Ichikawa Tatsuki, Miuma Satoshi, Yamashima Mio, Yamamichi Shinobu, Koike Makiko, Nakano Yusuke, Yajima Hiroyuki, Miyazaki Osamu, Ikeda Tomonari, Okamura Takuma, Komatsu Naohiro, Yoshino Miruki, Miyaaki Hisamitsu
Department of Gastroenterology, Nagasaki Harbor Medical Center, Nagasaki 850-8555, Japan.
Department of Comprehensive Community Care Systems, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8501, Japan.
Biomed Rep. 2025 Jul 25;23(4):158. doi: 10.3892/br.2025.2036. eCollection 2025 Oct.
The present study aimed to investigate the impact of weight loss and abstinence and exercise on liver fibrosis in metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction-associated steatotic liver disease and alcoholic-related liver disease (MetALD). A total of 67 patients with MASLD and 33 patients with MetALD were retrospectively evaluated after six months of follow-up for weight loss, abstinence and exercise. A decrease in liver fibrosis (decrease in dLSM2B) was defined as a reduction in liver stiffness (LS) by FibroScan and macrophage galactose-specific lectin-2 binding protein glycosylation isomer (M2BPGi) over the observation period. The decrease in dLSM2B levels was 35.8 and 39.4% in the MASLD and MetALD groups, respectively. In MASLD, the decreased weight rate (dBW%) was lower for a decrease in dLSM2B than for an increase. However, in MetALD, the dBW% was not significantly different between the groups. In MetALD, patients with complete abstinence and exercise frequency had a higher rate of decrease in dLSM2B. A prediction score of 0, 1 or 2 points was developed to predict the decrease in dLSM2B, with 1 point awarded for a dBW% reduction of ≥3.8 and 1 point for a FIB-4 reduction of ≥0.201. In patients with MASLD, there was a significant difference in the decrease in dLSM2B by 8.3% for a prediction score of 0, 36% for 1, and 72.2% for 2 points, whereas there was no significant difference in the improvement rate for 0-2 points. In conclusion, weight loss during MASLD and abstinence and exercise during MetALD were associated with a decrease in dLSM2B.
本研究旨在探讨减重、戒酒及运动对代谢功能障碍相关脂肪性肝病（MASLD）以及代谢功能障碍相关脂肪性肝病合并酒精性肝病（MetALD）患者肝纤维化的影响。对67例MASLD患者和33例MetALD患者进行了为期6个月的随访，回顾性评估其减重、戒酒及运动情况。肝纤维化的改善（dLSM2B降低）定义为在观察期内通过FibroScan检测的肝脏硬度（LS）及巨噬细胞半乳糖特异性凝集素-2结合蛋白糖基化异构体（M2BPGi）降低。MASLD组和MetALD组的dLSM2B水平分别下降了35.8%和39.4%。在MASLD中，dLSM2B降低时的体重减轻率（dBW%）低于升高时。然而，在MetALD中，两组间的dBW%无显著差异。在MetALD中，完全戒酒且运动频率高的患者dLSM2B降低率更高。开发了一个0、1或2分的预测评分系统来预测dLSM2B的降低情况，dBW%降低≥3.8得1分，FIB-4降低≥0.201得1分。在MASLD患者中，预测评分为0分时dLSM2B降低8.3%，评分为1分时降低36%，评分为2分时降低72.2%，差异有统计学意义，而0至2分的改善率无显著差异。总之，MASLD患者减重以及MetALD患者戒酒和运动与dLSM2B降低有关。
