Weight loss through lifestyle changes, bariatric surgery improved NAFLD in obese patients
Obese patients who lose weight via lifestyle intervention or bariatric surgery experienced improvement to histological and metabolic elements of nonalcoholic fatty liver disease in a study presented at the International Liver Congress in Amsterdam.
Researchers evaluated 120 obese patients treated with either lifestyle intervention via low-calorie diet and physical activity (49.2% of cases) or bariatric surgery (50.8%), with follow-up conducted after 12 months. All patients had presented with obesity-related issues and received liver and metabolic evaluation, along with liver biopsy in the event of suspected nonalcoholic fatty liver disease (NAFLD). A second biopsy was performed at 12 months in 46.7% of cases.
Across the cohort, participant experienced significant improvements in mean BMI (39 ± 0.51 kg/m2 at baseline to 31.5 ± 0.43 kg/m2) and visceral fat (214 ± 7.31 cm2 to 136 ± 8.46 cm2) (P<.001 for both). Significant decreases in ALT, aspartate aminotransferase and gamma glutamyltransferase (P<.001 for all) were observed, along with alkaline phosphatase (P=.037).
Mean NASH activity scores for the cohort decreased (3.96 ± 0.30 vs. 1.48 ± 0.29), along with scores for steatosis (1.55 ± 0.14 to 0.52 ± 0.11), lobular inflammation (1.21 ± 0.12 to 0.45 ± 0.1) and ballooning (1.20 ± 0.1 to 0.52 ± 0.11) (P<.001 for all). This decrease was significant for each treatment group, but investigators said the difference was more pronounced among bariatric surgery recipients. Those who underwent surgery also experienced significant improvement to fibrosis (mean stage 1.09 ± 0.24 at baseline to 0.52 ± 0.25; P=.046).
“Weight loss by lifestyle intervention can achieve a significant, histologically documented improvement of NAFLD in overweight and obese patients,” the researchers wrote. “Bariatric surgery results in even more pronounced improvement, including fibrosis regression.”
For more information:
Verrijken A. #76: The Effect of Weight Loss on Nonalcoholic Fatty Liver Disease in an Overweight and Obese Population. Presented at: The International Liver Congress 2013; April 24-28, Amsterdam.