期刊
AMERICAN JOURNAL OF SURGERY
卷 219, 期 3, 页码 504-507出版社
EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
DOI: 10.1016/j.amjsurg.2019.09.006
关键词
Bariatric surgery; NASH; Non-alcoholic steatohepatitis; HCC; Hepatocellular carcinoma; Weight loss
类别
资金
- NCI Cancer Center Support Grant [P30 CA44579]
- University of Virginia
Introduction: Obesity is a risk factor for non-alcoholic steatohepatitis (NASH) and hepatocellular carcinoma (HCC). Bariatric surgery can provide durable weight-loss, but little is known about the later development of NASH and HCC after surgery. Methods: Bariatric surgery (n = 3,410) and obese controls (n = 46,873) from an institutional data repository were propensity score matched 1:1 by demographics, comorbidities, BMI, and socioeconomic factors. Comparisons were made through paired univariate analysis and conditional logistic regression. Results: Total of 4,112 patients were well matched with no significant baseline differences except initial BMI (49.0 vs 48.2, p = 0.04). Bariatric group demonstrated fewer new-onset NASH (6 0.0% vs 10.3%, p < 0.0001) and HCC (0.05% vs 0.34%, p = 0.03) over a median follow-up of 7.1 years. After riskadjustment, bariatric surgery was independently associated with reduced development of NASH (OR 0.52, p <0.0001). Conclusions: Bariatric surgery is associated with reduced incidence of NASH and HCC in this large propensity matched cohort. This further supports the use of bariatric surgery for morbidly obese patients to ameliorate NASH cirrhosis and development of HCC. (C) 2019 Published by Elsevier Inc.
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