Cohort study demonstrates reduced liver fibrosis in patients with MASLD and MetALD through weight loss and lifestyle changes, indicating effective management strategies.
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.
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Ichikawa et al. (2025) studied this question.
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