Abstract Background Metabolic dysfunction–associated steatotic liver disease (MASLD) is now the most prevalent chronic liver disease, yet effective lifestyle strategies remain underutilized. Aim This study evaluated the impact of a structured lifestyle intervention on anthropometric, biochemical, and body composition parameters, and assessed the utility of bioelectrical impedance analysis (BIA) in monitoring therapeutic response. Methods We prospectively enrolled 253 MASLD patients (110 males, 43.4%; 143 females, 56.6%). All participants underwent a 12-week lifestyle program combining individualized dietary counseling and structured physical activity. Assessments at baseline and post-intervention included anthropometric indices, BIA-derived body composition, liver enzymes, lipid profile, and non-invasive steatosis/fibrosis scores (HSI, FIB-4). Correlation and regression analyses were performed to identify predictors of BMI reduction. Results After 12 weeks, patients achieved significant reductions in body weight, BMI, total fat mass, and visceral fat, alongside increases in fat-free mass and improvements in BIA indices including metabolic age and phase angle. Liver enzymes (ALT, AST) and lipid parameters (total cholesterol, triglycerides, LDL cholesterol) declined significantly, while HDL cholesterol increased. The Hepatic Steatosis Index decreased markedly, whereas FIB-4 values remained unchanged, reflecting the limitation of using a fixed platelet count. Correlation analyses revealed strong positive associations between BMI and BIA-derived fat metrics, and logistic regression identified fat percentage, fat mass, and metabolic age as independent predictors of BMI reduction. Conclusion BIA provides a practical and detailed method for monitoring changes in body composition that accompany improvements in metabolic and hepatic parameters, offering valuable insights into the impact of lifestyle interventions in MASLD.
Elsabaawy et al. (Sun,) studied this question.