Evidence map›Paper›PMID 25917981›Full record

SynthesisObesity surgery2015

Bariatric Surgery and Non-Alcoholic Fatty Liver Disease: a Systematic Review of Liver Biochemistry and Histology.

Guy Bower, Tania Toma, Leanne Harling, Long R Jiao, Evangelos Efthimiou, Ara Darzi, Thanos Athanasiou, Hutan Ashrafian

Registry-linked trialAbstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Obesity surgery, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05667558 (Assessment of Intake of Energy and Selected Nutrients, Nutritional Status, Body Composition and Biochemical Parameters of Obese Patients Before and After Bariatric Surgery), which is not on this map. Cited by 115 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
115citing papers in PubMed, 7 pooled it
16.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05667558 completednot on this mapstarted 2017, after this paper: background citation

Assessment of Intake of Energy and Selected Nutrients, Nutritional Status, Body Composition and Biochemical Parameters of Obese Patients Before and After Bariatric Surgery

TypeobservationalSponsorMedical University of BialystokRan2017 to 2018Enrolled30ConditionsObesity
3 · Its place in the literature

Who cites it

115 citing papers in PubMed, 7 syntheses or guidelines pooled it, 255 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Guideline
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Trial
  9. Trial
  10. Trial
  11. Article
  12. Article
  13. Article
  14. Review
  15. Article
  16. Article
  17. Review
  18. Bariatric surgery for treatment of morbid obesity in adults.The Korean journal of internal medicine · 2025
    Review
  19. Article
  20. Review

55 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

Guy BowerDepartment of Surgery and Cancer, Imperial College London, London, UK.
Tania TomaDepartment of Surgery and Cancer, Imperial College London, London, UK.
Leanne HarlingDepartment of Surgery and Cancer, Imperial College London, London, UK.
Long R JiaoDepartment of Surgery and Cancer, Imperial College London, London, UK.
Evangelos EfthimiouDepartment of Surgery and Cancer, Imperial College London, London, UK.
Ara DarziDepartment of Surgery and Cancer, Imperial College London, London, UK.
Thanos AthanasiouDepartment of Surgery and Cancer, Imperial College London, London, UK.
Hutan AshrafianDepartment of Surgery and Cancer, Imperial College London, London, UK. h.ashrafian@imperial.ac.uk.
Imperial College London · GBChelsea and Westminster Hospital · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNon-alcoholic fatty liver disease (NAFLD) is becoming a leading cause of global liver disease that is associated with the rising prevalence of obesity worldwide. There is now increasing clinical and mechanistic evidence reporting on the metabolic and weight loss effects of bariatric surgery on improving NAFLD in obese patients.

objectivesThe aim of this paper was to quantify the effects of bariatric surgery on NAFLD by appraising the modulation between pre- and post-operative liver enzyme levels (as markers of liver injury) and liver histology.

methodsA systematic review of studies reporting pre-operative and post-operative liver enzymes or liver histology was done in obese patients with NAFLD undergoing bariatric surgery. Data were meta-analysed using random-effects modelling. Subgroup analysis, quality scoring and risk of bias were assessed.

resultsBariatric surgery is associated with a significant reduction in the weighted incidence of a number of histological features of NAFLD including steatosis (50.2 and 95 %CI of 35.5-65.0), fibrosis (11.9 and 95 %CI of 7.4-16.3 %), hepatocyte ballooning (67.7 and 95 %CI 56.9-78.5) and lobular inflammation (50.7 and 95 %CI 26.6-74.8 %). Surgery is also associated with a reduction in liver enzyme levels, with statistically significant reductions in ALT (11.36 u/l, 95 %CI 8.36-14.39), AST (3.91 u/l, 95 %CI 2.23-5.59), ALP (10.55 u/l, 95 %CI 4.40-16.70) and gamma-GT (18.39 u/l, 95 %CI 12.62-24.16). Heterogeneity in results was high.

conclusionsBariatric surgery is associated with a significant improvement in both histological and biochemical markers of NAFLD. Future studies must focus on higher levels of evidence to better identify the benefits of bariatric surgery on liver disease in order to enhance future treatment strategies in the management of NAFLD.

Indexed as

Bariatric SurgeryBiomarkersFemaleHumansIncidenceLiverLiver Function TestsMaleNon-alcoholic Fatty Liver DiseaseObesity, MorbidPrevalenceBiomarkersBariatric surgeryBody mass indexInterventionMetabolic surgeryNAFLDNon-alcoholic fatty liver diseaseSurgeryWeight loss

Identifiers

PMID25917981
OpenAlexW1984603193

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.