مرض الكبد الدهني المرتبط بالخلل الأيضي: عندما لا يحقق التدخل الوقائي للكبد في نمط الحياة أهداف تحسين NASH والتليف

References

DOI: 10.1097/HEP.0000000000000323

• Bariatric surgery should be considered as a therapeutic option in patients who meet criteria for metabolic weight loss surgery, as it effectively resolves NAFLD or NASH in the majority of patients without cirrhosis and reduces mortality from CVD and malignancy.
• Although currently accepted criteria for bariatric surgery are BMI ≥ 40 kg/m2 irrespective of metabolic comorbid disease or BMI ≥ 35 kg/m2 with comorbidities (T2DM or pre-DM, uncontrolled hypertension, osteoarthritis of hip or knee, urinary incontinence), NAFLD/NASH is increasingly accepted as a comorbid condition benefitting from bariatric surgery.
• Decompensated cirrhosis should be considered an absolute contraindication for bariatric surgery due to increased risk and unproven liver-related benefit, unless performed in conjunction with liver transplantation at experienced centers.
• Bariatric surgery can resolve NASH, improve hepatic fibrosis, induce sustained weight loss of up to 30%, cure diabetes, and decrease all-cause morbidity and mortality.