Obesity surgery · 2025
Bariatric Surgery and Risk of End-Stage Liver Disease in a Four-Country Cohort Study.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Holmberg Dag, Santoni Giola, von Euler-Chelpin My, Kauppila Joonas H, Ness-Jensen Eivind, Lagergren Jesper
Аннотация
BACKGROUND: Metabolic dysfunction-associated steatotic liver disease can progress to end-stage liver disease. Whether bariatric surgery influences this risk is uncertain.
METHODS: This population-based cohort study included all patients with an obesity diagnosis between 1989 and 2020 according to the nationwide patient registries in Denmark, Finland, Norway, and Sweden. Bariatric surgery was compared with non-operative care for incidence and mortality in end-stage liver disease. Patients with a history of alcohol overconsumption or liver disease at baseline were excluded. Multivariable Cox regression provided hazard ratios (HR) with 95% confidence intervals (CI), adjusted for sex, calendar year, diabetes, Charlson comorbidity index, and country.
RESULTS: Among 654,409 participants with obesity, 86,356 (12.6%) underwent bariatric surgery. During a follow-up period of up to 31 years (median 7.3 years), bariatric surgery was followed by increased incidence (HR 1.23, 95% CI 1.11-1.37) and mortality (HR 1.93, 95% CI 1.56-2.38) in end-stage liver disease compared to non-operative care. The incidence decreased between 1 and 5 years after bariatric surgery but thereafter increased. Censoring patients who developed specific liver diseases (not steatotic liver disease) or alcohol overconsumption during follow-up canceled the association (HR 0.92, 95% CI 0.70-1.06). The mortality in end-stage liver disease was similar after bariatric surgery compared to non-operative care within 1-5 years of follow-up, but thereafter more than twofold increased. Analyses restricted to gastric bypass showed similar associations regarding both incidence (HR 1.26, 95% CI 1.11-1.43) and mortality (HR 2.20, 95% CI 1.72-2.82) of end-stage liver disease.
CONCLUSION: Bariatric surgery might be followed by an increased risk of end-stage liver disease.
METHODS: This population-based cohort study included all patients with an obesity diagnosis between 1989 and 2020 according to the nationwide patient registries in Denmark, Finland, Norway, and Sweden. Bariatric surgery was compared with non-operative care for incidence and mortality in end-stage liver disease. Patients with a history of alcohol overconsumption or liver disease at baseline were excluded. Multivariable Cox regression provided hazard ratios (HR) with 95% confidence intervals (CI), adjusted for sex, calendar year, diabetes, Charlson comorbidity index, and country.
RESULTS: Among 654,409 participants with obesity, 86,356 (12.6%) underwent bariatric surgery. During a follow-up period of up to 31 years (median 7.3 years), bariatric surgery was followed by increased incidence (HR 1.23, 95% CI 1.11-1.37) and mortality (HR 1.93, 95% CI 1.56-2.38) in end-stage liver disease compared to non-operative care. The incidence decreased between 1 and 5 years after bariatric surgery but thereafter increased. Censoring patients who developed specific liver diseases (not steatotic liver disease) or alcohol overconsumption during follow-up canceled the association (HR 0.92, 95% CI 0.70-1.06). The mortality in end-stage liver disease was similar after bariatric surgery compared to non-operative care within 1-5 years of follow-up, but thereafter more than twofold increased. Analyses restricted to gastric bypass showed similar associations regarding both incidence (HR 1.26, 95% CI 1.11-1.43) and mortality (HR 2.20, 95% CI 1.72-2.82) of end-stage liver disease.
CONCLUSION: Bariatric surgery might be followed by an increased risk of end-stage liver disease.