A recent investigation by researchers at the Cleveland Clinic has revealed a significant finding: bariatric surgery can radically decrease the risk of serious liver complications for individuals battling obesity and fatty liver-related cirrhosis.
This research, which appears in the esteemed journal Nature Medicine, offers a fresh perspective on treatment options for these patients.
Bariatric Surgery as a Therapeutic Approach
Dr. Ali Aminian, who leads the Bariatric & Metabolic Institute at the Cleveland Clinic, spearheaded the study.
He emphasizes that bariatric surgery should be considered a legitimate therapeutic approach for individuals suffering from both obesity and cirrhosis.
The results of the study are striking—participants who underwent the surgical procedure exhibited a 72% reduction in the likelihood of developing serious liver complications.
Furthermore, they saw an 80% decrease in the chances of progressing to decompensated cirrhosis among those with the compensated version of the disease.
In the U.S., metabolic dysfunction-associated steatohepatitis (MASH) has emerged as a common and serious chronic liver disorder closely tied to obesity and diabetes.
Fat begins to accumulate within liver cells, triggering a cascade of damaging responses that can lead to scarring.
Alarmingly, about 20% of those afflicted with MASH may go on to develop cirrhosis, impacting roughly three million people across the nation.
Long-Term Study Findings
Cirrhosis itself comes in two stages: compensated and decompensated.
Patients in the compensated stage may experience significant liver damage, yet their organ can still function well enough to sustain their overall health.
In contrast, those who reach the decompensated stage face life-threatening complications due to the liver’s inability to maintain essential bodily functions, often resulting in the need for a transplant.
Dr. Sobia Laique, a hepatologist specializing in transplant cases and a co-investigator of this study, noted the pressing need for effective treatment options for those with MASH-related cirrhosis.
Currently, patients often have few reliable therapeutic measures to mitigate the risk of severe liver issues, underscoring the urgency for targeted medical interventions.
The SPECCIAL study (Surgical Procedures Eliminate Compensated Cirrhosis In Advancing Long-term) aimed to compare the long-term repercussions of bariatric surgery against nonsurgical management for patients with obesity and compensated MASH-related cirrhosis.
In this rigorous investigation, 62 surgical patients at the Cleveland Clinic were contrasted with a control group of 106 nonsurgical patients, both tracked over a 15-year period with comparable initial health metrics.
The year 15 brought revealing statistics: only 20.9% of the surgical group faced major liver-related complications—such as liver cancer or death—compared to a sobering 46.4% in the nonsurgical cohort.
Furthermore, during the follow-up, 15.6% of the surgical patients progressed from compensated to decompensated cirrhosis, while the rate was 30.7% in the nonsurgical group.
On average, participants who underwent bariatric surgery shed about 26.6% (or 31.6 kg) of their body weight, contrasted with a modest 9.8% (10.7 kg) loss in the control group.
The Future of Treatment Options
Dr. Steven Nissen, Cleveland Clinic’s Chief Academic Officer and a senior investigator involved in the study, asserts that mainstream approaches currently revolve around lifestyle modifications.
However, these changes often fall short in achieving the required weight reduction and metabolic enhancements necessary to lower liver disease risks.
According to the findings from the SPECCIAL study, bariatric surgery offers a promising therapeutic avenue that could transform the trajectory of cirrhosis for specific patient populations.
This groundbreaking study is a first-of-its-kind exploration into the long-term effects of bariatric surgery on patients with MASH-related cirrhosis.
Notably, previous research conducted in 2021, known as the SPLENDOR study, advocated for bariatric surgery as an encouraging first-line strategy for treating MASH without accompanying cirrhosis.
Looking ahead, continued research is vital to assess the potential of new anti-obesity medications and their ability to deliver similar benefits for this demographic.
As the landscape of liver disease treatments evolves, the hope is that more effective solutions will emerge for those in dire need.
Scientists are also investigating how these treatments might complement existing therapies to improve overall liver health.
A breakthrough in liver cancer surgery could further enhance outcomes for patients, offering new hope alongside pharmaceutical advancements.
By integrating these innovations, the medical community moves closer to addressing the complex challenges associated with obesity-related liver disease.
Source: ScienceDaily