Objective: To study the effects of weight loss on nonalcoholic steatohepatitis (NASH) in obese patients.
Methods: It is a prospective study. Blood biochemical parameters were examined in 220 overweight or obese patients without alcoholic consumption and without detectable HBsAg. Ultrasonographic examination was performed by a fixed doctor. 45 obese patients followed a program of weight loss, including diet restriction, exercise or drug for a trial period of one year. Weight, blood biochemical tests and ultrasonic examination of liver were compared before and after the trial in all the patients.
Results: 75.9% of the patients were diagnosed as NASH. Logistic regression analysis revealed that the risk factors of NASH were body mass index (BMI, beta = 0.926, P = 0.021), age (beta = 0.973, P = 0.021), 2-hour postprandial glucose (beta = 0.987, P = 0.012), 1-hour postprandial net insulin in serum (beta = 1.027, P = 0.032), waist circumference (beta = 1.091, P = 0.038)and low density lipoprotein cholesterol (beta = 0.980, P = 0.041). After the treatment, 65.7% of the patients with NASH improved. The level of ALT in these patients decreased significantly (P = 0.040). The improvement of NASH correlated positively with the reduction of BMI (beta = 3.032, P = 0.010), triglycerides (TG, beta = 1.041, P = 0.025) and waist circumference (beta = 1.115, P = 0.029). The decrease of ALT level correlated with the decrease of BMI (beta = 1.165, P = 0.002), TG (beta = 0.986, P = 0.005), waist circumference (beta = 0.736, P = 0.041), and the increase of high density lipoprotein cholesterol (beta = -0.772, P = 0.016).
Conclusion: NASH is one of the most important complications of obesity. Weight loss is the mainstay of treatment for obese patients.