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Background The prevalence of obesity-related non-alcoholic fatty liver disease (NAFLD) is rising. NAFLD may result in non-alcoholic steatohepatitis (NASH), progressing to liver cirrhosis. Weight loss is recommended to treat obesity-related NASH. Lifestyle intervention may improve NASH. However, pertinent trials have so far focused on overweight patients, while patients with obesity are at highest risk of developing NAFLD. Furthermore, reports of effects on liver fibrosis are scarce. We evaluated the effect of lifestyle intervention on NAFLD in a real-life cohort of morbidly obese patients. Methods In our observational study 152 patients underwent lifestyle intervention with follow-up of 52 weeks. Non-invasive measures of obesity, metabolic syndrome, and liver steatosis, liver damage, and liver fibrosis were analyzed. Results Treatment response in terms of weight loss was achieved in 85.1%. Dysglycemia and dyslipidemia improved. The proportion of patients with fatty liver dropped from 98.1% to 54.3% (p<0.001). Weight loss >10% was associated with better treatment response (p=0.0009). Prevalence of abnormal serum transaminases fell from 81.0% to 50.5% (p<0.001). The proportion fibrotic patients, as determined by the NAFLD fibrosis score, dropped from 11.8% to 0% (p<0.05). Low serum levels of adiponectin correlated with degree of liver damage, i.e. serum liver transaminases (г=-0,32, p<0.05). Serum levels of adiponectin improved with intervention. Conclusion Lifestyle intervention effectively targeted obesity and the metabolic syndrome. Liver steatosis, damage and fibrosis were ameliorated in this real-life cohort of morbidly obese patients - mediated, in part, by changes in the adipokine profile. Patients with weight loss of >10% seemed to benefit most.
This article was published in the following journal.
Name: American journal of physiology. Gastrointestinal and liver physiology
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The condition of weighing two, three, or more times the ideal weight, so called because it is associated with many serious and life-threatening disorders. In the BODY MASS INDEX, morbid obesity is defined as having a BMI greater than 40.0 kg/m2.
A status with BODY WEIGHT that is grossly above the acceptable or desirable weight, usually due to accumulation of excess FATS in the body. The standards may vary with age, sex, genetic or cultural background. In the BODY MASS INDEX, a BMI greater than 30.0 kg/m2 is considered obese, and a BMI greater than 40.0 kg/m2 is considered morbidly obese (MORBID OBESITY).
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A procedure consisting of the SURGICAL ANASTOMOSIS of the proximal part of the JEJUNUM to the distal portion of the ILEUM, so as to bypass the nutrient-absorptive segment of the SMALL INTESTINE. Due to the severe malnutrition and life-threatening metabolic complications, this method is no longer used to treat MORBID OBESITY.
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