The prevalence of nonalcoholic fatty liver disease (NAFLD) is increasing rapidly in China, particularly among patients with type 2 diabetes mellitus (T2DM). Weight-loss strategies are recognized as effective treatments for NAFLD. A recent study evaluated the efficacy of the 5:2 fasting diet compared to the glucagon-like peptide-1 receptor agonist liraglutide in reducing liver fat in patients with T2DM and NAFLD.
Study Details
In this prospective, randomized study, 61 T2DM patients with NAFLD were divided into two groups: a 5:2 fasting diet group (n = 31) and a pharmacologic intervention group that received 1.8 mg of liraglutide daily (n = 30). Researchers collected data on body weight, waist circumference, plasma lipids and glucose profiles, fasting plasma insulin, and liver function parameters. Liver fat content was measured using the controlled attenuation parameter (CAP), while oxidative stress was assessed via superoxide dismutase (SOD) and malondialdehyde (MDA) levels.
Results
After 24 weeks, both groups exhibited significant reductions in CAP compared to baseline, with a decrease of 7.4% in the 5:2 diet group and 5.5% in the liraglutide group. Additionally, body weight, plasma lipids and glucose profiles, and liver function parameters showed notable improvements in both groups. The homeostasis model assessment-β (HOMA-β) increased significantly in both groups (all P < 0.05).
Stepwise linear regression analysis identified that in the liraglutide group, increases in HOMA-β and SOD, along with reductions in body mass index (BMI), were independent predictors of decreased CAP (P = 0.000, 0.000, 0.015, respectively). For the 5:2 diet group, reductions in BMI and MDA were independent factors influencing CAP decrease (P = 0.011 and 0.043, respectively).
Common side effects reported by patients in the 5:2 diet group included hunger (in 60%), weakness (in 10%), and constipation (in 0.3%).
Conclusions
The study, which was presented in a late-breaking poster session at the American Diabetes Association Scientific Sessions in Orlando, Florida, concluded that the 5:2 fasting diet achieved effects on liver fat content in T2DM patients with NAFLD that were comparable to treatment with liraglutide by decreasing BMI and oxidative stress. Both treatment strategies were reported to be safe and effective for glucose control.
The authors declared having no competing interests.