The efficacy of multi‐disciplinary lifestyle modifications in Taiwanese nonalcoholic steatohepatitis patients

Autor: Ming‐Lun Yeh, Chia‐Yen Dai, Chung‐Feng Huang, Shiu‐Feng Huang, Pei‐Chien Tsai, Po‐Yau Hsu, Ching‐I Huang, Yu‐Ju Wei, Po‐Cheng Liang, Ming‐Jong Bair, Mei‐Hsuan Lee, Zu‐Yau Lin, Jee‐Fu Huang, Ming‐Lung Yu, Wan‐Long Chuang
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Kaohsiung Journal of Medical Sciences, Vol 40, Iss 6, Pp 575-582 (2024)
Druh dokumentu: article
ISSN: 2410-8650
1607-551X
DOI: 10.1002/kjm2.12833
Popis: Abstract Lifestyle modification is the standard of care for nonalcoholic fatty liver disease (NAFLD) patients. We aimed to investigate the efficacy of a short‐term lifestyle modification program in the disease course of Taiwanese nonalcoholic steatohepatitis (NASH) patients with paired biopsies. All patients received a 6‐month, strict multidisciplinary program of lifestyle modifications led by physicians, dieticians, and nursing staff. The histopathological and clinical features were assessed. The endpoints were normalization of transaminase levels, metabolic parameters, a decrease in the NAFLD activity score (NAS) ≥1, and a decrease in the fibrosis stage ≥1. We also aimed to elucidate the predictors associated with disease progression. A total of 37 patients with biopsy‐proven NASH were enrolled. The normalization of transaminase levels increased from 0% to 13.5%. There were also significantly increased proportions of patients with normal total cholesterol, triglyceride, and hemoglobin A1c levels. Fifteen (40.5%) patients had an increased NAS ≥1, whereas 10 (27.0%) patients had NAS regression. Twelve (32.4%) patients had increased fibrosis ≥1 stage. Only 2 (5.4%) patients experienced fibrosis regression. A high fasting plasma glucose (FPG) level was associated with NAS progression. Older age and higher transaminase and FPG levels were factors associated with fibrosis progression. Seven (18.9%) patients achieved a body weight reduction >3%, and 4 (57.1%) of them experienced NAS regression. No significant effect of weight reduction on the progression of fibrosis was observed. The short‐term lifestyle modification program significantly decreased liver enzymes and metabolic parameters in NASH patients. A more precise or intensive program may be needed for fibrosis improvement.
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