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One-year intense nutritional counseling results in histological improvement in patients with non-alcoholic steatohepatitis: a pilot study.
Am J Gastroenterol. 2005 May; 100(5):1072-81.AJ

Abstract

BACKGROUND AND AIM

In individuals with biopsy-proven non-alcoholic steatohepatitis (NASH), short-term weight loss has been shown to improve biochemical abnormalities; however, its effect on liver histology is largely unknown. The aim of the article is to determine if dietary intervention is effective in improving histological features of steatohepatitis in patients with biopsy-proven NASH.

METHODS

Twenty-three patients (11M/12F) with BMI >25 kg/m(2) and biopsy-proven NASH received standardized nutritional counseling aimed at reducing insulin resistance (IR) and weight. Blood tests were checked at baseline and every 1-4 months, and liver biopsy was repeated at month 12. IR was assessed by the homeostasis model assessment (HOMA). Liver biopsies were scored according to modified Brunt criteria for NASH. "Histologic response" was defined as a reduction in total NASH score of >/=2 points with at least one point being in the non-steatosis component.

RESULTS

Sixteen patients (8M/8F) completed 12 months of dietary intervention, and 15 underwent repeat liver biopsies. At month 12, mean weight decreased from 98.3 to 95.4 kg. Mean waist circumference, visceral fat, fasting glucose, IR, triglycerides, AST, ALT, and histologic score were all reduced but the difference was not significant. Nine patients had a histologic response, six had stable scores, and none had a worsened score. Compared to patients with unchanged histologic scores, patients with improved scores had significantly greater reduction in weight, waist circumference, AST, ALT, steatosis grade, and total NASH score.

CONCLUSION

Among patients who successfully completed 1 yr of intense dietary intervention, nine of 15 patients with NASH displayed histologic improvement. This pilot study suggests that dietary intervention can be effective in improving histology in patients with biopsy-proven NASH.

Authors+Show Affiliations

Division of Gastroenterology, Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor, Michigan, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15842581

Citation

Huang, Mary Ann, et al. "One-year Intense Nutritional Counseling Results in Histological Improvement in Patients With Non-alcoholic Steatohepatitis: a Pilot Study." The American Journal of Gastroenterology, vol. 100, no. 5, 2005, pp. 1072-81.
Huang MA, Greenson JK, Chao C, et al. One-year intense nutritional counseling results in histological improvement in patients with non-alcoholic steatohepatitis: a pilot study. Am J Gastroenterol. 2005;100(5):1072-81.
Huang, M. A., Greenson, J. K., Chao, C., Anderson, L., Peterman, D., Jacobson, J., Emick, D., Lok, A. S., & Conjeevaram, H. S. (2005). One-year intense nutritional counseling results in histological improvement in patients with non-alcoholic steatohepatitis: a pilot study. The American Journal of Gastroenterology, 100(5), 1072-81.
Huang MA, et al. One-year Intense Nutritional Counseling Results in Histological Improvement in Patients With Non-alcoholic Steatohepatitis: a Pilot Study. Am J Gastroenterol. 2005;100(5):1072-81. PubMed PMID: 15842581.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - One-year intense nutritional counseling results in histological improvement in patients with non-alcoholic steatohepatitis: a pilot study. AU - Huang,Mary Ann, AU - Greenson,Joel K, AU - Chao,Cewin, AU - Anderson,Lilian, AU - Peterman,Debra, AU - Jacobson,Jon, AU - Emick,Dawn, AU - Lok,Anna S, AU - Conjeevaram,Hari S, PY - 2005/4/22/pubmed PY - 2005/6/2/medline PY - 2005/4/22/entrez SP - 1072 EP - 81 JF - The American journal of gastroenterology JO - Am. J. Gastroenterol. VL - 100 IS - 5 N2 - BACKGROUND AND AIM: In individuals with biopsy-proven non-alcoholic steatohepatitis (NASH), short-term weight loss has been shown to improve biochemical abnormalities; however, its effect on liver histology is largely unknown. The aim of the article is to determine if dietary intervention is effective in improving histological features of steatohepatitis in patients with biopsy-proven NASH. METHODS: Twenty-three patients (11M/12F) with BMI >25 kg/m(2) and biopsy-proven NASH received standardized nutritional counseling aimed at reducing insulin resistance (IR) and weight. Blood tests were checked at baseline and every 1-4 months, and liver biopsy was repeated at month 12. IR was assessed by the homeostasis model assessment (HOMA). Liver biopsies were scored according to modified Brunt criteria for NASH. "Histologic response" was defined as a reduction in total NASH score of >/=2 points with at least one point being in the non-steatosis component. RESULTS: Sixteen patients (8M/8F) completed 12 months of dietary intervention, and 15 underwent repeat liver biopsies. At month 12, mean weight decreased from 98.3 to 95.4 kg. Mean waist circumference, visceral fat, fasting glucose, IR, triglycerides, AST, ALT, and histologic score were all reduced but the difference was not significant. Nine patients had a histologic response, six had stable scores, and none had a worsened score. Compared to patients with unchanged histologic scores, patients with improved scores had significantly greater reduction in weight, waist circumference, AST, ALT, steatosis grade, and total NASH score. CONCLUSION: Among patients who successfully completed 1 yr of intense dietary intervention, nine of 15 patients with NASH displayed histologic improvement. This pilot study suggests that dietary intervention can be effective in improving histology in patients with biopsy-proven NASH. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/15842581/One_year_intense_nutritional_counseling_results_in_histological_improvement_in_patients_with_non_alcoholic_steatohepatitis:_a_pilot_study_ L2 - http://Insights.ovid.com/pubmed?pmid=15842581 DB - PRIME DP - Unbound Medicine ER -