Evaluation of weight loss and improvement of steatotic liver disease using magnetic resonance imaging in patients with metabolic dysfunction associated steatotic liver disease

Abstract

Aim

Weight loss (WL) is important for improving steatotic liver. However, there have been no sufficient reports comparing WL with liver fibrosis and steatotic changes using magnetic resonance imaging (MRI).

Methods

The study included 111 patients with metabolic dysfunction associated steatotic liver disease who did not take any new drugs during the study period. They were evaluated using MRI and FibroScan®, and then were given a mild low-carbohydrate diet. One year later, they were evaluated again, and changes in alanine transaminase (ALT), MRI proton density fat fraction (MRI-PDFF), and magnetic resonance elastography were examined.

Results

The patients achieved an average WL of 4.2 kg. MRI-PDFF was significantly improved by 0.68-fold for 5%–7% WL, 0.61-fold for 7–10 %WL, and 0.35-fold for 10% or more WL (vs. gain: p < 0.01). In patients with a WL of 5% or more, magnetic resonance elastography was decreased. MRI-PDFF reduction of 30% was observed in 56% of patients with 5%–7% WL, 75 % with 7%–10% WL, and 94% with 10% or more WL (p < 0.01). ALT normalization or 30% reduction was well associated with WL, with 73% for 5%–7% WL, 64% for 7%–10% WL, and 93% for 10% or more WL (p < 0.01). The optimal cutoff for MRI-PDFF improvement and ALT improvement was 5.3% WL in both tests according to receiver operating characteristic analysis (p < 0.01).

Conclusions

Many patients achieved improvement in MRI-PDFF and ALT with WL. WL of 5.3% can improve MRI-PDFF and ALT, contributing to a better prognosis for metabolic dysfunction associated steatotic liver disease patients.