Modest weight loss tied to significant improvement in NAFLD: claims study

Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease worldwide with no specific treatment. Weight loss is the most effective therapeutic strategy in its management; however, there is no consensus on its specificsPrevious Trials show that weight loss interventions improve biomarkers of non-alcoholic fatty liver disease (NAFLD), but it is unclear if a dose-response relationship exists.

To evaluate the relationship between weight loss and nonalcoholic fatty liver disease (NAFLD), the authors conducted a meta-analysis of weight loss interventions, which included 43 studies with 2809 participants. Median follow-up was 6 months. Nine databases and trial registries were searched until October 2020. Single-arm, non-randomized comparative, or randomized trials of weight loss interventions (behavioral weight loss programs [BWLPs], pharmacotherapy, or bariatric surgery) in people with NAFLD were eligible for inclusion if they reported an association between changes in weight and changes in blood, radiological, or histological biomarkers of liver disease.

Data analysis revealed the following facts.

• For every 1 kg of weight loss, there was a 0.83-unit reduction in alanine aminotransferase, a 0.56-unit reduction in aspartate transaminase, and a 0.77% drop in steatosis assessed by histology or radiology.
• A dose–response relationship was identified with regard to liver inflammation, ballooning, and resolution of NAFLD or nonalcoholic steatohepatitis; there was limited evidence of a dose–response relationship with NAFLD activity score or fibrosis.
• Forty-three studies (BWMPs: 26, pharmacotherapy: 9, surgery: 8) with 2809 participants were included. The median follow-up was 6 (interquartile range: 6) months.
• The direction of effect was generally consistent but the estimates imprecise. Every 1 kg of weight lost was associated with 0.83-unit (95% CI: 0.53 to 1.14, p < 0.0001, I2 = 92%, n = 18) reduction in alanine aminotransferase (U/L), 0.56-unit (95% CI: 0.32 to 0.79, p < 0.0001, I2 = 68%, n = 11) reduction in aspartate transaminase (U/L), and 0.77 percentage point (95% CI: 0.51 to 1.03, p < 0.0001, I2 = 72%, n = 11) reduction in steatosis assessed by radiology or histology.

For full article follow the link:The Effect of the Magnitude of Weight Loss on Non-Alcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis Metab. Clin. Exp. 2020 Nov 28;[EPub Ahead of Print], DA Koutoukidis, C Koshiaris, JA Henry, M Noreik, E Morris, I Manoharan, K Tudor, E Bodenham, A Dunnigan, SA Jebb, P Aveyard

Primary source: Metabolism - Clinical and Experimental