COMPARISON OF THE EFFECTIVENESS OF LONG AND SHORT TERM WEIGHT REDUCTION INTERVENTIONS ON LIVER FUNCTION IN PATIENTS WITH NON-ALCOHOLIC FATTY LIVER DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS

Background and Aim: Weight reduction interventions (WRIs) are valued as the first line treatment for patients with non-alcoholic fatty liver disease (NAFLD). Several studies have reviewed the benefits of WRIs but none of them performed meta-analysis upon the intervention time. This study aimed to recommend the best WRI with proper time through evaluation liver functions in NAFLD. Methods: A systematic and comprehensive search was performed on EMBASE and MEDLINE databases up to July 2018. Post-intervention data of eligible studies were analyzed using the fixed-effect analysis. In case of heterogeneity, random-effects model and sub-group analysis upon on pre-defined criteria were applied. meta bias analysis and eagers test were used to assess potential publication bias.Results: 23 studies met inclusion criteria with 34 trial arms based on duration and type of intervention. The meta-analysis revealed notable reduction of liver enzymes (ALT, AST and GGT) in response to lifestyle interventions (p-Value <0.05). While none of the diet and exercise interventions separately exerted significant impact. There was greater liver enzymes reduction of long term lifestyle intervention in compare with short term. Low calorie diet in short term diet intervention and modified diet in long term lifestyle intervention leaded to AST reduction.Conclusion: Implementation diet and exercise together as lifestyle intervention leads to improvement liver function due to synergic effect of diet and exercise interventions. The longer time of lifestyle programs are more like to benefit. The best recommendation for NAFLD patents is following lifestyle intervention more than 6 months along with special attention to the type of diet.

کلیدواژه ها:

non-alcoholic fatty liver disease ، weight reduction ، Diet intervention