B0523 - Lifestyle Modifications Decrease Hepatic Steatosis in Taiwanese With Metabolic-Associated Fatty Liver Disease

Monday, October 24, 2022

10:00 AM – 12:00 PM ET

Location: Crown Ballroom

Presenting Author(s)

He Qiu, MD, MBA

Rutgers New Jersey Medical School
Newark, NJ

He Qiu, MD, MBA¹, Tso-Tsai Liu, MD², Jen-Hung Wang, MD², Ming-Wun Wong, MD², Chih-Hsun Yi, MD², Lin Lin, MD², Wei-Yi Lei, MD², Jui-Sheng Hung, MD², Chien-Lin Chen, MD², Ma Ai Thanda Han, MD³
¹Rutgers New Jersey Medical School, Newark, NJ; ²Hualien Tzu Chi Hospital, Hualien, Hualien, Taiwan; ³Banner University Medical Center, University of Arizona, Phoenix, AZ

Introduction: Metabolic-associated fatty liver disease (MAFLD) represents a growing global problem and is associated with increasing obesity prevalence. Lifestyle modifications are the currently recommended approaches for MAFLD. Fibroscan device/transient elastography may be used to estimate the degree of liver scarring and steatosis using a controlled attenuation parameter (CAP) value. This study evaluated the short-term effect of lifestyle modifications on transient elastography values in an obese population with MAFLD.

Methods: Thirty-two MAFLD patients aged between 18-60 years old who had a body mass index (BMI) of ≧23 kg/m² with evidence of fatty liver disease by abdominal ultrasound were recruited for this prospective study. All subjects participated in a 3-month program of lifestyle modification. Sequential demographic parameters and biochemical tests were compared before and after program completion. Liver fat and fibrosis changes were measured using transient elastography with CAP and liver stiffness measurements (LSM).

Results: The mean age was 38.7 years old. The body weight (88.09 kg vs. 80.35 kg), body mass index (32.24 kg/m²vs. 29.4 kg/m²), waist (103.19 cm vs. 95.75 cm) and hip circumference (111.67 cm vs. 104.75 cm), and blood pressure (128/78 mmHg vs. 119/71 mmHg) significantly improved after intervention. Aspartate aminotransaminase (24.06 U/L vs. 18.91 U/L), alanine aminotransaminase (33 U/L vs. 23.72 U/L), creatinine (0.75 mg/dL vs. 0.70 mg/dL), cholesterol (176.41 mg/dL vs. 166.22 m/dL), gamma-glutamyl transferase (26.59 IU/L vs. 19.81 IU/L), and low-density lipoprotein cholesterol (115.63 mg/dL vs. 103.19 mg/dL) also improved after the 3-month intervention. The average CAP significantly decreased after intervention (297.5 dB/m vs. 255.0 dB/m), however, no significant difference in LSM was observed (5.24 kPa vs. 4.82 kPa) after intervention.

Discussion: This study demonstrated that liver fat, assessed by CAP score, significantly reduced after a 3-month structured lifestyle modification program in patients with MAFLD. In addition, weight reduction, which is the major determining factor for MALFD improvement and/or resolution, was achieved with the structured program, and the CAP value may be used to monitor liver steatosis and respond to intervention. It is believed that this is the first study that evaluates the utility of CAP values for monitoring hepatic steatosis in an obese population with MAFLD through exercise and diet modification.

Figure: Figure 1. Controlled Attenuation Parameter (CAP) and Liver Stiffness (LSM) values before and after intervention.

	Pre-intervention	Postintervention	Difference	p-value
Waist (cm)	103.19±13.12	95.75±11.96	-7.44±3.72	< 0.001
Hip (cm)	111.67±10.72	104.75±10.55	-6.92±3.27	< 0.001
Weight (kg)	88.09±20.75	80.35±19.51	-7.74±3.97	< 0.001
WHR	0.92±0.06	0.91±0.05	-0.01±0.02	0.026
Body Fat (%)	37.07±4.18	34.27±4.44	-2.8±1.44	< 0.001
BMI (kg/m^2)	32.24±4.98	29.4±4.72	-2.84±1.35	< 0.001
SBP (mmHg)	127.66±15.57	119.09±12.02	-8.56±10.61	< 0.001
DBP (mmHg)	78.03±13.58	71.09±8.29	-6.94±13.23	0.006
Heart rate (BPM)	84.5±11.45	76.03±10.91	-8.47±12.06	< 0.001
HbA1c (%)	5.44±0.54	5.47±0.36	0.03±0.33	0.67
Fasting Glucose (mg/dL)	89.44±8.06	92.22±7.56	2.78±6.59	0.023
AST (U/L)	24.06±8.85	18.91±6.4	-5.16±8.76	0.002
ALT (U/L)	33±20.76	23.72±14.72	-9.28±19.79	0.012
GGT (IU/L)	26.59±18.23	19.81±14.83	-6.78±10.05	0.001
BUN (mg/dL)	11.09±2.23	11.31±2.29	0.22±2.55	0.631
Creatinine (mg/dL)	0.75±0.17	0.70±0.14	-0.05±0.08	0.002
Chol (mg/dL)	176.41±31.32	166.22±32.13	-10.19±24.14	0.023
TG (mg/dL)	122.59±49.11	113.28±61.32	-9.31±46.8	0.269
HDL (mg/dL)	42.88±8.29	43.94±8.86	1.06±4.99	0.238
LDL (mg/dL)	115.63±28.03	103.19±29.83	-12.44±20.59	0.002
HOMA-IR (mg/dL)	2.65±1.61	2.45±1.85	-0.2±1.94	0.564

Table: Comparison of Parameters and Biochemical Testing Before and After Intervention.

WHR, waist-hip ratio; BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; BPM, beats per minute. HbA1c, hemoglobin A1c; AST, aspartate aminotransferase; ALT, alanine aminotransferase; GGT, gamma-glutamyl transferase; BUN, blood urea nitrogen; Chol, total cholesterol; TG, triglyceride; HDL, high-density lipoprotein; LDL, low-density lipoprotein; HOMA-IR, Homeostatic Model Assessment for Insulin Resistance.

Disclosures:

He Qiu indicated no relevant financial relationships.

Tso-Tsai Liu indicated no relevant financial relationships.

Jen-Hung Wang indicated no relevant financial relationships.

Ming-Wun Wong indicated no relevant financial relationships.

Chih-Hsun Yi indicated no relevant financial relationships.

Lin Lin indicated no relevant financial relationships.

Wei-Yi Lei indicated no relevant financial relationships.

Jui-Sheng Hung indicated no relevant financial relationships.

Chien-Lin Chen indicated no relevant financial relationships.

Ma Ai Thanda Han indicated no relevant financial relationships.

He Qiu, MD, MBA¹, Tso-Tsai Liu, MD², Jen-Hung Wang, MD², Ming-Wun Wong, MD², Chih-Hsun Yi, MD², Lin Lin, MD², Wei-Yi Lei, MD², Jui-Sheng Hung, MD², Chien-Lin Chen, MD², Ma Ai Thanda Han, MD³. B0523 - Lifestyle Modifications Decrease Hepatic Steatosis in Taiwanese With Metabolic-Associated Fatty Liver Disease, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.