Obesity and non-alcohol-related fatty liver disease (NAFLD) are two interlinked health conditions that pose significant risks for cardiovascular disease (CVD). CVD is a leading cause of morbidity and mortality worldwide, and addressing the underlying risk factors is critical in mitigating its impact. Bariatric surgery, a weight loss procedure, has been shown to improve CVD outcomes in patients with obesity, but its effects on NAFLD-associated CVD risks have not been sufficiently explored. In this article, we explore the emerging evidence that suggests bariatric surgery as an effective intervention for reducing CVD risks associated with obesity and NAFLD.
Non-alcoholic fatty liver disease (NAFLD) is a common metabolic disorder associated with obesity, insulin resistance, type 2 diabetes, dyslipidemia, and hypertension. Studies suggest that NAFLD increases the risk of all-cause mortality, with cardiovascular diseases (CVDs) being the leading cause of death. Bariatric surgery (BS) is a weight-loss intervention, proven to be beneficial in patients with obesity. It may also be useful for patients with obesity and NAFLD to maintain long-term weight loss. However, it is unclear whether BS significantly impacts cardiovascular outcomes in patients with NAFLD.
A retrospective cohort study measured the association of BS with major adverse cardiovascular events and all-cause mortality in patients with NAFLD. The data collected from electronic health records identified eligible patients from January 2005 to December 2021, divided into two groups – those who underwent BS and those who did not undergo BS. The two groups were matched to each other using 1:1 propensity score matching (PSM). The primary outcome studied was the incidence of major adverse cardiovascular events, including new onset heart failure (HF), composite cardiovascular events, composite cerebrovascular events, and composite coronary artery interventions. The study found that patients with obesity and NAFLD undergoing BS had a significantly lower risk of major adverse cardiovascular outcomes and all-cause mortality than patients who did not receive BS.
The cohort study results showed that patients with obesity and NAFLD who received BS had a significantly lower risk of new onset HF, composite cardiovascular events, composite cerebrovascular events, and composite coronary artery interventions compared with the non-BS group. Furthermore, all-cause mortality was significantly lower in the BS group than in the non-BS group. The study also demonstrated that the risks of 1-, 3-, 5-, and 7-year all-cause mortality were significantly lower in the BS group than the matched non-BS controls.
The study has its limitations, including the nature of the data collected from electronic health records, creating a susceptibility to errors in coding or data entry. Nevertheless, the results suggest that BS is an effective intervention for improving long-term adverse cardiovascular outcomes in patients with obesity and NAFLD. Further research is required to study the impact of BS on NAFLD in prospective studies.
In conclusion, bariatric surgery is proving to be a game-changer in the management of obesity and non-alcohol-related fatty liver disease. This procedure not only helps patients achieve significant weight loss but also leads to better cardiovascular outcomes. The findings from this study provide further evidence of the therapeutic benefits of bariatric surgery. The safety and efficacy of this procedure can help curtail the progression of obesity-related diseases such as diabetes, hypertension, and cardiovascular disease. As research in this area continues, we may soon see a significant shift towards bariatric surgery as a standard treatment option for individuals struggling with obesity and related co-morbidities.
