What is nonalcoholic fatty liver? It is defined as hepatic steatosis in the absence of alcohol use or any other chronic liver ailment. It constitutes one of the most widespread liver diseases, touching approximately fifteen million persons in America. People who weigh over 140 percent of their perfect body weight are at considerably higher risk of experiencing nonalcoholic fatty liver disease. Additionally, people suffering from diabetes mellitus and hyperlipidemia have a greater chance to develop nonalcoholic fatty liver disease. Due to these associations, it was taken for granted that weight decrease was going to be an effective treatment for overweight people affected by nonalcoholic fatty liver disease. Wang and colleagues browsed the literature to evaluate the evidence supporting the effectiveness of weight reduction in the treatment of nonalcoholic fatty liver disease.
The authors conducted an extensive hunt for appropriate research through computerized databases (including the Cochrane Hepato-Biliary Group Controlled Trials Register, the Cochrane Controlled Trials Register, MEDLINE, and EMBASE). They also carried out some manual search of abstracts from different scientific meetings. These included the various studies that reported histology of the liver, serum transaminase levels, or radiologic imaging of the liver in obese patients who succeeded in losing weight. Various methods of reducing weight included diet, physical activity, medication therapy, surgical interventions, or any combination. Research was excluded if the weight-loss surgical interference was jejunoileal or small-bowel bypass procedures.
Out of the 517 potentially important trials identified, fifteen met the inclusion criteria. One was a randomized controlled trial, two were non-randomized controlled trials, nine were case series, one was a retrospective review, and two were case reports. Nine of the studies had 25 or fewer participants, while three studies included more than 50 participants. Twelve studies used behavior, dietary, or pharmaco-therapeutic interventions, while three studies used surgical intervention. All the research reported general improvements in outcome measures such as serum transaminase levels, radiologic markers, or hepatic histology. During one study, liver histology got worse in patients who lost over 1.6 kg (3 lb, 8 oz) weekly. In one of the surgical interference, there was a double raise in the number of patients who experienced lobular hepatitis after surgery.
The scientists conclude that although weight decrease is regarded as an effective therapy for nonalcoholic fatty liver, very few data advocate or refute this recommendation. They also say that there is a necessity for randomized controlled trials to find out whether weight decrease in these patients is advantageous. This fact is essential due to the fact that nonalcoholic fatty liver disease is an rising public health problem.
