Bariatric Surgery Lowers Heart Risk in People With Fatty Liver Disease

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Bariatric Surgery Lowers Heart Risk in People With Fatty Liver Disease

Undergoing bariatric (weight-loss) surgery was linked to a lower risk for cardiovascular events — like a heart attack or stroke — in people with nonalcoholic fatty liver disease (NAFLD), according to a new study published in the journal JAMA Network Open.

Bariatric surgery has previously been shown to offer major health benefits related to both NAFLD and cardiovascular disease — in addition to its beneficial effect on type 2 diabetes. In people with type 2 diabetes and obesity, bariatric surgery has been shown to reduce liver fat and the risk for NAFLD — a major and overlooked problem in people with type 2 diabetes. The surgery has also been shown to reduce the risk for death from cardiovascular causes, as well as the risk for death from all causes within a specified period of time. Gastric bypass, in particular — a form of bariatric surgery that involves reducing the stomach to a small pouch — has been shown to reduce the risk for cardiovascular events in people with type 2 diabetes.

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For the latest study, researchers looked at the effects of undergoing bariatric surgery in a group of 86,964 adults ages 18 to 64 with NAFLD and severe obesity. None of the participants had a history of cardiovascular disease before their diagnosis of NAFLD. The average age of participants was 44, and 30,300 underwent bariatric surgery as part of the study, while 56,664 received standard nonsurgical care for their NAFLD.

Bariatric surgery linked to lower risk for cardiovascular events in NAFLD

During a follow-up period lasting an average of 21 months, 1,568 participants who underwent bariatric surgery (5.2%) experienced a cardiovascular event — either a heart attack, an ischemic stroke (stroke caused by a clot), or heart failure. During the same period, 7,215 participants who received standard nonsurgical care (12.7%) had a cardiovascular event. Once the researchers adjusted for differences in cardiovascular risk between the two groups, they found that that for every 100 years of living, members of the nonsurgical group experienced 4.8 more cardiovascular events. What’s more, by the end of the study, bariatric surgery was linked to a 49% lower overall risk for cardiovascular disease — a category that includes not just cardiovascular events but disease processes like atherosclerosis (narrowing of arteries due to buildup of a fatty substance called plaque).

The researchers noted that there could be several different explanations for why the loss of body fat — and especially liver fat — could improve cardiovascular outcomes in people with NAFLD. Excess liver fat may contribute to inflammation throughout the body, they wrote, which can contribute to atherosclerosis and other cardiovascular disease processes. Fat tissue is also known to release substances that change how the body both builds and breaks down blood clots — potentially explaining the increased risk for heart attack and stroke that the study found.

The study’s findings “provide evidence in support of bariatric surgery as an effective therapeutic tool” for people with NAFLD and obesity, the researchers concluded. “Although bariatric surgery is a more aggressive approach than lifestyle modifications, it may be associated with other benefits, such as improved quality of life and decreased long-term health care burden.”

Want to learn more about fatty liver disease? Read “Diabetes and NAFLD” and “Preventing Fatty Liver (NAFLD).” 

Quinn Phillips

Quinn Phillips

Quinn Phillips on social media

A freelance health writer and editor based in Wisconsin, Phillips has a degree from Harvard University. He is a former Editorial Assistant for Diabetes Self-Management and has years of experience covering diabetes and related health conditions. Phillips writes on a variety of topics, but is especially interested in the intersection of health and public policy.

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