{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T11:33:15Z","timestamp":1790249595525,"version":"4.1.0"},"reference-count":20,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,7,12]],"date-time":"2025-07-12T00:00:00Z","timestamp":1752278400000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Endocrino Diabet &amp;amp; Metabol"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Nonalcoholic 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\u2010like peptide\u20101 receptor agonists (GLP\u20101 RAs) have been explored for their impact on liver\u2010related outcomes. This study evaluates the comparative effectiveness of BS and GLP\u20101 RAs in reducing the incidence of new\u2010onset NASH and related hepatic complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a large, population\u2010based, 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\u20101RA between January 1, 2014 and December 31, 2019, were included. Patients in the BS group were matched with patients in the GLP\u20101RA group according to age, demographics, comorbidities and medication by using 1:1 propensity matching.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 180,022 eligible adults, 143,404 underwent BS, while 36,618 received GLP\u20101 RA therapy. Following propensity score matching, 33,594 patients in the BS group (mean age 49.1\u2009\u00b1\u200913.2\u2009years; 72.73% female) were matched to an equal number of individuals in the GLP\u20101 RA group (mean age 48.9\u2009\u00b1\u200914.0\u2009years; 72.41% female). Compared to those receiving GLP\u20101 RA therapy, patients who underwent BS had a significantly lower risk of HCC (HR, 0.304; 95% CI, 0.099\u20130.931), which showed the strongest protective effect, followed by a substantial reduction in NASH (HR, 0.509; 95% CI, 0.469\u20130.551). The reduction in liver cirrhosis risk was not statistically significant (HR, 0.865; 95% CI, 0.696\u20131.075). These associations remained across follow\u2010up periods of 1, 3, 5 and 7\u2009years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>These findings suggest that BS was significantly associated with lower risk of new onset of NASH\/NAFLD.<\/jats:p><\/jats:sec>","DOI":"10.1002\/edm2.70075","type":"journal-article","created":{"date-parts":[[2025,7,12]],"date-time":"2025-07-12T15:23:18Z","timestamp":1752333798000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Comparative Effectiveness of Bariatric Surgery Versus <scp>GLP\u20101<\/scp> Receptor Agonists in Reducing the Risk of New\u2010Onset of <scp>NASH<\/scp>: A Retrospective Multinational Cohort Study From North America and Europe"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2408-2691","authenticated-orcid":false,"given":"Abdallah","family":"Hussein","sequence":"first","affiliation":[{"name":"Internal Medicine Department Virtua Health Inc.  Voorhees New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5122-8200","authenticated-orcid":false,"given":"Ameer","family":"Awashra","sequence":"additional","affiliation":[{"name":"Department of Medicine An Najah National University  Nablus Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6539-0417","authenticated-orcid":false,"given":"Islam","family":"Rajab","sequence":"additional","affiliation":[{"name":"Internal Medicine Department St. Joseph's University Medical Center  Paterson New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8968-7034","authenticated-orcid":false,"given":"Mohammad","family":"Bdair","sequence":"additional","affiliation":[{"name":"Department of Medicine An Najah National University  Nablus Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0164-3268","authenticated-orcid":false,"given":"Dawoud","family":"Hamdan","sequence":"additional","affiliation":[{"name":"Department of Medicine An Najah National University  Nablus Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6397-8033","authenticated-orcid":false,"given":"Ahmad","family":"Nouri","sequence":"additional","affiliation":[{"name":"Department of Medicine An Najah National University  Nablus Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elaf","family":"Khatib","sequence":"additional","affiliation":[{"name":"College of Health Professions, Thomas Jefferson University  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghiras","family":"Khatib","sequence":"additional","affiliation":[{"name":"School of Public Health, Drexel University  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nyan","family":"Latt","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology Virtua Health Inc.  Voorhees New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,12]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/HC9.0000000000000561"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/CRD.0000000000000932"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.14565"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2024.4661"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/oby.24002"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/metabo11020073"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468\u20101253(22)00338\u20107"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2025.1516126"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.4254\/wjh.v16.i10.1142"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.15607"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.222695"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.18553\/jmcp.2024.30.9\u2010a.s1"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/08971900241253661"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.2147\/DDDT.S404055"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1159\/000371699"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2020.06.006"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2401943"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc19\u20101892"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(21)00591\u20102"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.15392"}],"container-title":["Endocrinology, Diabetes &amp; Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/edm2.70075","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,26]],"date-time":"2025-07-26T08:37:39Z","timestamp":1753519059000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/edm2.70075"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7]]},"references-count":20,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1002\/edm2.70075"],"URL":"https:\/\/doi.org\/10.1002\/edm2.70075","archive":["Portico"],"relation":{},"ISSN":["2398-9238","2398-9238"],"issn-type":[{"value":"2398-9238","type":"print"},{"value":"2398-9238","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7]]},"assertion":[{"value":"2025-03-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70075"}}