Table. Characteristics of Included Studies.
| Source | Disease | Total, No. | Participants, % | Duration, mo | Weight Loss Intervention | Comparison | Outcomes Measured | |
|---|---|---|---|---|---|---|---|---|
| Male | Female | |||||||
| Dong et al,32 2016 China | NAFLD | 280 | 100 | 0 | 24 | Diet and exercise | Usual care | ALT, AST, GGT, NFS, FLI, steatosis-US |
| Sun et al,34 2012 China | NAFLD | 1087 | 64 | 36 | 12 | Diet and exercise | Minimal intervention | ALT, AST, GGT |
| Wong et al,47 2013 Hong Kong | NAFLD | 154 | 46 | 54 | 12 | Diet and exercise | Minimal intervention | ALT, AST, FLI, liver stiffness, steatosis-MRI |
| Cheng et al,31 2017 China | NAFLD | 86 | 23 | 77 | 9 | Arm 1: Diet | Usual care | ALT, AST, GGT, steatosis-MRI |
| Arm 2: Exercisea | ||||||||
| Arm 3: Diet and exercise | ||||||||
| Abenavoli et al,36 2017 Italy | NAFLD | 30 | 60 | 40 | 6 | Arm 1: Diet and exercise | Usual care | ALT, AST, GGT, FLI, liver stiffness, steatosis-US |
| Arm 2: Diet, exercise, and antioxidant supplementa | ||||||||
| Axley et al,39 2018 United States | NAFLD | 30 | 37 | 63 | 6 | Diet and exercise | Minimal intervention | ALT, AST |
| Eckard et al,40 2013 United States | NAFLD | 3241 | 59 | 6 | Arm 1: Low-fat diet and exercise | Minimal intervention | ALT, AST, NAS, fibrosis | |
| Arm 2: Moderate-fat diet and exercise | ||||||||
| Promrat et al,45 2010 United States | NASH | 31 | 71 | 29 | 6 | Diet and exercise | Minimal intervention | ALT, AST, NAS, steatosis-H, inflammation, ballooning, fibrosis, definite NASH |
| Katsagoni et al,42 2018 Greece | NAFLD | 63 | 68 | 32 | 6 | Arm 1: Diet | Minimal intervention | ALT, GGT, NFS, liver stiffness |
| Arm 2: Diet and exercise | ||||||||
| Abd El-Kader et al,35 2016 Saudi Arabia | NASH | 100 | 70 | 30 | 3 | Diet and exercise | Usual care | ALT, AST |
| Al-Jiffri et al,37 2013 Saudi Arabia | NAFLD | 100 | 100 | 0 | 3 | Diet and exercise | Usual care | ALT, AST, ALP, GGT |
| Asghari et al,29 2018 Iran | NAFLD | 60 | 68 | 32 | 3 | Arm 1: Diet | Placebo | ALT, AST, steatosis-US, |
| Arm 2: Resveratrola | ||||||||
| St George et al,46 2009 Australia | NAFLDb | 152 | 63 | 37 | 3 | Arm 1: Low-intensity diet and exercise | Minimal intervention | ALT, AST, GGT |
| Arm 2: Moderate-intensity diet and exercise | ||||||||
| Lim et al,27 2018 Singapore | NAFLD | 86 | NR | NR | 3 | Diet and exercise and mobile app | Diet and exercise | ALT, AST |
| Selezneva et al,33 2014 Russia | NAFLD | 174 | NR | NR | 1 | Diet | Isocaloric diet | ALT, AST |
| Armstrong et al,38 2016 United Kingdom | NASH | 52 | 59 | 41 | 12 | Liraglutide | Placebo | ALT, AST, ALP, GGT, ELF, NAS, steatosis-H, inflammation, ballooning, fibrosis, definite NASH |
| Khoo et al,43 2017 Singapore | NAFLD | 30 | 92 | 8 | 6 | Liraglutide | Diet and exercise | ALT, AST, liver stiffness |
| Harrison et al,41 2009 United States | NASH | 41 | 32 | 68 | 9 | Orlistat and diet | Diet | ALT, AST, ALP, NAS, steatosis-H, inflammation, ballooning |
| Ye et al,28 2017 NR | NASH | 30 | NR | NR | 6 | Orlistat | Placebo | Steatosis-MRI |
| Zelber-Sagi et al,48 2006 Israel | NAFLD | 52 | 43 | 57 | 6 | Orlistat, diet, and exercise | Placebo, diet, and exercise | ALT, AST, GGT, steatosis-US, steatosis-H, fibrosis |
| Bahmanadabi et al,30 2011 Iran | NAFLD | 40 | 20 | 80 | 3 | Sibutramine hydrochloride and diet | Diet | ALT, AST, steatosis-US |
| Lee et al,44 2012 Singapore | NASH | 18 | 61 | 39 | 6 | Gastric balloon surgical procedure, diet, and exercise | Sham procedure, diet, and exercise | ALT, NAS, steatosis-H, inflammation, ballooning, fibrosis |
Abbreviations: ALP, alkaline phosphatase; ALT, alanine aminotransferase; AST, aspartate transaminase; ELF, Enhanced Liver Fibrosis; FLI, Fatty Liver Index; GGT, γ-glutamyltransferase; NAFLD, nonalcoholic fatty liver disease; NAS, NAFLD activity score; NASH, nonalcoholic steatohepatitis; NFS, NAFLD fibrosis score; NR, not reported; steatosis-H, histologically assessed steatosis; steatosis-MRI, magnetic resonance imaging–assessed steatosis; steatosis-US, ultrasonography assessed steatosis.
This study arm was excluded from the analysis because it did not meet the review eligibility criteria.
Eight participants had hepatitis C and were not receiving antiviral therapy (n = 6 in the intervention; n = 2 in the control). We included the study in the analysis because the authors reported that their results did not change in a sensitivity analysis that excluded these participants. We also ran a sensitivity analysis excluding this study, and the estimates of the meta-analysis did not change.