EFFECT OF A LIFEST YLE MODIFICATION ON INFL AMMATORY STATE IN OBESIT Y WITH CONCOMITANT NONALCOHOLIC FATTY LIVER DISEASE

Abstract

Resume. The aim of this study was to assess the effect of weight loss due to lifestyle modification as part of obesity treatment in patients with obesity and concomitant NAFLD on inflammatory state. Methods and materials. The study enrolled 53 outpatients with obesity and concomitant NAFLD (Group II) and 52 NAFLD patients as a comparison group (Group I). The control group consisted of 23 healthy volunteers. For all patients we measured serum C-reactive protein, interleukin-6 (IL-6) and IL-15. The patients were randomized to follow-up groups who received only general recommendations (Groups IA and IIA) and active lifestyle modification (ALM) for 24 weeks (Groups IB and IIB). Results. The results of our study showed that patients with obesity and NAFLD displayed statistically significant changes in metabolic and proinflammatory state. Furthermore, we found that after 24 weeks of follow-up in patients with group IA, the content of CRP tended to decrease by 25.00 [–2,63; 44.14]%, which did not reach statistical significance (p > 0.05). However, in patients from group IB, who received ALM, the CRP level decreased by 32.79 [19.05; 53,57]%, i.e. reached a statistical significance (p < 0,05). Relevant changes were observed in the group of patients with obesity and concomitant NAFLD (Group II). Patients of the group IIA displayed the level of CRP decreased by only 10.58 [–3.96; 23.13]% (p > 0.05), but the group IIB showed a statistically significant decrease in CRP by 68.90 [17.18; 89.21]% (p < 0.05). The study in the IL-6 level determined a decrease by 11.49 [–19.91; 24.69]% (p > 0.05) after 24-weeks follow-up in group IA, and in group IIA by 14.34 [–22.10; 22.28]% (p > 0.05). In juxta position, the ALM groups dispayed a statistically significant decrease in IL-6 in the Group IB by 26.84 [19,28; 37.15]% (p < 0.05), and in group IIB by 37.50 [18.81; 55.40]% (p < 0.05). After 24-week follow-up IL-15 decreased insignificantly in group IA by 1.44 [–0.42; 3.22]% (p > 0.05) and in group IIA by 2.25 [–0.53; 9.49]% (p > 0.05). However, the patients receiving ALM showed a significant decrease in the IL-15 level in Group IB by 2.47 [1,23; 7.25]% (p < 0.05), and in Group IIB by 37.32 [33.41; 40.61]% (p < 0.05). Conclusions. The ALM-related weight loss exerts a positive effect on the clinical course of both obesity and NAFLD, including inhibition systemic inflammation by reducing the levels of pro-inflammatory cytokines, i. e. has an immunocorrective effect; and is a pathogenetically proven treatment of both obesity and NAFLD.