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Bariatric surgery and the liver—Mechanisms, benefits, and risks
Author(s) -
Lefere Sander,
Onghena Louis,
Vanlander Aude,
Nieuwenhove Yves,
Devisscher Lindsey,
Geerts Anja
Publication year - 2021
Publication title -
obesity reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.845
H-Index - 162
eISSN - 1467-789X
pISSN - 1467-7881
DOI - 10.1111/obr.13294
Subject(s) - medicine , nonalcoholic fatty liver disease , fatty liver , cirrhosis , insulin resistance , obesity , liver transplantation , adipose tissue , liver disease , weight loss , type 2 diabetes , diabetes mellitus , surgery , intensive care medicine , disease , bioinformatics , transplantation , endocrinology , biology
Summary The prevalence of obesity and metabolic diseases such as type 2 diabetes and nonalcoholic fatty liver disease (NAFLD) has risen dramatically over the past decades. At present, bariatric surgery is the most effective treatment for this global health problem, through effects on food intake, gut hormone secretion, metabolic signaling pathways, and adipose tissue dysfunction. The liver occupies a central role in carbohydrate, protein, and lipid metabolism. Notably, a reduction in hepatic fat content and an improvement in hepatic insulin resistance are among the earliest beneficial effects of bariatric surgery, which has therefore emerged as an attractive treatment option for NAFLD. However, as the scope and popularity of weight loss surgery have expanded, new questions have arisen regarding its safety in patients with liver cirrhosis, the outcome of liver transplantation in patients with a history of bariatric surgery, and over incidental reports of liver failure following surgery. Studies in humans and rodents have also linked bariatric surgery to an increased risk of developing alcohol use disorder, a major risk factor for liver disease. This review integrates data from clinical and translational research to delineate both the beneficial impact of bariatric surgery on the liver and the potential risks involved.