the Multifaceted Landscape of MASLD: A Comprehensive Synthesis of Recent Studies, from Pathophysiology to Organoids and Beyond Allison Soto, Colby Spongberg, Alessandro Martinino, Francesco Giovinazzo Biomedicines.2024; 12(2): 397. CrossRef
Bacteroides and NAFLD: pathophysiology and therapy Jun Zhang, Jing Zhou, Zheyun He, Hongshan Li Frontiers in Microbiology.2024;[Epub] CrossRef
Review article: Hepatic steatosis and its associations with acute and chronic liver diseases Aaron B. Koenig, Albert Tan, Hala Abdelaal, Fanny Monge, Zobair M. Younossi, Zachary D. Goodman Alimentary Pharmacology & Therapeutics.2024; 60(2): 167. CrossRef
Emerging mechanisms of non-alcoholic steatohepatitis and novel drug therapies Hao CHEN, Yang ZHOU, Haiping HAO, Jing XIONG Chinese Journal of Natural Medicines.2024; 22(8): 724. CrossRef
The Role of Preoperative Abdominal Ultrasound in the Preparation of Patients Undergoing Primary Metabolic and Bariatric Surgery: A Machine Learning Algorithm on 4418 Patients’ Records Mohamed Hany, Mohamed El Shafei, Mohamed Ibrahim, Ann Samy Shafiq Agayby, Anwar Ashraf Abouelnasr, Moustafa R. Aboelsoud, Ehab Elmongui, Bart Torensma Obesity Surgery.2024; 34(9): 3445. CrossRef
Cytokeratin 18 in nonalcoholic fatty liver disease: value and application Yuan Wu, Jing Zhou, Jun Zhang, Hongshan Li Expert Review of Molecular Diagnostics.2024; 24(11): 1009. CrossRef
Weight Loss After Sleeve Gastrectomy According to Metabolic Dysfunction-Associated Steatotic Liver Disease Stage in Patients with Obesity: A Liver Biopsy-Based Prospective Study José Ignacio Martínez-Montoro, Isabel Arranz-Salas, Carolina Gutiérrez-Repiso, Ana Sánchez-García, Luis Ocaña-Wilhelmi, José M. Pinazo-Bandera, Diego Fernández-García, Araceli Muñoz-Garach, Dieter Morales-García, Miren García-Cortés, Eduardo García-Fuente Nutrients.2024; 16(22): 3857. CrossRef
Gut Microbiota and Plasma Bile Acids Associated with Non-Alcoholic Fatty Liver Disease Resolution in Bariatric Surgery Patients Álvaro Pérez-Rubio, Polina Soluyanova, Erika Moro, Guillermo Quintás, Iván Rienda, María Dolores Periañez, Andrés Painel, José Vizuete, Judith Pérez-Rojas, José V. Castell, Ramón Trullenque-Juan, Eugenia Pareja, Ramiro Jover Nutrients.2023; 15(14): 3187. CrossRef
First
Prev
