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Lookup NU author(s): Dr Sviatlana Zhyzhneuskaya, Dr Ahmad Al-Mrabeh, Alison Barnes, Dr Kieren Hollingsworth, Dr Patrick Welsh, Emeritus Professor Roy TaylorORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© 2024 The Author(s). Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK. Aims: Ectopic fat is reduced by effective weight management, but difficult to assess clinically. Methods: We evaluated paired data on 42 participants in the intervention group of the Diabetes Remission Clinical Trial (DiRECT) at baseline, 12 and 24 months after weight loss as indicators of liver fat content measured by 3-point Dixon MRI. Results: Baseline liver fat was elevated at 13.0 [7.8–23.3]% with fasting plasma glucose 7.9 [7.1–10.1] mmol/L. Prevalence of baseline MASLD was 86.4%. After weight loss of 11.9 ± 1.2 kg (0–37 kg) at 12 months, remission of MASLD occurred in 74% and liver fat normalised for many (1.8 [1.2–5.2]%; p < 0.0001) as did fasting glucose (5.9 [5.5–7.2] mmol/L; p < 0.0001). Alanine aminotransferase (ALT) and gamma glutamyl transferase (GGT) decreased at 12 months by 38 [19–60]% (p < 0·0001) and 38 [16–53]% (p < 0.0001) respectively. The positive predictive value for decrease in liver fat, with baseline values of >40 IU/L, was 100% for ALT and 87.5% for GGT. As expected, change in liver fat correlated with change in ALT (r = 0.64; p < 0.0001), GGT (r = 0.38; p = 0.013), AST (r = 0.36; p = 0.018), fatty liver index (r = 0.50; p < 0.0001) and hepatic steatosis index (r = 0.44; p < 0.0001). Conclusion: Metabolic dysfunction-associated steatotic liver disease, an important marker of ill-health is improved by intentional weight loss. If enzyme levels are raised at baseline, following weight loss, changes in ALT and GGT usefully reflect change in liver fat content, with high positive predictive value. Monitoring liver enzymes can provide a simple way to assess change in liver fat following weight loss in day-to-day clinical practice.
Author(s): Zhyzhneuskaya SV, Al-Mrabeh AH, Peters C, Barnes AC, Hollingsworth KG, Welsh P, Sattar N, Lean MEJ, Taylor R
Publication type: Article
Publication status: Published
Journal: Diabetic Medicine
Year: 2024
Pages: Epub ahead of print
Online publication date: 08/12/2024
Acceptance date: 18/10/2024
Date deposited: 17/12/2024
ISSN (print): 0742-3071
ISSN (electronic): 1464-5491
Publisher: John Wiley and Sons Inc.
URL: https://doi.org/10.1111/dme.15462
DOI: 10.1111/dme.15462
Data Access Statement: The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.
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