The Effect of Moderate Weight Loss on a Non-Invasive Biomarker of Liver Fibrosis: A Randomised Controlled Trial

• Main Authors: Dimitrios A. Koutoukidis, Susan A. Jebb, Paul Aveyard, Nerys M. Astbury
• Format: Article
• Language: English
• Published: Karger Publishers 2020-03-01
• Series: Obesity Facts
• Subjects: weight loss; liver fibrosis; biomarkers
• Online Access: https://www.karger.com/Article/FullText/505667
• ISSN: 1662-4025; 1662-4033

Background: Referral to weight loss programmes is the only effective treatment for non-alcoholic fatty liver disease (NAFLD). Clinicians should advise weight loss and screen for liver fibrosis using the Enhanced Liver Fibrosis (ELF) score. Aim: To examine if the ELF score changes with weight loss. Design and Setting: Randomised controlled trial (ISRCTN85485463) in UK primary care during 2007–2008. Method: Adults with a BMI of 27–35 kg/m2 and ≥1 risk factor for obesity-related disease were randomised to attend a community weight loss programme (n = 45) or receive usual weight loss advice from a practice nurse (n = 28). Weight and the ELF score were measured at baseline and 1 year. Analysis of covariance examined mean changes in the ELF score between groups and its relationship with weight loss. Results: Mean (SD) BMI was 31.10 kg/m2 (2.55) with evidence of moderate levels of liver fibrosis at baseline (mean ELF score: 8.93 [0.99]). There was no evidence that the community weight loss programme reduced the ELF score compared with usual care (difference +0.13 points, 95% CI: –0.25 to 0.52) despite greater weight loss (difference: –2.66 kg, 95% CI: –5.02 to –0.30). Mean weight loss in the whole cohort was 7.8% (5.9). There was no evidence of an association between weight change and change in ELF; the coefficient for a 5% weight loss was –0.15 (95% CI: –0.30 to 0.0002). Conclusion: We found no evidence that the ELF score changed meaningfully following moderate weight loss. Clinicians should not use the ELF score to measure improvements in NAFLD fibrosis following weight loss programmes.