Department of Internal Medicine, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
J Gastroenterol Hepatol. 2012 Aug;27(8):1341-7. doi: 10.1111/j.1440-1746.2012.07165.x.
We evaluated efficacy of exercise and diet modification for steatosis improvement of non-obese non-alcoholic fatty liver disease (NAFLD) patients.
We analyzed retrospectively the clinical and histological parameters of consecutive living liver donors, who experienced repeated liver biopsies due to steatosis and were treated using exercise and diet modification.
From 1995 to 2009, among a total of 1365 potential living liver donors with NAFLD seen on the initial liver biopsy, 120 consecutive donors with steatosis ≥ 30% or an estimated donor-recipient weight ratio < 0.8, underwent exercise and diet modification and received follow-up liver biopsy at our institution. Median age was 33 years, and median interval between the two consecutive biopsies was 10 weeks (range, 1-39). At the time of initial biopsy, the number of normal body mass index, overweight, and obese donors was 49 (40.8%), 65 (54.2%), and 6 (5.0%), respectively. After lifestyle modification, weight reduction and steatosis improvement were observed in 92 (76.7%) and 103 (85.8%) donors, respectively, at the time of follow-up biopsy. On multivariate analysis, initially higher steatosis (hazard ratio [HR] 1.03, P = 0.02), total cholesterol reduction ≥ 10% (HR 5.59, P = 0.02), and weight reduction ≥ 5% (HR 6.63, P = 0.03) were significantly associated with ≥ 20% steatosis improvement in 120 donors with NAFLD, after exercise and diet modification.
Exercise and diet modification were effective in reducing steatosis in potential living liver donors with non-obese NAFLD. Total cholesterol reduction ≥ 10% could be used as a non-invasive predictor for steatosis improvement in liver donors with NAFLD, after exercise and diet modification.
我们评估了运动和饮食改变对非肥胖非酒精性脂肪性肝病（NAFLD）患者肝脂肪变性改善的疗效。
我们回顾性分析了因脂肪变性而接受重复肝活检且接受运动和饮食改变治疗的连续活体肝供者的临床和组织学参数。
1995 年至 2009 年，在总共 1365 名接受初始肝活检的具有 NAFLD 的潜在活体肝供者中，120 名连续供者的脂肪变性≥30%或估计供体-受体体重比<0.8，在我们的机构接受运动和饮食改变并接受随访肝活检。中位年龄为 33 岁，两次连续活检之间的中位间隔为 10 周（范围 1-39）。在初始活检时，正常体重指数、超重和肥胖供者的数量分别为 49（40.8%）、65（54.2%）和 6（5.0%）。在生活方式改变后，92（76.7%）和 103（85.8%）名供者在随访活检时分别观察到体重减轻和脂肪变性改善。多变量分析显示，初始脂肪变性较高（危险比 [HR] 1.03，P=0.02）、总胆固醇降低≥10%（HR 5.59，P=0.02）和体重减轻≥5%（HR 6.63，P=0.03）与 120 名接受运动和饮食改变的非肥胖 NAFLD 供者的脂肪变性改善≥20%显著相关。
运动和饮食改变可有效降低非肥胖 NAFLD 活体肝供者的脂肪变性。总胆固醇降低≥10%可作为运动和饮食改变后 NAFLD 肝供者脂肪变性改善的非侵入性预测指标。
