Liver fat scores do not reflect interventional changes in liver fat content induced by high-protein diets.

Abstract

Non-alcoholic fatty liver disease (NAFLD) is common in Metabolic Syndrome and type 2 diabetes (T2DM), driven by energy imbalance, saturated fats and simple carbohydrates. NAFLD requires screening and monitoring for late complications. Liver fat indices may predict NAFLD avoiding expensive or invasive gold-standard methods, but they are poorly validated for use in interventional settings. Recent data indicate a particular insensitivity to weight-independent liver fat reduction. We evaluated 31 T2DM patients, completing a randomized intervention study on isocaloric high-protein diets. We assessed anthropometric measures, intrahepatic lipid (IHL) content and serum liver enzymes, allowing AUROC calculations as well as cross-sectional and longitudinal Spearman correlations between the fatty liver index, the NAFLD-liver fat score, the Hepatosteatosis Index, and IHL. At baseline, all indices predicted NAFLD with moderate accuracy (AUROC 0.731-0.770), supported by correlation analyses. Diet-induced IHL changes weakly correlated with changes of waist circumference, but no other index component or the indices themselves. Liver fat indices may help to easily detect NAFLD, allowing cost-effective allocation of further diagnostics to patients at high risk. IHL reduction by weight-independent diets is not reflected by a proportional change in liver fat scores. Further research on the development of treatment-sensitive indices is required.Trial registration: The trial was registered at clinicaltrials.gov: NCT02402985.

• Authors: Stefan Kabisch, Mariya Markova, Silke Hornemann, Stephanie Sucher, Olga Pivovarova-Ramich, Jürgen Machann, Johannes Hierholzer, Sascha Rohn, Andreas F H Pfeiffer
• Journal: Scientific reports (Sci Rep) Vol. 11 Issue 1 Pg. 8843 (04 23 2021) ISSN: 2045-2322 [Electronic] England
• PMID: 33893355 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Topics

• Adipose Tissue (pathology)
• Adult
• Aged
• Cross-Sectional Studies
• Diabetes Mellitus, Type 2 (complications, diet therapy, pathology)
• Diet, High-Protein
• Female
• Humans
• Insulin Resistance
• Liver (pathology)
• Longitudinal Studies
• Magnetic Resonance Spectroscopy
• Male
• Non-alcoholic Fatty Liver Disease (complications, pathology)
• Waist Circumference