title: Effect of body weight and lifestyle changes on long-term course of nonalcoholic fatty liver disease in Koreans.
abstract: BACKGROUND
  Although the prevalence of nonalcoholic fatty liver disease (NAFLD) has been increasing, there have been few studies of long-term changes in NAFLD in large numbers of subjects. This study was performed to assess the long-term changes in severity of fatty liver and to analyze the association with changes in body weight and lifestyle factors.
  
  
  METHODS
  We analyzed lifestyle factors, biochemical data, and abdominal ultrasonography in subjects who underwent voluntary medical checkups at a 5-year interval. Fatty liver on ultrasonography was graded as normal, mild, moderate, or severe by the degree of echogenicity.
  
  
  RESULTS
  The analyzed population consisted of 2895 subjects of age 47+/-8.7 years (range, 20-79 years). Among the 1938 subjects who had normal livers at baseline, 374 subjects (19%) developed fatty liver 5 years later. Those who developed fatty liver showed more weight gain, increase of aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma glutamyl transferase (gamma-GT), and glucose levels during the 5-year period. Among the 930 subjects who had fatty liver at baseline, 263 (28%) subjects showed a decrease in grade and 209 (22%) progressed to a higher grade of fatty liver after 5 years. The group with a lower grade lost -2.2+/-4.3 kg of body weight from baseline, and reduction in hepatic steatosis grade was associated with decreased serum AST, ALT, triglycerides, gamma-GT, and fasting glucose levels.
  
  
  CONCLUSIONS
  Even a small weight reduction was associated with improvements in NAFLD and related metabolic abnormalities such as dyslipidemia and hyperglycemia. Subjects with fatty liver should be advised to lose weight through lifestyle modifications.
authors.affiliation: Health Promotion Center, Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Hong-Kyu
authors.initials: HK
authors.lastname: Kim
authors.forename: Joong-Yeol
authors.initials: JY
authors.lastname: Park
authors.forename: Ki-Up
authors.initials: KU
authors.lastname: Lee
authors.forename: Go-Eun
authors.initials: GE
authors.lastname: Lee
authors.forename: Seong-Hoon
authors.initials: SH
authors.lastname: Jeon
authors.forename: Jin-Ho
authors.initials: JH
authors.lastname: Kim
authors.forename: Chul-Hee
authors.initials: CH
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D001835:Body Weight; D005234:Fatty Liver / Q000178:diet therapy / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006801:Humans; D007723:Korea; D008019:Life Style; D008111:Liver Function Tests; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015431:Weight Loss; D055815:Young Adult