P2617 - Comparison of Bariatric Surgery and Glucagon-Like Peptide-1 Analogs for Prevention of Nonalcoholic Fatty Liver Disease in an Obese Population: A Large Multi-Center Study

Ethan M.. Cohen, MD¹, Ayowumi A. Adekolu, MD¹, Soban A.. Maan, MD², Joyce Foryoung, MD¹, Shyam Thakkar, MD², Shailendra Singh, MD^2
1West Virginia University School of Medicine, Morgantown, WV; ²West Virginia University, Morgantown, WV

Introduction: Since the 1980s, the prevalence of obesity has nearly tripled across the globe. As obesity rates have risen, so too have obesity-related complications including hypertension, diabetes, cardiovascular events, and most recently, nonalcoholic fatty liver disease (NAFLD), among others. Several pharmacologic and surgical interventions like GLP-1 agonists and bariatric surgery (BS), have been developed to combat these long-term adverse health events. However, few large-scale studies have compared these methods directly. We aimed to compare the risk of NAFLD in patients who underwent BS with those who received GLP-1 analog treatment using a large, multi-center database.

Methods: This was a large, retrospective, population-based cohort study utilizing data from the TriNetX platform. Adult patients with a BMI of 35 or higher were included. Patients diagnosed with NAFLD before the index event, or up to one year after the index event were excluded. Patients in the BS group were matched with those in the GLP-1 analog group according to age, demographics, comorbidities, and medications by using 1:1 propensity matching. Cox proportional hazards model was used to estimate the hazard ratios (HRs).

Results: Prior to propensity matching, the BS cohort included 142,085 patients and the GLP-1 agonist group included 705,945 patients. After propensity matching, each cohort had 124,022 patients. The risk of NAFLD in the BS cohort was significantly lower than in the GLP cohort at various follow-up intervals (3, 5, 7, and 10 years).

Discussion: Our study found that, compared to GLP-1 analogs, BS was associated with a significantly lower risk of developing NAFLD.


Disclosures:


Ethan M.. Cohen, MD¹, Ayowumi A. Adekolu, MD¹, Soban A.. Maan, MD², Joyce Foryoung, MD¹, Shyam Thakkar, MD², Shailendra Singh, MD². P2617 - Comparison of Bariatric Surgery and Glucagon-Like Peptide-1 Analogs for Prevention of Nonalcoholic Fatty Liver Disease in an Obese Population: A Large Multi-Center Study, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.