Clinical utility of liver function tests for resolution of metabolic dysfunction‐associated steatotic liver disease after weight loss in the Diabetes Remission Clinical Trial
Authors' conclusion
Metabolic dysfunction-associated steatotic liver disease, an important marker of ill-health is improved by intentional weight loss. If enzyme levels are raised at baseline, following weight loss, changes in ALT and GGT usefully reflect change in liver fat content, with high positive predictive value. Monitoring liver enzymes can provide a simple way to assess change in liver fat following weight loss in day-to-day clinical practice.
Study context
- Population
- Participants in the intervention group of the Diabetes Remission Clinical Trial (DiRECT); liver fat by 3-point Dixon MRIintervention group
- Participants
- 42 participants
- Primary endpoint
- LFTs as indicators of liver fat content measured by 3-point Dixon MRI
- Follow-up
- Baseline, 12 and 24 months
Methodological detailssingle-group (intervention group), paired data
- Single-group (intervention group)
- Paired data
Primary result
As reported in the abstract
- Correlation of change in liver fat with change in ALT (p < 0.0001)
- r = 0.64
- Correlation of change in liver fat with change in gamma glutamyl transferase (GGT) (p = 0.013)
- r = 0.38
- Correlation of change in liver fat with change in AST (p = 0.018)
- r = 0.36
- Correlation of change in liver fat with change in fatty liver index (p < 0.0001)
- r = 0.50
- Correlation of change in liver fat with change in hepatic steatosis index (p < 0.0001)
- r = 0.44
- PPV for decrease in liver fat, baseline ALT >40 IU/L
- 100%
- PPV for decrease in liver fat, baseline GGT >40 IU/L
- 87.5%
Further findings
Baseline characteristics
- Liver fat
- 13.0 [7.8-23.3]%
- FPG
- 7.9 [7.1-10.1] mmol/L
- Prevalence of MASLD
- 86.4%
Weight loss, MASLD remission, liver fat and FPG · 12 months
- Weight loss
- 11.9 ± 1.2 kg (0-37 kg)
- Remission of MASLD
- 74%
- Liver fat (p < 0.0001)
- 1.8 [1.2-5.2]%
- FPG (p < 0.0001)
- 5.9 [5.5-7.2] mmol/L
Decrease in ALT and GGT · 12 months
- ALT decrease (p < 0.0001)
- 38 [19-60]%
- GGT decrease (p < 0.0001)
- 38 [16-53]%
Original publication
Clinical utility of liver function tests for resolution of metabolic dysfunction‐associated steatotic liver disease after weight loss in the Diabetes Remission Clinical Trial. Diabet Med. Published 8 December 2024. doi:10.
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