Beneficial effects of intra-gastric balloon with lifestyle modification on overweight/obese subtype of metabolic dysfunction-associated fatty liver disease

Methods

In this prospective cohort study, patients referred to an obesity clinic were treated with lifestyle modification with or without (based on patient preference) 6 months IGB. Fibrosis and steatosis were assessed with Fibroscan® at baseline, and in case of initial significant or advanced fibrosis or severe steatosis 6 months later. Results: 100 patients were included, largely without comorbidity.

At baseline, advanced chronic liver disease (≥F3) was present in 11% and severe steatosis in 46%. IGB was placed in 59% and only lifestyle modification initiated in 41%. Baseline characteristics did not differ between both groups.

At 6 months, 29 of 50 participants qualifying for repeated evaluation had a second Fibroscan® (19 IGB, 10 lifestyle modification only, without differences in baseline characteristics between both groups). In the IGB group, BMI decreased significantly more (P<0.001) than in the lifestyle modification only group. Liver stiffness decreased markedly in the IGB group (median: from 6.0 to 4.9 kPa, p=0.005), which was not the case in the lifestyle modification only group (median: from 5.5 to 6.9 kPa, p=0,477).

Steatosis improved in both groups, (IGB: controlled attenuation parameter values from 328±34 to 272±62 dB/m, P=0.006: lifestyle modification only: from 344±33 to 305±43 dB/m: P=0.006). Conclusions: Prevalence of MAFLD is high in obese patients without comorbidity. Both steatosis and fibrosis improve after 6 months intra-gastric balloon combined with lifestyle modification.