A low-energy total diet replacement programme demonstrates a favourable safety profile and improves liver disease severity in non-alcoholic steatohepatitis
<p><strong>Objective:</strong> Low-energy diets are used to treat obesity and diabetes, but there are fears that they may worsen liver disease in patients with nonalcoholic steatohepatitis (NASH) and significant-to-advanced fibrosis.</p> <p><strong>Methods:</s...
| Main Authors: | , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
Wiley
2023
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| _version_ | 1797110211744366592 |
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| author | Koutoukidis, D Mozes, F Jebb, S Tomlinson, J Pavlides, M Saffioti, F Huntriss, R Aveyard, P Cobbold, J |
| author_facet | Koutoukidis, D Mozes, F Jebb, S Tomlinson, J Pavlides, M Saffioti, F Huntriss, R Aveyard, P Cobbold, J |
| author_sort | Koutoukidis, D |
| collection | OXFORD |
| description | <p><strong>Objective:</strong> Low-energy diets are used to treat obesity and diabetes, but there are fears that they may worsen liver disease in patients with nonalcoholic steatohepatitis (NASH) and significant-to-advanced fibrosis.</p>
<p><strong>Methods:</strong> In this 24-week single-arm trial, 16 adults with NASH, fibrosis, and obesity received one-to-one remote dietetic support to follow a low-energy (880 kcal/d) total diet replacement program for 12 weeks and stepped food reintroduction for another 12 weeks. Liver disease severity was blindly evaluated (magnetic resonance imaging proton density fat fraction [MRI-PDFF], iron-corrected T1 [cT1], liver stiffness on magnetic resonance elastography [MRE], and liver stiffness on vibration-controlled transient elastography [VCTE]). Safety signals included liver biochemical markers and adverse events.</p>
<p><strong>Results:</strong> A total of 14 participants (87.5%) completed the intervention. Weight loss was 15% (95% CI: 11.2%–18.6%) at 24 weeks. Compared with baseline, MRI-PDFF reduced by 13.1% (95% CI: 8.9%–16.7%), cT1 by 159 milliseconds (95% CI: 108–216.5), MRE liver stiffness by 0.4 kPa (95% CI: 0.1–0.8), and VCTE liver stiffness by 3.9 kPa (95% CI: 2.6–7.2) at 24 weeks. The proportions with clinically relevant reductions in MRI-PDFF (≥30%), cT1 (≥88 milliseconds), MRE liver stiffness (≥19%), and VCTE liver stiffness (≥19%) were 93%, 77%, 57%, and 93%, respectively. Liver biochemical markers improved. There were no serious intervention-related adverse events.</p>
<p><strong>Conclusions:</strong> The intervention demonstrates high adherence, favorable safety profile, and promising efficacy as a treatment for NASH.</p> |
| first_indexed | 2024-03-07T07:51:17Z |
| format | Journal article |
| id | oxford-uuid:b6a8d3d4-f45d-4642-84c2-ffc09d7a6e77 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T07:51:17Z |
| publishDate | 2023 |
| publisher | Wiley |
| record_format | dspace |
| spelling | oxford-uuid:b6a8d3d4-f45d-4642-84c2-ffc09d7a6e772023-07-17T08:10:22ZA low-energy total diet replacement programme demonstrates a favourable safety profile and improves liver disease severity in non-alcoholic steatohepatitisJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:b6a8d3d4-f45d-4642-84c2-ffc09d7a6e77EnglishSymplectic ElementsWiley2023Koutoukidis, DMozes, FJebb, STomlinson, JPavlides, MSaffioti, FHuntriss, RAveyard, PCobbold, J<p><strong>Objective:</strong> Low-energy diets are used to treat obesity and diabetes, but there are fears that they may worsen liver disease in patients with nonalcoholic steatohepatitis (NASH) and significant-to-advanced fibrosis.</p> <p><strong>Methods:</strong> In this 24-week single-arm trial, 16 adults with NASH, fibrosis, and obesity received one-to-one remote dietetic support to follow a low-energy (880 kcal/d) total diet replacement program for 12 weeks and stepped food reintroduction for another 12 weeks. Liver disease severity was blindly evaluated (magnetic resonance imaging proton density fat fraction [MRI-PDFF], iron-corrected T1 [cT1], liver stiffness on magnetic resonance elastography [MRE], and liver stiffness on vibration-controlled transient elastography [VCTE]). Safety signals included liver biochemical markers and adverse events.</p> <p><strong>Results:</strong> A total of 14 participants (87.5%) completed the intervention. Weight loss was 15% (95% CI: 11.2%–18.6%) at 24 weeks. Compared with baseline, MRI-PDFF reduced by 13.1% (95% CI: 8.9%–16.7%), cT1 by 159 milliseconds (95% CI: 108–216.5), MRE liver stiffness by 0.4 kPa (95% CI: 0.1–0.8), and VCTE liver stiffness by 3.9 kPa (95% CI: 2.6–7.2) at 24 weeks. The proportions with clinically relevant reductions in MRI-PDFF (≥30%), cT1 (≥88 milliseconds), MRE liver stiffness (≥19%), and VCTE liver stiffness (≥19%) were 93%, 77%, 57%, and 93%, respectively. Liver biochemical markers improved. There were no serious intervention-related adverse events.</p> <p><strong>Conclusions:</strong> The intervention demonstrates high adherence, favorable safety profile, and promising efficacy as a treatment for NASH.</p> |
| spellingShingle | Koutoukidis, D Mozes, F Jebb, S Tomlinson, J Pavlides, M Saffioti, F Huntriss, R Aveyard, P Cobbold, J A low-energy total diet replacement programme demonstrates a favourable safety profile and improves liver disease severity in non-alcoholic steatohepatitis |
| title | A low-energy total diet replacement programme demonstrates a favourable safety profile and improves liver disease severity in non-alcoholic steatohepatitis |
| title_full | A low-energy total diet replacement programme demonstrates a favourable safety profile and improves liver disease severity in non-alcoholic steatohepatitis |
| title_fullStr | A low-energy total diet replacement programme demonstrates a favourable safety profile and improves liver disease severity in non-alcoholic steatohepatitis |
| title_full_unstemmed | A low-energy total diet replacement programme demonstrates a favourable safety profile and improves liver disease severity in non-alcoholic steatohepatitis |
| title_short | A low-energy total diet replacement programme demonstrates a favourable safety profile and improves liver disease severity in non-alcoholic steatohepatitis |
| title_sort | low energy total diet replacement programme demonstrates a favourable safety profile and improves liver disease severity in non alcoholic steatohepatitis |
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