Low carbohydrate intervention effective in treating patients with NAFLD
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A low carbohydrate intervention targeting type 2 diabetes reversal and prediabetes regression may be an effective treatment method for nonalcoholic fatty liver disease, according to a speaker at The Liver Meeting Digital Experience.
“In this analysis, we showed that a very low carbohydrate intervention improved liver enzymes and noninvasive NAFLD liver surrogate markers in a real-world outpatient virtual clinical setting,” Shaminie Athinarayanan, PhD, associate director of clinical research at Virta Health, said during a presentation. “As previously observed, the degree of improvement liver markers increases with the degree of weight loss achieved in the intervention.”
Athinarayanan and colleagues assessed a total cohort of 1,526 patients (44% women; 90% with type 2 diabetes; 10% with prediabetes) who received a “very low” carbohydrate intervention for at least 1 year. The researchers examined changes in liver enzymes, including aspartate aminotransferase, alanine aminotransferase and alkaline phosphatase (ALP; mean ALT, 31.7 U/L; mean AST, 24.7 U/L; mean ALP, 77 U/L) as well as changes in weight, glycemic control, triglycerides, triglyceride glucose index and hepatic steatosis index from baseline to follow-up.
The researchers found decreases in weight (–9.3%), BMI (–9.3%), HbA1c (–11.8%), fasting glucose (–11.7%) and triglycerides (–24%; P < .001 for all) from baseline to follow-up.
Coinciding with the weight loss, Athinarayanan and colleagues found decreases in triglyceride glucose index (–4%), hepatic steatosis index (–8.3%), AST (–12.1%), ALP (–6.2%) and ALT (–17.3%; P <.001 for all) from baseline. This presented a link between weight loss in the patients and the assessed liver markers.
According to the presentation, 55.2% of patients achieved weight loss greater than 7% and approximately 66% achieved weight loss of more than 5%.
Researchers concluded that the degree of weight loss achieved associated with the degree of improvement in liver markers, showing notable improvements in liver enzymes and noninvasive NAFLD surrogate markers in the low carbohydrate intervention. Additionally, the researchers found that weight loss of at least 7% to 10% was associated with nonalcoholic steatohepatitis histology improvement.
“A very low carbohydrate intervention can be considered as an alternative lifestyle option for NAFLD treatment.” Athinarayanan said during the presentation. “This telemedical intervention can be successfully implemented as an outpatient treatment option to complement liver specialty clinics for managing and treating patients with NAFLD.”