Effect of intensive weight-loss intervention on metabolic, ultrasound and anthropometric parameters among patients with obesity and non-alcoholic fatty liver disease: an RCT.

Autor: Arora C; Department of Home Science, University of Delhi, Delhi, India., Malhotra A; Department of Home Science, Lakshmibai College, University of Delhi, Delhi, India., Ranjan P; Department of Medicine, All India Institute of Medical Sciences, New Delhi, India. drpiyushdost@gmail.com., Singh V; Dept. of Geriatric Medicine, All India Institute of Medical Sciences, New Delhi, India., Singh N; Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India., Shalimar; Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India., Dwivedi SN; Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India., Vikram NK; Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.
Jazyk: angličtina
Zdroj: European journal of clinical nutrition [Eur J Clin Nutr] 2022 Sep; Vol. 76 (9), pp. 1332-1338. Date of Electronic Publication: 2022 Apr 20.
DOI: 10.1038/s41430-022-01111-8
Abstrakt: Background: Lifestyle intervention is the mainstay therapy for Non-Alcoholic Fatty Liver Disease (NAFLD). We aimed to assess the efficacy of an intensive (9 contact points in 6 months) weight-loss intervention among patients with obesity (BMI 25-39.9 kg/m 2 ) and NAFLD in north India.
Methods: A total of 140 patients (18-60 years) with obesity and NAFLD were randomized into intervention (n = 70) and control (n = 70) groups, at a tertiary-care hospital. Weight, anthropometric parameters, Controlled Attenuation Parameter (CAP), Liver Stiffness Measurement (LSM), liver enzymes, grade of fatty liver and HOMA-IR were measured at baseline (T 0 ) and 6 months (T 6 ). There was a high drop-out, exacerbated by the Covid-19 pandemic. Completers comprised of 59 participants (n = 30 intervention, n = 29 control). Intention to treat analysis was done.
Results: At T 6 , ALT normalized in significantly higher (p = 0.03) number of cases in the intervention arm (66.7%) versus control arm (18.2%). No significant improvement was seen in other metabolic, ultrasound or anthropometric outcomes. Weight (p < 0.001), AST (p = 0.01), ALT (p = 0.02), body fat% (p < 0.001), WC (p < 0.001) and CAP (p < 0.001) significantly improved within the intervention arm along with a trend of improvement in steatosis and HOMA-IR. Control group showed significant decrease in weight (p < 0.001), WC (p < 0.001) and CAP (p = 0.02). Twice the number of patients in intervention arm (46.7%) lost ≥5% weight, compared to control arm (24.1%) (p = 0.07).
Conclusion: The intensive weight-loss intervention was not effective in improving the treatment outcomes among patients with obesity and NAFLD. However, given the potential of our intervention, we recommend larger trials with more intensive weight-loss interventions.
(© 2022. The Author(s), under exclusive licence to Springer Nature Limited.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje