Bariatric Nutritional Intervention in Obese Patients with Compensated Liver Cirrhosis: A Four-Year Prospective Study

Dig Dis Sci. 2024 Apr;69(4):1467-1478. doi: 10.1007/s10620-023-08223-6. Epub 2024 Feb 27.

Abstract

Background: Obesity and liver cirrhosis represent significant health challenges, often leading to various complications.

Aims: This prospective study aimed to investigate the impact of a four-year bariatric intervention, focusing on adherence to the Mediterranean Diet, on anthropometric, hematologic, and biochemical parameters in obese patients with compensated liver cirrhosis. Additionally, the study evaluated the concurrent contribution of weight loss to these health indicators.

Methods: The study involved 62 patients with compensated liver cirrhosis (mean age 65.87 ± 6 years) and 44 healthy controls (mean age 59.11 ± 8 years), all with a BMI > 30 kg/m2. Both groups underwent a weight loss intervention based on the Mediterranean diet, with a four-year follow-up. Anthropometric, biochemical and hematologic parameters were evaluated at several time points during the study and their statistical significance was assessed.

Results: Anthropometric parameters, including weight, BMI, waist and hip circumference, percentage of fat mass, and handgrip strength, exhibited significant improvements (p < 0.05), particularly within the first year of the intervention. Liver function tests and lipid profiles of the patients also showed significant enhancements (p < 0.05). Hematological and biochemical indices, such as hematocrit and ferritin, experienced discreet improvements in the patient cohort (p < 0.05).

Conclusions: This study highlights the potential of a structured bariatric intervention rooted in the Mediterranean diet to positively influence the health of obese patients with compensated liver cirrhosis. The observed improvements in anthropometric, biochemical, and hematologic parameters, particularly within the first year of the intervention, suggest the importance of dietary modifications in managing the health of this patient population.

Keywords: Bariatrics; Compensated liver cirrhosis; Liver cirrhosis; Mediterranean diet; Obesity.

MeSH terms

  • Aged
  • Bariatrics*
  • Body Mass Index
  • Hand Strength*
  • Humans
  • Liver Cirrhosis
  • Middle Aged
  • Obesity / epidemiology
  • Prospective Studies
  • Weight Loss