Effect of a combination of pemafibrate and a mild low-carbohydrate diet on obese and non-obese patients with metabolic-associated fatty liver disease.
Effect of a combination of pemafibrate and a mild low-carbohydrate diet on obese and non-obese patients with metabolic-associated fatty liver disease.
复制标题
培马贝特和轻度低碳水化合物饮食组合对患有代谢相关脂肪肝病的肥胖和非肥胖患者的影响。
DOI：
10.1111/jgh.16154
复制
发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Enomoto N
中科院分区：
文献类型：
--
作者：
Suzuki Y;Maekawa S;Yamashita K;Osawa L;Komiyama Y;Nakakuki N;Takada H;Muraoka M;Sato M;Takano S;Fukasawa M;Yamaguchi T;Funayama S;Morisaka H;Onishi H;Enomoto N
背景和目的最近，pemafibrate和低碳水化合物饮食（LCD）均被报道可改善脂肪肝疾病。然而，目前尚不清楚它们的组合是否改善脂肪肝疾病，并且在肥胖和非肥胖患者中同样有效。方法在38例代谢相关脂肪肝疾病（MAFLD）患者中，根据基线体重指数（BMI），实验室值变化，磁共振弹性成像（MRE），和磁共振成像-质子密度脂肪分数在联合使用pemafibrate和轻度LCD治疗1年后，研究了MRI-PDFF（MRI-PDFF）。（P= 0.002），肝胆酶改善（γ-谷氨酰转移酶，P= 0.027;天冬氨酸转氨酶，P< 0.001;丙氨酸转氨酶[ALT]，P< 0.001），以及肝纤维化标志物的改善（FIB-4指数，P= 0.032; IV型胶原的7s结构域，P= 0.002; M2 BPGi，P< 0.001）。振动控制瞬态弹性成像从8.8 kPa改善至6.9 kPa（P< 0.001），MRE从3.1 kPa改善至2.8 kPa（P= 0.017）。肝脏脂肪变性的MRI‐PDFF从16.6%改善至12.3%（P= 0.007）。在BMI ≥ 25的患者中，ALT（r= 0.659，P < 0.001）和MRI-PDFF（r= 0.784，P < 0.001）的改善与体重减轻显著相关。然而，在BMI低于25的患者中，ALT或PDFF的改善并不伴随着体重减轻。ConclusionsCombined treatment with pemafibrate and a low-carbohydrate diet results in weight loss and improvement in ALT，MRE，and MRI‐PDFF in MAFLD patients.尽管这些改善与肥胖患者的体重减轻相关，但在非肥胖患者中观察到的改善与体重减轻无关，表明该组合在肥胖和非肥胖MAFLD患者中均有效。
Background and AimRecently, pemafibrate and a low‐carbohydrate diet (LCD) have each been reported to improve fatty liver disease. However, it is unclear whether their combination improves fatty liver disease and is equally effective in obese and non‐obese patients.MethodsIn 38 metabolic‐associated fatty liver disease (MAFLD) patients, classified by baseline body mass index (BMI), changes in laboratory values, magnetic resonance elastography (MRE), and magnetic resonance imaging‐proton density fat fraction (MRI‐PDFF) were studied after 1 year of combined pemafibrate plus mild LCD.ResultsThe combination treatment resulted in weight loss (P= 0.002), improvement in hepatobiliary enzymes (γ‐glutamyl transferase,P= 0.027; aspartate aminotransferase,P< 0.001; alanine transaminase [ALT],P< 0.001), and improvement in liver fibrosis markers (FIB‐4 index,P= 0.032; 7 s domain of type IV collagen,P= 0.002; M2BPGi,P< 0.001). Vibration‐controlled transient elastography improved from 8.8 to 6.9 kPa (P< 0.001) and MRE improved from 3.1 to 2.8 kPa (P= 0.017) in the liver stiffness. MRI‐PDFF improved from 16.6% to 12.3% in liver steatosis (P= 0.007). In patients with a BMI of 25 or higher, improvements of ALT (r= 0.659,P< 0.001) and MRI‐PDFF (r= 0.784,P< 0.001) were significantly correlated with weight loss. However, in patients with a BMI below 25, the improvements of ALT or PDFF were not accompanied by weight loss.ConclusionsCombined treatment with pemafibrate and a low‐carbohydrate diet resulted in weight loss and improvements in ALT, MRE, and MRI‐PDFF in MAFLD patients. Although such improvements were associated with weight loss in obese patients, the improvements were observed irrespective of weight loss in non‐obese patients, indicating this combination can be effective both in obese and non‐obese MAFLD patients.