Effect of Weight Loss on Magnetic Resonance Imaging Estimation of Liver Fat and Volume in Patients With Nonalcoholic Steatohepatitis
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Background & aims Little is known about how weight loss affects magnetic resonance imaging (MRI) of liver fat and volume or liver histology in patients with nonalcoholic steatohepatitis (NASH). We measured changes in liver fat and liver volume associated with weight loss by using an advanced MRI method.Methods We analyzed data collected from a previous randomized controlled trial in which 43 adult patients with biopsy-proven NASH underwent clinical evaluation, biochemical tests, and MRI and liver biopsy analyses at the start of the study and after 24 weeks. We compared data between patients who did and did not have at least 5% decrease in body mass index (BMI) during the study period.Results Ten of 43 patients had at least a 5% decrease in BMI during the study period. These patients had a significant decrease in liver fat, which was based on MRI proton density fat fraction estimates (18.3% ± 7.6% to 13.6% ± 13.6%, P = .03), a relative 25.5% reduction. They also had a significant decrease in liver volume (5.3%). However, no significant changes in levels of alanine aminotransferase or aspartate aminotransferase were observed with weight loss. Thirty-three patients without at least 5% decrease in BMI had insignificant increases in estimated liver fat fraction and liver volume.Conclusions A reduction in BMI of at least 5% is associated with significant decrease in liver fat and volume in patients with biopsy-proven NASH. These data should be considered in assessing effect size in studies of patients with nonalcoholic fatty liver disease or obesity that use MRI-estimated liver fat and volume as end points.
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Glycemia responds to small amounts of weight loss, but larger weight loss is needed for clinically meaningful improvement in NAFLD/NASH and other health variables.
“While glycemia is sensitive to small degrees of body weight loss, greater body weight loss is required for clinically meaningful benefits to NAFLD/NASH as well as other health variables.10”
From Management of type 2 diabetes, obesity, or nonalcoholic steatohepatitis with high‐dose GLP‐1 receptor agonists and GLP‐1 receptor‐based co‐agonists (2024) · cites this paper as [10]
In patients with NAFLD, a modest weight loss can produce a significant decrease in liver fat content, with improved serum aminotransferase activity and beneficial health effects.
“In patients with NAFLD, a modest weight loss can produce a significant decrease in liver fat content, with improved serum aminotransferase activity and beneficial health effects [69,70].”
From Mediterranean diet nutrients to turn the tide against insulin resistance and related diseases (2020) · cites this paper as [69]
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- Authors
- Patel, N. S., Doycheva, I., Peterson, M. R., Hooker, J., Kisselva, T., Schnabl, B., Seki, E., Sirlin, C. B., & Loomba, R.
- Affiliations
- UC San Diego Health System (US)
- Corresponding author
- Loomba, Rohit
- ORCID
- Venue
- Clinical Gastroenterology and Hepatology
- Publisher
- Elsevier BV
- Published
- 2015-03
- Volume
- 13
- Issue
- 3
- Pages
- 561-568.e1
- ISSN
- 1542-3565 (ISSN-L)
- PMC
- PMC4333065
- OpenAlex
- W2141246254
- Cited by
- 173
- References
- 41
- Citations by year
- 2026: 9 · 2025: 12 · 2024: 21 · 2023: 21 · 2022: 13 · 2021: 14 · 2020: 23 · 2019: 14 · 2018: 11 · 2017: 11 · 2016: 14 · 2015: 7 · 2014: 3
- FWCI
- 8.82
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Clinical Gastroenterology and Hepatology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (R01AA020172, R01AA02017204)
- National Institute of Diabetes and Digestive and Kidney Diseases (R24DK080506, DK 080506, R01DK088925, K23-DK090303-02, K23DK090303, R01DK085252)
- National Institute of Environmental Health Sciences (P42ES010337)
- National Center for Research Resources (UL1RR031980)
- Topics
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced MRI Techniques and Applications
- Health Sciences › Medicine › Surgery › Organ Transplantation Techniques and Outcomes
- Keywords
- nonalcoholic steatohepatitis, weight loss, liver fat, liver volume, proton density fat fraction, body mass index, obesity, non-alcoholic fatty liver disease, liver histopathology, alanine aminotransferase, aspartate aminotransferase
- MeSH terms
- Adult, Aged, Biopsy, Fats, Female, Histocytochemistry, Humans, Liver, Magnetic Resonance Imaging, Male, Middle Aged, Radiography, Weight Loss, Body Mass Index, Non-alcoholic Fatty Liver Disease
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