Effects of semaglutide vs bariatric surgery on noninvasive markers of hepatic steatosis and fibrosis in obesity with metabolic dysfunction-associated steatotic liver disease
Authors' conclusion
Semaglutide and LSG both improved non-invasive markers for hepatic steatosis and fibrosis, whereas lifestyle intervention alone showed limited benefit.
Study context
- Population
- Adults with obesity and MASLD; all had hepatic steatosis at baselineanalysed over 72 weeks
- Participants
- 92 adults
- Exposure
- Lifestyle vs lifestyle plus semaglutide vs lifestyle plus laparoscopic sleeve gastrectomy
- LIFESTYLEn = 30reference
- SEMAn = 30
- SURGERYn = 32
- Outcome
- Change in controlled attenuation parameter (CAP)
- Follow-up
- 72 weeks
Methodological detailssingle-centre, observational
- Single-centre
- Observational
Main finding
As reported in the abstract
LIFESTYLE
−17.9
± 14.0 · dB/m
SEMA
−46.0
± 14.0 · dB/m
SURGERY
−83.7
± 10.0 · dB/m
Overall p = 0.002
- Controlled attenuation parameter (CAP) decreased significantly over 72 weeks
- P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | LIFESTYLE | SEMA | SURGERY | P value |
|---|---|---|---|---|
| Liver stiffness measurement (LSM) change · 72 weeksLIFESTYLE vs SEMA · overall comparison of the 3 groups, including SURGERY | −0.8 (SD 1.0) kPa | −2.8 (SD 0.8) kPa | −4.9 (SD 1.1) kPa | overall p < 0.001 |
| Liver stiffness measurement (LSM) change · 72 weeksSEMA vs SURGERY · no significant difference | P = 0.428 |
Liver stiffness measurement (LSM) change · 72 weeks
- Baseline LSM differed between groups
FibroScan-AST (FAST) score · 72 weeks
- FAST scores decreased significantly over time across all groups
- P < 0.001
FIB-4 · 72 weeks
- FIB-4 increased modestly after SURGERY
- +0.29; p < 0.001
- FIB-4 stable in SEMA and LIFESTYLE
- both p > 0.3
Weight loss · 72 weeks
- Weight loss (in the order LIFESTYLE, SEMA, SURGERY as listed in the abstract)
- −4.2 ± 1.8, −10.7 ± 1.5 and −31.6 ± 1.5%
Weight dependence of LSM improvement
- LSM improvement weight-dependent in SURGERY
- P = 0.027
- LSM improvement in SEMA independent of weight change
- P = 0.508
Original publication
Effects of semaglutide vs bariatric surgery on noninvasive markers of hepatic steatosis and fibrosis in obesity with metabolic dysfunction-associated steatotic liver disease. J Clin Endocrinol Metab. Published 27 August 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →