Evidence mapPaperPMID 41804193Full record

SynthesisDiabetes, obesity & metabolism2026

Weight Loss as a Determinant of Histological Improvement in Metabolic Dysfunction-Associated Steatotic Liver Disease in People With Obesity. A Systematic Review and Network Meta-Analysis of Randomised Clinical Trials.

Matteo Monami, Amanda Belluzzi, Silvio Buscemi, Luca Busetto, Ricardo Cohen, Maurizio De Luca, Andrea Galli, Edoardo Mannucci, Tarissa Z Petry, Benedetta Ragghianti and 2 more

Abstract readSystematic ReviewNetwork Meta-Analysis
In one paragraph

Synthesis in Diabetes, obesity & metabolism, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Matteo MonamiCareggi Teaching Hospital and University of Florence, Florence, Italy.ORCID https://orcid.org/0000-0001-9349-828X
Amanda BelluzziRovigo Hospital, ULSS5 Polesana, Rovigo, Italy.
Silvio BuscemiDepartment of Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza (PROMISE), University of Palermo, Palermo, Italy.ORCID https://orcid.org/0000-0003-0730-7649
Luca BusettoDepartment of Medicine, University of Padova, Padova, Italy.
Ricardo CohenThe Center for Obesity and Diabetes, Hospital Alemao Oswaldo Cruz, Sao Paulo, Brazil.
Maurizio De LucaRovigo Hospital, ULSS5 Polesana, Rovigo, Italy.
Andrea GalliCareggi Teaching Hospital and University of Florence, Florence, Italy.
Edoardo MannucciCareggi Teaching Hospital and University of Florence, Florence, Italy.ORCID https://orcid.org/0000-0001-9759-9408
Tarissa Z PetryThe Center for Obesity and Diabetes, Hospital Alemao Oswaldo Cruz, Sao Paulo, Brazil.
Benedetta RagghiantiCareggi Teaching Hospital and University of Florence, Florence, Italy.
Paolo SbracciaDepartment of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
Dror DickerInternal Medicine D and Obesity Clinic, Hasharon Hospital-Rabin Medical Center, Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMetabolic dysfunction-associated steatotic liver disease (MASLD) is closely linked to obesity and insulin resistance, and sustained weight loss is associated with histological improvement. Whether different obesity-management modalities exert weight-independent hepatic effects remains uncertain.

methodsWe conducted a systematic review and network meta-analysis (NMA) of randomised controlled trials evaluating lifestyle intervention, obesity management medications, endoscopic sleeve gastroplasty and metabolic and bariatric surgery in adults with BMI ≥ 27 kg/m

resultsSix RCTs (n = 1379) met inclusion criteria. Tirzepatide, semaglutide, sleeve gastrectomy and Roux-en-Y gastric bypass were superior to placebo or standard care for achieving MASH resolution. Because the network was weakly connected and largely placebo-anchored, indirect estimates were imprecise. Across study arms, greater TBWL% was associated with higher rates of MASH resolution and fibrosis improvement; however, these associations were strongly influenced by a small number of high-weight-loss surgical arms.

conclusionsWeight loss was consistently associated with histologic improvement across available RCTs. However, the limited evidence base, sparse network structure and ecological nature of the meta-regression preclude causal inference. These findings should be considered exploratory and hypothesis-generating, underscoring the need for adequately powered head-to-head trials.

Indexed as

Fatty LiverNon-alcoholic Fatty Liver DiseaseObesityWeight LossAnti-Obesity AgentsBariatric SurgeryHumansLiverMetabolic DiseasesRandomized Controlled Trials as TopicSemaglutideTirzepatideTreatment OutcomeAnti-Obesity AgentsSemaglutideTirzepatideendoscopic bariatric proceduresmetabolic bariatric surgerymetabolic dysfunction‐associated steatotic liver diseasenetwork meta‐analysisobesityobesity management medications

Identifiers

PMID41804193
PMCPMC13071265

What Socratic holds

Texttitle and abstract
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.