Weight Loss via Lifestyle Modification Significantly Reduces Features of Nonalcoholic Steatohepatitis Gastroenterology 2015, 10.1053/j.gastro.2015.04.005.

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Weight Loss via Lifestyle Modification Significantly Reduces Features of Nonalcoholic Steatohepatitis Gastroenterology 2015, 10.1053/j.gastro.2015.04.005 Eduardo Vilar-Gomez, Yadina Martinez-Perez, Luis Calzadilla-Bertot, Ana Torres-Gonzalez, Bienvenido Gra-Oramas, Licet Gonzalez-Fabian, Scott L. Friedman, Moises Diago, Manuel Romero-Gomez Veronika Hechler, Bern 10.06.2015

Background Nonalcoholic fatty liver disease (NAFLD) has emerged as a leading cause of chronic liver disease worldwide Associated with an increased risk of diabetes and ischemic heart disease NAFLD encompasses a spectrum ranging from bland steatosis to steatohepatitis (NASH), the more aggressive form of NAFLD -> may progress to cirrhosis Currently no approved therapies for NASH Aim: changes in serological and histological features of NASH through weight loss by lifestyle modifications Veronika Hechler, Bern 10.06.2015

Methods Prospective study of 293 patients with histologically proven NASH Patients encouraged to adopt recommended lifestyle changes (hypocaloric diet combined with exercise) to reduce their weight Duration: 52 weeks, from June 2009 through May 2013 Liver biopsies collected and analyzed histologically at the beginning of the study and at week 52 Veronika Hechler, Bern 10.06.2015

In/exclusion criteria Inclusion criteria: Patients aged ≥ 18 years with histological diagnosis of definite NASH Patients who accepted to participate in a lifestyle intervention program Diabetic patients only if moderately well controlled (HbA1c<9) for ≥3 months Eclusion criteria: Histological diagnoses of borderline steatohepatitis or cirrhosis alcohol consumption of > 20g/d for ♂ and > 10g/d for ♀during last 2 years Other causes of liver disease (viral, autoimmune, drug-induced, Wilson, …) Veronika Hechler, Bern 10.06.2015

Results 25% of patients had resolution of steatohepatitis, 47% had reductions in NAS (NAFLD activity score), 19% had regression of fibrosis Degree of weight loss associated with improvements in all NASH-related histological parameters (odds ratio, 1.1-2.0; P<.01) Patients with ≥5% weight loss had more NASH resolution and NAS ruduction than patients with <5% weight loss (P<.001) No significant correlations between changes in physical activity score and weight loss percentage (r=0.07, P=0.45) Veronika Hechler, Bern 10.06.2015

Graphic presentation

Conclusions a greater extent of weight loss, induced by lifestyle changes, is associated with level of improvement in histologic features of NASH highest rates of NAS reduction, NASH resolution and fibrosis regression occurred in patients with weight losses of ≥10% Veronika Hechler, Bern 10.06.2015

Thank you for your attention! Veronika Hechler, Bern 10.06.2015