Long-term Effects of Bariatric Surgery in Patients with Non-alcoholic Fatty Liver Disease: A Literature Review and Meta-Analysis
Bibliographic record
Abstract
Introduction: Weight loss is the only proven effective treatment for non-alcoholic fatty liver disease (NAFLD). Bariatric surgery has been shown to lead to significant weight loss in subjects, and improve other co-morbidities of obesity such as glucose intolerance, hypertension and hyperlipidemia but there is scant data available on its effects on NAFLD. Methods: We included controlled studies comparing patients with NAFLD or NASH who underwent bariatric surgery with those who underwent non-surgical management. We systematically search PubMed/MEDLINE, Embase, and CINAHL to identify eligibility studies. Two independent investigators assessed trial eligibility and abstracted data. Results: Our search identified 2588 citations with 5 trials, having 4399 patients, meeting our eligibility criteria. Compared to the control group, patients undergoing bariatric surgery had significant improvement in all-cause mortality (OR 0.12; 95% CI 0.03-0.55; p=0.006; I2=0%), diagnosis of cirrhosis (OR 0.24; 95% CI 0.10-0.59; p=0.002), change in weight measured as >10% of total body weight lost (OR 21.67; 95% CI 3.73-125.77; p=0.0006), and change in weight measured as mean kilograms lost (mean difference of 21.0 kg; 95% CI 8.40-33.60; p=0.001), regression of fibrosis (OR 18.90; 95% CI 2.10-170.39; p=0.009), reduction in ALT (-3.87, 95%CI -3.89-3.85, p=2=0%). In our literature review, we identified 29 of uncontrolled trials reporting changes in histology after bariatric surgery. Of these, 20 studies reported a decrease in the prevalence of hepatic steatosis (from 84.5% to 36.1%), 6 studied reported a decrease in the prevalence of NASH (from 51.45% to 9.76%), 11 studies reported a change in steatosis score (D weighted mean -1.49) and 9 reported a change in fibrosis score (D weighted mean -0.34). Conclusion: In this meta-analysis, patients with NAFLD who underwent bariatric surgery showed signifi cant reduction of all-cause mortality, weight loss, fibrosis score and ALT. Further studies are needed to assess the longterm benefit of bariatric surgery in the treatment of patients with NAFLD.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.023 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.017 | 0.030 |
| Bibliometrics | 0.007 | 0.009 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".