Obesity and its influence on liver dysfunction, morbidity and mortality after liver resection

Abstract

Background: Obesity and associated steatosis is an increasing health problem worldwide. Its influence on post-hepatectomy liver failure (PHLF) and after liver resection (LR) is still unclear.Methods: Patients who underwent LR were investigated and divided into three groups [normal weight: body mass index (BMI) 18.5-24.9 kg/m 2 , overweight: BMI 25.0-29.9 kg/m 2 , obese: BMI ≥30 kg/m 2 ] in this retrospective study. Primary aim of this study was to assess the influence of BMI and nonalcoholic steatohepatitis (NASH) on PHLF and morbidity.Results: Of 888 included patients, 361 (40.7%) had normal weight, 360 (40.5%) were overweight, 167 (18.8%) were obese. Median age was 62.5 years (IQR, 54-69 years). The primary indication for LR was colorectal liver metastases (CLM) (n=366, 41.2%). NASH was present in 58 (16.1%) of normal weight, 84 (23.3%) of overweight and 69 (41.3%) of obese patients (P<0.001). PHLF occurred in 16.3% in normal weight, 15.3% in overweight and 11.4% in obese patients (P=0.32). NASH was not associated with PHLF.There was no association between patients' weight and the occurrence of postoperative complications (P=0.45). At multivariable analysis solely major LR (OR 2.7, 95% CI: 1.83-4.04; P<0.001) remained a significant predictor for PHLF.Conclusions: Postoperative complications and PHLF are comparable in normal weight, overweight and obese patients and LRs using modern techniques can be safely performed in these patients.

Investigating the causal association between obesity and risk of hepatocellular carcinoma and underlying mechanisms

“…HCC stands as the most common primary liver malignancy and ranks among the top causes of cancer-related fatalities worldwide 10 , 26 . Prior studies have demonstrated that the risk of HCC increases by 17% in overweight individuals and rises to 89% in those with obesity, underscoring the association between the severity of metabolic imbalances and liver pathology 27 , 28 . Various mechanisms have been identified that potentially connect obesity to the development of cancers like HCC.…”