title: Restriction of calorie and iron intake results in reduction of visceral fat and serum alanine aminotransferase and ferritin levels in patients with chronic liver disease.
abstract: OBJECTIVE
  To clarify the impact of visceral fat on chronic liver diseases such as non-alcoholic fatty liver disease (NAFLD) and hepatitis C, we investigated the effects of lifestyle modifications on the amount of visceral fat, liver biochemistry and serum ferritin levels in patients with liver disease.
  
  
  METHODS
  Eighty-two patients (NAFLD, n = 37; hepatitis C, n = 45) were advised to adopt lifestyle modifications, including dietary changes and exercise, and these were maintained for 6 months. Bodyweight, percentage of body fat, visceral fat area (VFA) and serum alanine aminotransferase (ALT) and ferritin were measured before and after intervention.
  
  
  RESULTS
  In NAFLD, the mean VFA of 134.5 cm(2) was significantly reduced to 125.3 cm(2) after 6 months (P < 0.001). ALT levels improved significantly between the values measured before and after intervention (P = 0.039). The VFA prior to intervention was 100 cm(2) in hepatitis C patients and it was reduced significantly after 6 months to 95.6 cm(2) (P < 0.001). ALT levels also improved significantly in the hepatitis C patients (P < 0.001). The serum ferritin levels also reduced in these patients. Improvements in serum ALT and ferritin levels correlated with the amount of visceral fat reduction in both groups (P = 0.046, P = 0.008, respectively).
  
  
  CONCLUSIONS
  These findings demonstrate that restriction of calorie and iron intake results in reduction of visceral fat, liver enzymes and ferritin in patients with chronic liver disease. Visceral fat may be a central target for future interventions, not only in NAFLD but also in hepatitis C.
authors.affiliation: Department of Gastroenterology and Hepatology, Division of Clinical Medicine and Biomedical Sciences, Institute of Medical Science, Mie University Graduate School of Medicine Division of Dietary Service, Mie University School Hospital, Tsu, Japan.
authors.forename: Motoh
authors.initials: M
authors.lastname: Iwasa
authors.forename: Nagisa
authors.initials: N
authors.lastname: Hara
authors.forename: Kazuko
authors.initials: K
authors.lastname: Iwata
authors.forename: Masumi
authors.initials: M
authors.lastname: Ishidome
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Sugimoto
authors.forename: Hideaki
authors.initials: H
authors.lastname: Tanaka
authors.forename: Naoki
authors.initials: N
authors.lastname: Fujita
authors.forename: Yoshinao
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Takei