Multidisciplinary lifestyle intervention is associated with improvements in liver damage and in surrogate scores of NAFLD and liver fibrosis in morbidly obese patients.

Autor: Bischoff M; Krankenhaus Barmherzige Brüder München, Romanstrasse 93, 80639, Munich, Germany., Zimny S; Department of Medicine II, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany., Feiner S; Krankenhaus Barmherzige Brüder München, Romanstrasse 93, 80639, Munich, Germany., Sauter J; Department of Medicine II, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany., Sydor S; Department of Internal Medicine, University Hospital Knappschaftskrankenhaus, Ruhr-University Bochum, In der Schornau 23-25, 44892, Bochum, Germany., Denk G; Department of Medicine II, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany., Nagel JM; Krankenhaus Barmherzige Brüder München, Romanstrasse 93, 80639, Munich, Germany., Bischoff G; Krankenhaus Barmherzige Brüder München, Romanstrasse 93, 80639, Munich, Germany., Rust C; Krankenhaus Barmherzige Brüder München, Romanstrasse 93, 80639, Munich, Germany., Hohenester S; Department of Medicine II, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany. simon.hohenester@med.uni-muenchen.de.
Jazyk: angličtina
Zdroj: European journal of nutrition [Eur J Nutr] 2022 Aug; Vol. 61 (5), pp. 2725-2735. Date of Electronic Publication: 2022 Mar 11.
DOI: 10.1007/s00394-022-02846-7
Abstrakt: 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.
(© 2022. The Author(s).)
Databáze: MEDLINE
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