Lifestyle interventions effective against nonobese NAFLD patients
Lifestyle interventions appear to effectively induce remission of nonalcoholic fatty liver disease (NAFLD) in both obese and nonobese patients, reports a new study.
The study included 154 NAFLD patients who were randomly assigned to receive usual care (n=77) or a 12-month lifestyle intervention programme and regular exercise (n=77). In each group, 39 and 38 patients had body mass index (BMI) <25 and ≥25 kg/m2, respectively. Proton-magnetic resonance spectroscopy was used to assess the primary outcome of NAFLD remission.
Significantly more patients with BMI <25 kg/m2 who received the intervention vs usual care had NAFLD remission at 12 months (67 percent vs 18 percent; p<0.001). In the respective groups, the mean decline in intrahepatic triglyceride content (IHTG) was 6.1 percent and 1.3 percent, the difference between which was statistically significant (p=0.001).
In patients with BMI ≥25 kg/m2, 61 percent of those who received the lifestyle intervention programme achieved NAFLD remission. This effect was significantly greater than that from usual care (21 percent; p<0.001). The resulting mean reductions in IHTG were 7.4 percent and 2.9 percent, respectively (p=0.004).
The effects of lifestyle intervention also appeared sustainable. A the 6-year follow-up, significantly more participants who received the exercise intervention vs controls had BMI lower than baseline (19.1 percent vs 8.6 percent; p=0.037).
Moreover, although rebound in body weight was observed after termination of the intervention, the mean change in body weight at year 6 was significantly more pronounced in the intervention vs control group (–1.9±4.7 vs 0.4±3.3 kg; p=0.0022).