rss
Gut 2004;53:413-419 doi:10.1136/gut.2003.027581
  • Liver

Modest weight loss and physical activity in overweight patients with chronic liver disease results in sustained improvements in alanine aminotransferase, fasting insulin, and quality of life

  1. I J Hickman1,
  2. J R Jonsson2,
  3. J B Prins3,
  4. S Ash4,
  5. D M Purdie5,
  6. A D Clouston2,
  7. E E Powell6
  1. 1School of Medicine, University of Queensland, and Department of Nutrition and Dietetic Services, Princess Alexandra Hospital, Brisbane, Australia
  2. 2School of Medicine, University of Queensland, Brisbane, Australia
  3. 3Department of Endocrinology and Diabetes, Princess Alexandra Hospital, Brisbane, Australia
  4. 4Nutrition and Dietetic Services, Princess Alexandra Hospital, Brisbane, Australia
  5. 5Population and Clinical Sciences Division, Queensland Institute of Medical Research, Brisbane, Australia
  6. 6School of Medicine, University of Queensland, and Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Australia
  1. Correspondence to:
    Dr E Powell
    Princess Alexandra Hospital, Ipswich Rd, Woolloongabba, Qld, 4102, Australia; ElizabethPowellhealth.qld.gov.au
  • Accepted 20 October 2003

Abstract

Background and aim: Obesity is a risk factor for progression of fibrosis in chronic liver diseases such as non-alcoholic fatty liver disease and hepatitis C. The aim of this study was to investigate the longer term effect of weight loss on liver biochemistry, serum insulin levels, and quality of life in overweight patients with liver disease and the effect of subsequent weight maintenance or regain.

Patients: Thirty one patients completed a 15 month diet and exercise intervention.

Results: On completion of the intervention, 21 patients (68%) had achieved and maintained weight loss with a mean reduction of 9.4 (4.0)% body weight. Improvements in serum alanine aminotransferase (ALT) levels were correlated with the amount of weight loss (r = 0.35, p = 0.04). In patients who maintained weight loss, mean ALT levels at 15 months remained significantly lower than values at enrolment (p = 0.004), while in regainers (n = 10), mean ALT levels at 15 months were no different to values at enrolment (p = 0.79). Improvements in fasting serum insulin levels were also correlated with weight loss (r = 0.46, p = 0.04), and subsequent weight maintenance sustained this improvement. Quality of life was significantly improved after weight loss. Weight maintainers sustained recommended levels of physical activity and had higher fasting insulin levels (p = 0.03) at enrolment than weight regainers.

Conclusion: In summary, these findings demonstrate that maintenance of weight loss and exercise in overweight patients with liver disease results in a sustained improvement in liver enzymes, serum insulin levels, and quality of life. Treatment of overweight patients should form an important component of the management of those with chronic liver disease.

Footnotes

    This Article

    1. Abstract
    2. Full text
    3. PDF

    Register for free content

    The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.

    Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.