Department of Diabetes, Endocrinology and Hematology, Dokkyo Medical University Saitama Medical Center, 2-1-50 Minami-Koshigaya, Koshigaya, Saitama, 343-8555, Japan.
Department of Diabetes Mellitus, Saitama Cooperative Hospital, 1317 Kizoro, Kawaguchi, Saitama, 333-0831, Japan.
Sci Rep. 2022 Sep 8;12(1):15219. doi: 10.1038/s41598-022-19420-0.
Weight reduction therapy represents a fundamental strategy to prevent nonalcoholic fatty liver disease (NAFLD) in patients with obesity, which may result in liver fibrosis. Histological findings previously demonstrated that weight reduction therapy attenuated NAFLD. The FIB4 index is widely used to assess the status of NAFLD. The present study investigated whether the FIB4 index improved during weight reduction therapy. We used cohort data of the Japan Obesity and Metabolic syndrome Study and examined the correlation between body weight (BW) loss (BW loss) and changes in the FIB4 index (ΔFIB4 index) in patients who successfully reduced their BW by more than 5% from baseline BW after 3, 6, and 12 months (M) of weight reduction therapy. A negative correlation (r = -0.342, p = 0.029) was observed between BW loss and FIB4 index after 3 M, but not after 6 M, whereas a positive correlation (r = 0.298, p = 0.03) was noted after 12 M. These results revealed changes in the correlation between ΔBW loss and ΔFIB4 index during the therapy, mainly due to time-dependent changes in components of the FIB4 index formula. Thus, we concluded that the FIB4 index is useful and reliable to assess liver fibrosis until 3 M during weight reduction therapy. However, after 3 M, we should recognize that the FIB4 index may not reflect liver status. Therefore, it is important to consider this characteristic of the FIB4 index as a limitation when assessing liver fibrosis in obese patients receiving weight reduction therapy.
减重疗法是肥胖患者预防非酒精性脂肪性肝病（NAFLD）的基本策略，因为它可能导致肝纤维化。先前的组织学研究结果表明，减重疗法可以减轻 NAFLD。FIB4 指数广泛用于评估 NAFLD 的状况。本研究旨在探讨减重治疗过程中 FIB4 指数是否会改善。我们使用日本肥胖与代谢综合征研究的队列数据，检查了在减重治疗 3、6 和 12 个月（M）时，体重减轻（BW 减轻）超过基线 BW 的 5%的患者的 BW 减轻与 FIB4 指数变化（ΔFIB4 指数）之间的相关性。我们发现，在 3 M 时，BW 减轻与 FIB4 指数呈负相关（r = -0.342，p = 0.029），但在 6 M 时则没有相关性，而在 12 M 时呈正相关（r = 0.298，p = 0.03）。这些结果表明，在治疗过程中，ΔBW 减轻与 ΔFIB4 指数之间的相关性发生了变化，这主要是由于 FIB4 指数公式成分的时间依赖性变化所致。因此，我们得出结论，在减重治疗期间，FIB4 指数在 3 M 之前是评估肝纤维化的有效且可靠的指标。然而，在 3 M 之后，我们应该认识到 FIB4 指数可能无法反映肝脏状况。因此，在评估接受减重治疗的肥胖患者的肝纤维化时，需要考虑 FIB4 指数的这一特征作为限制因素。
