Modification of the diabetes prevention program for the treatment of nonalcoholic fatty liver disease: A pilot study.

Abstract

The Diabetes Prevention Program (DPP) is the gold standard lifestyle modification program that reduces incident type 2 diabetes mellitus. Patients with prediabetes and patients with non-alcoholic fatty liver disease (NAFLD) often share metabolic features; we hypothesized that the DPP could be adapted and used to improve outcomes in patients with NAFLD. NAFLD patients were recruited into a 1year modified DPP. Demographics, medical comorbidities, and clinical laboratory values were collected at baseline, 6 and 12months. The primary endpoint was change in weight at 12months. Secondary endpoints were changes in hepatic steatosis, metabolic comorbidities, and liver enzymes (per-protocol basis) and retention at 6 and 12months. Fourteen NAFLD patients enrolled; three dropped out before 6months. From baseline to 12months, hepatic steatosis (p=0.03), alanine aminotransferase (p=0.02), aspartate aminotransferase (p= 0.02), high-density lipoprotein (p=0.01) and NAFLD fibrosis score (p<0.001) improved, but low-density lipoprotein worsened (p=0.04). Seventy-nine percent of patients completed the modified DPP. Patients lost weight and had improvements in five out of six indicators of liver injury and lipid metabolism. NCT04988204.