Multidisciplinary lifestyle intervention is associated with improvements in liver damage and in surrogate scores of NAFLD and liver fibrosis in morbidly obese patients
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Published:2022-03-11
Issue:5
Volume:61
Page:2725-2735
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ISSN:1436-6207
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Container-title:European Journal of Nutrition
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language:en
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Short-container-title:Eur J Nutr
Author:
Bischoff Monika, Zimny Sebastian, Feiner Sebastian, Sauter Johannes, Sydor Svenja, Denk Gerald, Nagel Jutta M., Bischoff Gert, Rust Christian, Hohenester SimonORCID
Abstract
Abstract
Purpose
Non-alcoholic fatty liver disease (NAFLD) is the hepatic manifestation of the metabolic syndrome. Particularly morbidly obese patients are at risk of developing progressive liver disease. Nutritional and lifestyle intervention is recommended as the standard of care in NAFLD. However, there is a striking lack of evidence to support the efficacy of lifestyle intervention to treat NAFLD in morbidly obese patients. Here, we aimed to assess the impact of lifestyle intervention on NAFLD in the morbidly obese in a real-world setting.
Methods
136 obese patients were included in an industry-independent, multiprofessional lifestyle intervention program with a lead-in phase of 12 weeks of formula diet and a total of 48 weeks intensive counselling. Body weight and markers of the metabolic syndrome were analyzed. Presence of NAFLD was screened for by use of non-invasive markers of fatty liver, non-alcoholic steatohepatitis and liver fibrosis.
Results
Weight loss goals (i.e. > 5% or > 10% of initial body weight, respectively, depending on baseline BMI) were achieved in 89.7% of subjects in the intention-to-treat analysis and 93.9% in the per-protocol analysis. This was associated with a pronounced improvement in serum ALT values. The percentage of subjects who fulfilled non-invasive criteria for fatty liver dropped from 95.2 to 54.8%. Risk of NASH improved and the number of patients at risk of liver fibrosis declined by 54.1%.
Conclusion
Lifestyle intervention was associated with a marked improvement of serum ALT and an improvement of surrogate scores indicative of NAFLD and, importantly, advanced fibrosis, in a real-world cohort of morbidly obese patients.
Funder
deutsche forschungsgemeinschaft Ludwig-Maximilians-Universität München
Publisher
Springer Science and Business Media LLC
Subject
Nutrition and Dietetics,Medicine (miscellaneous)
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