The following is a summary of the “Changes in abdominal adipose tissue depots assessed by MRI correlate with hepatic histologic improvement in non-alcoholic steatohepatitis,” published in the February 2023 issue of Hepatology by Shen, et al.

Those who are overweight are at increased risk for developing NASH, which can ultimately lead to cirrhosis. Therefore, they conducted a secondary analysis of prospectively collected data from the multicenter, randomized, placebo-controlled FLINT study to determine whether or not a decrease in adipose tissue compartment sizes was associated with an enhancement of liver histologic grading. To this goal, we included (n = 76) adult individuals from the FLINT study who underwent liver biopsies and abdominal MRI scans before and after the 72-week treatment period. Using magnetic resonance imaging, the volume of adipose tissue compartments was measured.

Neither the baseline nor the longitudinal adipose tissue volume between the treatment and placebo groups differed significantly (P = 0.107 to 0.745). Histologic improvement in NASH (i.e., NAS [non-alcoholic fatty liver disease activity score] reductions of 2 points, at least 1 point from lobular inflammation and hepatocellular ballooning, and no worsening of fibrosis) was linked to decreased volumes of deep subcutaneous adipose tissue (dSAT) and visceral adipose tissue (P = 0.031 and 0.030, respectively). 

Reductions in dSAT and PDFF were associated with histologic improvement in NASH (regression coefficient = -2.001 and -0.083, P = 0.044 and 0.033, respectively) in a multivariate logistic regression analysis that also included demographics, treatment group, baseline histology, baseline and changes in adipose tissue volumes, and MRI hepatic proton density fat fraction (PDFF) and serum aminotransferases. Greater longitudinal decreases in dSAT and possibly visceral adipose tissue volumes were associated with higher hepatic histologic improvements in persons with NASH in the FLINT trial, and this was independent of reductions in hepatic PDFF.

Source: sciencedirect.com/science/article/abs/pii/S0168827822032846