Evidence map›Paper›PMID 40650867›Full record

ArticleEndocrinology, diabetes & metabolism2025

Comparative Effectiveness of Bariatric Surgery Versus GLP-1 Receptor Agonists in Reducing the Risk of New-Onset of NASH: A Retrospective Multinational Cohort Study From North America and Europe.

Abdallah Hussein, Ameer Awashra, Islam Rajab, Mohammad Bdair, Dawoud Hamdan, Ahmad Nouri, Elaf Khatib, Ghiras Khatib, Nyan Latt

Abstract readComparative StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Endocrinology, diabetes & metabolism, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
  4. Review
  5. Review
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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

9 authors.

Abdallah HusseinInternal Medicine Department, Virtua Health Inc., Voorhees, New Jersey, USA.ORCID https://orcid.org/0000-0002-2408-2691
Ameer AwashraDepartment of Medicine, An Najah National University, Nablus, Palestine.ORCID https://orcid.org/0009-0002-5122-8200
Islam RajabInternal Medicine Department, St. Joseph's University Medical Center, Paterson, New Jersey, USA.ORCID https://orcid.org/0009-0003-6539-0417
Mohammad BdairDepartment of Medicine, An Najah National University, Nablus, Palestine.ORCID https://orcid.org/0000-0002-8968-7034
Dawoud HamdanDepartment of Medicine, An Najah National University, Nablus, Palestine.ORCID https://orcid.org/0009-0000-0164-3268
Ahmad NouriDepartment of Medicine, An Najah National University, Nablus, Palestine.ORCID https://orcid.org/0009-0002-6397-8033
Elaf KhatibCollege of Health Professions, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Ghiras KhatibSchool of Public Health, Drexel University, Philadelphia, Pennsylvania, USA.
Nyan LattGastroenterology and Hepatology, Virtua Health Inc., Voorhees, New Jersey, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNonalcoholic steatohepatitis (NASH) is a severe form of nonalcoholic fatty liver disease (NAFLD) that can progress to cirrhosis and hepatocellular carcinoma (HCC). Obesity is a major risk factor for NASH, and metabolic interventions such as bariatric surgery (BS) and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have been explored for their impact on liver-related outcomes. This study evaluates the comparative effectiveness of BS and GLP-1 RAs in reducing the incidence of new-onset NASH and related hepatic complications.

methodsThis was a large, population-based, retrospective cohort using data from the TriNetX platform. Adult patients with a body mass index (BMI, of 35 or greater and without a history of NAFLD/NASH (without cirrhosis) who underwent BS versus GLP-1RA between January 1, 2014 and December 31, 2019, were included. Patients in the BS group were matched with patients in the GLP-1RA group according to age, demographics, comorbidities and medication by using 1:1 propensity matching.

resultsAmong 180,022 eligible adults, 143,404 underwent BS, while 36,618 received GLP-1 RA therapy. Following propensity score matching, 33,594 patients in the BS group (mean age 49.1 ± 13.2 years; 72.73% female) were matched to an equal number of individuals in the GLP-1 RA group (mean age 48.9 ± 14.0 years; 72.41% female). Compared to those receiving GLP-1 RA therapy, patients who underwent BS had a significantly lower risk of HCC (HR, 0.304; 95% CI, 0.099-0.931), which showed the strongest protective effect, followed by a substantial reduction in NASH (HR, 0.509; 95% CI, 0.469-0.551). The reduction in liver cirrhosis risk was not statistically significant (HR, 0.865; 95% CI, 0.696-1.075). These associations remained across follow-up periods of 1, 3, 5 and 7 years.

conclusionsThese findings suggest that BS was significantly associated with lower risk of new onset of NASH/NAFLD.

Indexed as

Bariatric SurgeryGlucagon-Like Peptide-1 Receptor AgonistsNon-alcoholic Fatty Liver DiseaseObesityAdultEuropeFemaleHumansMaleMiddle AgedNorth AmericaRetrospective StudiesTreatment OutcomeGlucagon-Like Peptide-1 Receptor Agonistsbariatric surgeryGLP‐1 receptor agonistshepatocellular carcinomaliver cirrhosismetabolic dysfunctionnonalcoholic steatohepatitis (NASH)obesitypropensity score matchingreal‐world dataretrospective cohort study

Identifiers

PMID40650867
PMCPMC12255231

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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.