Table 3.
The impact of treatment withdrawal (lifestyle or GLP-1A) following 12 weeks of intervention in people with MASLD.
| Lifestyle (n = 12) |
GLP-1RA, liraglutide (n = 12) |
|||
|---|---|---|---|---|
| End of treatment | 12-weeks post-intervention withdrawal | End of treatment | 12-weeks post-intervention withdrawal | |
| Weight, body composition and blood pressure | ||||
| Weight (kg) | 100.4 ± 6.1 | 100.0 ± 5.9 | 97.9 ± 4.4 | 99.3 ± 4.1 |
| BMI (kg/m2) | 34.5 ± 1.6 | 34.4 ± 1.5 | 33.0 ± 1.6 | 33.4 ± 1.5 |
| Body fat (%) | 43.7 ± 2.2 | 43.6 ± 2.4 | 40.4 ± 2.9 | 40.1 ± 2.9 |
| Total fat mass (kg) | 42.8 ± 3.8 | 42.4 ± 3.8 | 37.8 ± 3.7 | 38.0 ± 3.7 |
| Total lean mass (kg) | 54.0 ± 3.1 | 53.7 ± 3.0 | 54.9 ± 3.2 | 56.0 ± 3.2§ |
| Estimated visceral adipose mass (kg) | 2.1 ± 0.3 | 2.1 ± 0.3 | 1.8 ± 0.3 | 2.0 ± 0.3 |
| Blood pressure (mmHg) systolic (S)/diastolic (D) | S: 121 ± 3 D: 71 ± 3 |
S: 128 ± 2§ D: 77 ± 3‡ |
S: 127 ± 4 D: 79 ± 2 |
S: 133 ± 4 D: 81 ± 2 |
| Physical activity | ||||
| Physical activity (IPAQ), time sitting (h/day) | 9.3 ± 1.6 | 8.3 ± 1.8 | 5.1 ± 0.6 a | 4.7 ± 0.7 |
| Physical activity (IPAQ), total weekly activity (h) | 9.6 ± 3.0 | 6.5 ± 1.5 | 17.6 ± 5.8 | 19.5 ± 7.0 |
| Fasting lipid profile | ||||
| Triglyceride (mmol/L) | 1.2 ± 0.2 | 1.5 ± 0.4 | 1.2 ± 0.1 | 1.4 ± 0.1 |
| Total cholesterol (mmol/L) | 4.6 ± 0.2 | 5.0 ± 0.3§ | 3.9 ± 0.2 | 4.2 ± 0.2§ |
| HDL cholesterol (mmol/L) | 1.2 ± 0.1 | 1.3 ± 0.1‡ | 1.0 ± 0.1 | 1.1 ± 0.1 |
| non-HDL cholesterol (mmol/L) | 3.4 ± 0.2 | 3.7 ± 0.3‡ | 2.9 ± 0.2 | 3.1 ± 0.2‡ |
| NEFA (μmol/L) | 437 ± 34 | 389 ± 47 | 459 ± 47 | 407 ± 55 |
| Insulin and glucose metabolism | ||||
| HbA1c (mmol/mol) | 36 ± 1 | 37 ± 1 | 35 ± 1 | 37 ± 1.0‡ |
| Fasting glucose (mmol/L) | 4.9 ± 0.1 | 4.7 ± 0.2‡ | 4.5 ± 0.1∗ | 5.1 ± 0.2‡ |
| Number with impaired glucose tolerance (%) | 0 | 0 | 1 (8) | 0 |
| Glucose AUC over 180 min OGTT (mmol/L.min) | 7.5 ± 0.4 | 7.1 ± 0.4 | 6.1 ± 0.3† | 7.1 ± 0.5 |
| Fasting insulin (pmol/L) | 92 ± 22 | 110 ± 31 | 127 ± 17 | 127 ± 27 |
| Insulin AUC over 180min OGTT (pmol/L.min) | 727 ± 110 | 685 ± 154 | 833 ± 75 | 682 ± 129 |
| HOMA-IR | 3.3 ± 0.8 | 3.7 ± 1.1 | 4.2 ± 0.6 | 4.4 ± 1.1 |
| Glucose oxidation (Breath13CO2 AUC) over 180 min OGTT (mmol/kg lean mass) | 2.2 × 10-4 ± 1.5 × 10-5 | 2.7 × 10-4 ± 1.8 × 10-5§ | 2.1 × 10-4 ± 2.0 × 10-5 | 2.4 × 10-4 ± 2.0 × 10-5 |
| Liver biochemistry | ||||
| ALT (IU/L) | 48 ± 9 | 50 ± 12 | 46 ± 7 | 54 ± 10 |
| AST (IU/L) | 33 ± 5 | 38 ± 11 | 31 ± 4 | 36 ± 4 |
| Adipose tissue | ||||
| ADIPO-IR (fasting NEFA × fasting insulin) (mmol/L × pmol/L) | 43.8 ± 14.8 | 54.8 ± 17.2 | 57.9 ± 10.2 | 64.2 ± 14.0 |
| Magnetic resonance spectroscopy and imaging | ||||
| MRS hepatic steatosis (%) | 14.0 ± 2.5 | 15.3 ± 2.9 | 18.5 ± 2.4 | 20.8 ± 3.1 |
| Intrahepatic iron (mg/g dry weight) | 1.1 ± 0.1 | 1.1 ± 0.1 | 1.3 ± 0.2 | 1.2 ± 0.1 |
| Iron corrected T1 (cT1) (ms) | 818 ± 30 | 821 ± 32 | 819 ± 30 | 845 ± 29 |
| Non-invasive markers of liver fibrosis | ||||
| FIB-4 FIB-4 risk stratification; low/indeterminate/high (n) |
1.1 ± 0.2 8/4/0 |
1.2 ± 0.2 8/4/0 |
0.9 ± 0.1 10/2/0 |
1.0 ± 0.1§ 10/2/0 |
| NFS NFS risk stratification; low/indeterminate/high (n) |
-1.0 ± 0.3 5/7/0 |
-1.0 ± 0.4 4/8/0 |
-2.0 ± 0.4 8/4/0 |
-2.0 ± 0.4 8/4/0 |
| Hepatic DNL | ||||
| Fasting DNL (%) | 9.4 ± 2.1 | 14.1 ± 2.6‡ | 9.2 ± 2.7 | 14.6 ± 2.3‡ |
| DNL AUC over 180 min OGTT (%.min) | 10.1 ± 2.3 | 16.2 ± 3.5‡ | 9.3 ± 2.4 | 13.3 ± 2.2 |
Data are presented as mean ± SEM unless otherwise stated.
ALT, alanine aminotransferase; AST, aspartate aminotransferase; AUC, area under curve; DNL, de novo lipogenesis; FIB-4, fibrosis-4; GLP-1RA, glucagon-like peptide 1 receptor agonist; HOMA-IR, homeostatic model assessment for insulin resistance; IPAQ, International Physical Activity Questionnaire; MRS, magnetic resonance spectroscopy; NEFA, non-esterified fatty acid; NFS, NAFLD fibrosis score; OGTT, oral glucose tolerance test.
p <0.05.
p <0.01 lifestyle vs. GLP-1RA.
p <0.05.
p <0.01 end of treatment vs. 12-weeks post-treatment within group; paired or unpaired t tests where appropriate.