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Metabolic Surgery Reduces Risk of Severe Liver Outcomes in MASH-Related Cirrhosis, Study Finds

A new study published in Nature Medicine on recently suggests that metabolic surgery may significantly lower the risk of severe liver complications in patients with compensated metabolic dysfunction-associated steatohepatitis (MASH)-related cirrhosis and obesity. The findings provide hope for an effective intervention in the absence of approved medical therapies for this condition.

Led by Ali Aminian, M.D., from the Bariatric and Metabolic Institute at the Cleveland Clinic, the observational study assessed the long-term impact of metabolic surgery compared to nonsurgical treatment in patients diagnosed with MASH-related cirrhosis. The study followed 62 patients who underwent metabolic surgery and 106 patients who received standard non-surgical treatment, with an average follow-up of 10 years.

The study revealed that metabolic surgery was associated with a markedly lower risk of major adverse liver outcomes (MALO). The 15-year cumulative incidence of MALO was 20.9% in the surgical group, compared to 46.4% in the nonsurgical group, with an adjusted hazard ratio of 0.28. Additionally, the 15-year cumulative incidence of decompensated cirrhosis was 15.6% in the surgical group, compared to 30.7% in the nonsurgical group, translating to an adjusted hazard ratio of 0.20.

The results indicate that metabolic surgery could be a game-changer for patients with obesity and compensated MASH-related cirrhosis, potentially slowing the progression of liver disease and reducing severe complications. “In the absence of approved medical therapies for compensated MASH-related cirrhosis, metabolic surgery may represent a safe and effective therapeutic option to influence the trajectory of cirrhosis in selected patients,” the authors concluded.

While the study presents compelling evidence in favor of metabolic surgery, experts emphasize the need for further clinical trials to validate these findings and assess long-term outcomes. With rising rates of obesity and fatty liver disease worldwide, metabolic surgery may offer a promising avenue for reducing liver-related complications in high-risk


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