Impact of a lifestyle intervention for weight loss on liver-related outcomes in adults with obesity: a subanalysis of a clinical trial
Abstract
Background: This study aimed to evaluate the impact of a structured weight-loss intervention on liver steatosis and liver stiffness in adults with obesity.
Methods: Post hoc analysis of prospectively collected data from a randomized crossover trial (NCT05420311) assessing changes in liver-related outcomes measured from baseline to three months during the overall sequential lifestyle intervention in adults with obesity. Participants sequentially followed a calorie-restricted standard diet, calorie-restricted ketogenic diet (KD), or modified alternate day fasting (mADF)—one month per diet—. Changes in controlled attenuation parameter (CAP), liver stiffness measurement (LSM) and estimated steatosis/LSM-based fibrosis risk categories assessed by vibration-controlled transient elastography were evaluated from baseline to three months during the overall sequential lifestyle intervention. Other assessments included changes in liver enzymes, anthropometric, and cardiometabolic parameters.
Results: Seventy-six participants were included in this subanalysis. Mean weight loss was 7.6 ± 4.7 kg at the end of the study period. Significant reductions in CAP and LSM from baseline to 3 months were observed (from 286.6 ± 70.7 dB/m to 256.6 ± 57.1, p < 0.001, and from 8.8 ± 6.0 kPa to 6.9 ± 3.5 kPa, p = 0.012, respectively). In addition, a significant reduction in the percentage of patients with liver steatosis and LSM-based fibrosis risk ≥F2 was observed. Significant decreases in serum levels of liver enzymes (aspartate aminotransferase, alanine aminotransferase, and gamma-glutamyl transferase) were also detected.
Conclusions: A structured weight-loss lifestyle intervention may be associated with improvements in non-invasive liver-related outcomes in adults with obesity.
Trial registration: ClinicalTrials.gov (NCT05420311).
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BibTeX
@article{rodriguezmunoz2026impact,
title = {{Impact of a lifestyle intervention for weight loss on liver-related outcomes in adults with obesity: a subanalysis of a clinical trial}},
author = {Alba Rodriguez-Muñoz and José Ignacio Martínez-Montoro and Cristina María Díaz-Perdigones and Alba Subiri-Verdugo and Daniel Hinojosa-Nogueira and Virginia Mela and Alberto Vilches-Pérez and Isabel Moreno-Indias and Francisco J. Tinahones},
journal = {BMC Medicine},
year = {2026},
month = oct,
doi = {10.1186/s12916-026-05345-2},
url = {https://link.springer.com/article/10.1186/s12916-026-05345-2},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Impact of a lifestyle intervention for weight loss on liver-related outcomes in adults with obesity: a subanalysis of a clinical trial
AU - Alba Rodriguez-Muñoz
AU - José Ignacio Martínez-Montoro
AU - Cristina María Díaz-Perdigones
AU - Alba Subiri-Verdugo
AU - Daniel Hinojosa-Nogueira
AU - Virginia Mela
AU - Alberto Vilches-Pérez
AU - Isabel Moreno-Indias
AU - Francisco J. Tinahones
PY - 2026
DA - 2026/10/26
JO - BMC Medicine
DO - 10.1186/s12916-026-05345-2
UR - https://link.springer.com/article/10.1186/s12916-026-05345-2
AB - Background: This study aimed to evaluate the impact of a structured weight-loss intervention on liver steatosis and liver stiffness in adults with obesity. Methods: Post hoc analysis of prospectively collected data from a randomized crossover trial (NCT05420311) assessing changes in liver-related outcomes measured from baseline to three months during the overall sequential lifestyle intervention in adults with obesity. Participants sequentially followed a calorie-restricted standard diet, calorie-restricted ketogenic diet (KD), or modified alternate day fasting (mADF)—one month per diet—. Changes in controlled attenuation parameter (CAP), liver stiffness measurement (LSM) and estimated steatosis/LSM-based fibrosis risk categories assessed by vibration-controlled transient elastography were evaluated from baseline to three months during the overall sequential lifestyle intervention. Other assessments included changes in liver enzymes, anthropometric, and cardiometabolic parameters. Results: Seventy-six participants were included in this subanalysis. Mean weight loss was 7.6 ± 4.7 kg at the end of the study period. Significant reductions in CAP and LSM from baseline to 3 months were observed (from 286.6 ± 70.7 dB/m to 256.6 ± 57.1, p < 0.001, and from 8.8 ± 6.0 kPa to 6.9 ± 3.5 kPa, p = 0.012, respectively). In addition, a significant reduction in the percentage of patients with liver steatosis and LSM-based fibrosis risk ≥F2 was observed. Significant decreases in serum levels of liver enzymes (aspartate aminotransferase, alanine aminotransferase, and gamma-glutamyl transferase) were also detected. Conclusions: A structured weight-loss lifestyle intervention may be associated with improvements in non-invasive liver-related outcomes in adults with obesity. Trial registration: ClinicalTrials.gov (NCT05420311).
SN - 1741-7015
ER -