{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:58:16Z","timestamp":1786121896339,"version":"build-2736575974"},"reference-count":40,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T00:00:00Z","timestamp":1776038400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T00:00:00Z","timestamp":1776038400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>We compared the impact of metabolic bariatric surgery (MBS) versus semaglutide on clinical outcomes in individuals with metabolic dysfunction\u2010associated steatotic liver disease (MASLD) and type 2 diabetes (T2D).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with MASLD and T2D who had MBS or semaglutide in 2018\u20132023 were identified (TriNetX database). The primary outcome was a composite of major adverse liver outcomes (MALO): decompensation events or liver transplant. Secondary outcomes included a composite of major adverse cardiovascular events (MACE), first diagnosis of cirrhosis, heart failure, or obesity\u2010associated cancer (OAC), and all\u2010cause mortality (ACM). Subgroup analyses were performed for Roux\u2010en\u2010Y gastric bypass (RYGB) and sleeve gastrectomy (SG).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>MBS, compared with semaglutide, was associated with a higher hazard rate (HR) of MALO (HR 1.63; 95% CI 1.12\u20132.37); this was driven by RYGB (2.01; 1.26\u20133.20) but not by SG (0.97; 0.52\u20131.78). However, after excluding patients with pre\u2010existing cirrhosis, MBS was associated with a reduced HR of new cirrhosis (0.46; 0.29\u20130.73). For extrahepatic events, MBS was associated with a reduced HR of MACE (0.51; 0.38\u20130.67), heart failure (0.41; 0.27\u20130.62), and OAC (0.56; 0.34\u20130.92). There was no difference in ACM between MBS and semaglutide, but in subgroup analysis, RYGB was associated with increased ACM compared to semaglutide (1.64; 1.01\u20132.67).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In patients with MASLD and T2D, MBS, and specifically RYGB, as compared to semaglutide, may drive a relatively increased risk of MALO despite protection against MACE, the first diagnosis of cirrhosis, heart failure, and OAC. Liver evaluation in individuals with T2D referred for MBS may help optimize their treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.70757","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T09:34:53Z","timestamp":1776072893000},"page":"5684-5695","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Differential Impact of Metabolic Bariatric Surgery Versus Semaglutide on Adverse Hepatic and Extrahepatic Outcomes in Individuals With Metabolic Dysfunction\u2010Associated Steatotic Liver Disease and Type 2 Diabetes"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1230-7651","authenticated-orcid":false,"given":"Weronika","family":"Stupalkowska","sequence":"first","affiliation":[{"name":"Department of Cardiovascular and Metabolic Medicine Institute of Life Course and Medical Sciences, University of Liverpool  Liverpool UK"},{"name":"Laboratory for Surgical and Metabolic Research Brigham and Women's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex E.","family":"Henney","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Metabolic Medicine Institute of Life Course and Medical Sciences, University of Liverpool  Liverpool UK"},{"name":"Metabolism &amp; Nutrition Research Group Liverpool University Hospitals NHS Foundation Trust  Liverpool Merseyside UK"},{"name":"Liverpool Centre for Cardiovascular Sciences University of Liverpool and Liverpool University Hospitals NHS Foundation Trust  Liverpool Merseyside UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David R.","family":"Riley","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Metabolic Medicine Institute of Life Course and Medical Sciences, University of Liverpool  Liverpool UK"},{"name":"Metabolism &amp; Nutrition Research Group Liverpool University Hospitals NHS Foundation Trust  Liverpool Merseyside UK"},{"name":"Liverpool Centre for Cardiovascular Sciences University of Liverpool and Liverpool University Hospitals NHS Foundation Trust  Liverpool Merseyside UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2707-1768","authenticated-orcid":false,"given":"Eric G.","family":"Sheu","sequence":"additional","affiliation":[{"name":"Laboratory for Surgical and Metabolic Research Brigham and Women's Hospital  Boston Massachusetts USA"},{"name":"Division of General and GI Surgery Mass General Brigham  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uazman","family":"Alam","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Metabolic Medicine Institute of Life Course and Medical Sciences, University of Liverpool  Liverpool UK"},{"name":"Metabolism &amp; Nutrition Research Group Liverpool University Hospitals NHS Foundation Trust  Liverpool Merseyside UK"},{"name":"Liverpool Centre for Cardiovascular Sciences University of Liverpool and Liverpool University Hospitals NHS Foundation Trust  Liverpool Merseyside UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel J.","family":"Cuthbertson","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Metabolic Medicine Institute of Life Course and Medical Sciences, University of Liverpool  Liverpool UK"},{"name":"Metabolism &amp; Nutrition Research Group Liverpool University Hospitals NHS Foundation Trust  Liverpool Merseyside UK"},{"name":"Liverpool Centre for Cardiovascular Sciences University of Liverpool and Liverpool University Hospitals NHS Foundation Trust  Liverpool Merseyside UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,13]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)01811-7"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/HEP.0000000000000520"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/HEP.0000000000000604"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.3350\/cmh.2024.0431"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.14825"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.16016"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2024.0318"},{"key":"e_1_2_9_9_1","doi-asserted-by":"crossref","first-page":"403","DOI":"10.2147\/DMSO.S141235","article-title":"Reasons for Discontinuation of GLP1 Receptor Agonists: Data From a Real\u2010World Cross\u2010Sectional Survey of Physicians and Their Patients With Type 2 Diabetes","volume":"10","author":"Sikirica M. 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