NAFLD and weight loss: The Salerno experience on close monitoring. (March 2023)

• Record Type: Journal Article
• Authors: Torre, P.; Schiavo, L.; Masarone, M.; Motta, B.M.; Belladonna, F.; Aquino, M.; Persico, M.
• Is Part Of: Digestive and liver disease. Volume 55(2023)Supplement 1
• Page Start: S64
• Page End: S65
• Publication Date: 2023-03
• Subjects: Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; 616.33005
• DOI: 10.1016/j.dld.2023.01.127
• Languages: English
• ISSNs: 1590-8658

Abstract

Abstract : Introduction: Weight loss is the cornerstone in the treatment of NAFLD and was found associated with a histological improvement proportional to its extent. However, it is a difficult goal to achieve and maintain. Moreover, the precise link between weight changes and NAFLD is not fully understood. Aims: To describe the possible positive influences of a nutritionist-guided low-glycemic index diet on anthropometric parameters, Transient Elastography (TE), Controlled Attenuation Parameter (CAP, with the SmartExam software), and blood chemistry in overweight or obese NAFLD patients. The genetic correlation with TE/CAP measurements was also taken into account. Patients and Methods: 69/106 patients who were attending our Hepatology Unit, with NAFLD, aged ≥ 18, and with a BMI ≥ 25 accepted to start the nutritionist-guided diet. Baseline anthropometric data, TE/CAP, and blood test results were recorded. Single nucleotide polymorphisms in NAFLD risk genes were analyzed and genetic risk score (GRS) was calculated. Control visits were scheduled after 1 and 3 months. TE/CAP was performed during each visit, and after 3 months blood tests were repeated. Results: 57/69 patients (82.61%) attended at least one of the control visits. A significant difference from baseline was observed at both 1-month and 3-month visit in weight (-4.26 kg [-4.78%] p <0.0001, and -7.67 kg [-8.43%] p <0.0001), BMI (-1.55 Kg/m 2, p <0.0001, and -2.75 Kg/m 2, p <0.0001), and CAP (-27.67 dB/m, p =0.0062, and -42 dB/m, p =0.0182). Changes in CAP were proportional to the extent of weight loss, whereas mean liver stiffness remained almost unchanged. Baseline CAP was proportional to GRS; high GRS patients presented a higher decrease in TE/CAP values after 3 months of diet. After 3 months of diet, significant differences in glycemia and triglycerides were observed; AST, ALT, total cholesterol and HDL cholesterol also improved. Conclusions: In our NAFLD population, after diet-induced weight loss, an improvement in metabolic parameters was observed. The early reduction of CAP could increase patient awareness of the ongoing improvements. Genetics could influence the reduction of steatosis during weight loss.