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Weight loss improves quality of life for NAFLD patients

Weight loss significantly improved quality of life for a patient with nonalcoholic fatty liver disease, according to data published in Hepatology.

“In this study of patients with biopsy-proven NAFLD, we show that weight loss is associated with significant improvements in [quality of life],” Elliot B. Tapper, MD, division of gastroenterology/hepatology, department of medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, and colleague wrote. “Furthermore, we show that the subgroups most likely to benefit include nondiabetics with active [nonalcoholic steatohepatitis] and F0 [to] F2 fibrosis.”

Elliot B. Tapper

Tapper and colleague Michelle Lai, MD, assistant professor of medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, conducted a prospective study of 151 patients with NAFLD enrolled in a NAFLD registry at Beth Israel Deaconess Medical Center between 2009 and 2014. All patients received a liver biopsy and underwent lifestyle assessment, blood tests and quality of life tools, including the Chronic Liver Disease Questionnaire (CLDQ) — a validated health-related quality of life measurement, according to the research. CLDQ was repeated at 6 months.

Sixty-percent of the cohort were men (n = 91), 30% of whom had diabetes (n = 46). Further, 21% of patients had advanced fibrosis or cirrhosis (n = 30) and 47% had a NAFLD Activity Score (NAS) greater than 4 (n = 67).

During follow-up, 31% of patients achieved at least a 5% reduction in weight (n = 47). These patients had a 0.45-point improvement in the total CLDQ (95% CI, 0.24-0.66) compared with a 0.003-point improvement in patients who did not experience a reduction in weight (95% CI, –0.12 to 0.12).

Patients with nonalcoholic steatohepatitis without diabetes or advanced fibrosis were most likely to achieve quality of life benefits from reduced weight.

For every decrement in BMI, researchers observed a corresponding increase of 0.09 points in the CLDQ scale (P = .005) after adjusting for covariates such as histology, diabetes, sex, age, change in alanine aminotransferase serum levels and change in Fibrosis-4 index. When BMI decreased by 5 points, patients experienced a 10% adjusted improvement in quality of life.

The researchers concluded: “Patients with NAFLD can experience significant improvements in [quality of life] that appear specific to weight loss and not biochemical improvements.” – by Melinda Stevens

Disclosure: Lai reports funding from the National Institutes of Health. Tapper reports no relevant financial disclosures.