{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T23:42:11Z","timestamp":1785800531982,"version":"3.56.0"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","license":[{"start":{"date-parts":[[2019,8,21]],"date-time":"2019-08-21T00:00:00Z","timestamp":1566345600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Hepatol Commun"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:p>Weight loss is the primary intervention for nonalcoholic fatty liver disease (NAFLD). A decrease in resting metabolic rate (RMR) out of proportion to the degree of weight loss may promote weight regain. We aimed to determine the impact of hepatic steatosis on weight loss\u2010associated changes in RMR and metabolic adaptation, defined as the difference between predicted and measured RMR after weight loss. We retrospectively analyzed prospectively collected data from 114 subjects without diabetes (52 with NAFLD), with body mass index (BMI) &gt;35, and who enrolled in a 6\u2010month weight loss intervention. Hepatic steatosis was determined by unenhanced computed tomography scans by liver:spleen attenuation ratio &lt;1.1. RMR was measured by indirect calorimetry. At baseline, patients with hepatic steatosis had higher BMI, fat mass (FM), fat\u2010free mass (FFM), and RMR (RMR, 1,933\u00a0kcal\/day; 95% confidence interval [CI], 841\u20102,025\u00a0kcal\/day; versus 1,696; 95% CI, 1,641\u20101,751; <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0&lt;\u00a00.0001). After 6\u00a0months, the NAFLD group experienced larger absolute declines in weight, FM, and FFM, but percentage changes in weight, FFM, and FM were similar between groups. A greater decline in RMR was observed in patients with NAFLD (\u2212179\u00a0kcal\/day; 95% CI, \u2212233 to \u2212126\u00a0kcal\/day; versus \u2212100; 95% CI, \u221251 to \u2212150; <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.0154) for the time\u00a0\u00d7\u00a0group interaction, and patients with NAFLD experienced greater metabolic adaptation to weight loss (\u221297\u00a0kcal\/day; 95% CI, \u2212143 to \u221250\u00a0kcal\/day; versus \u221231.7; 95% CI, \u221274 to 11; <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.0218) for the prediction\u00a0\u00d7\u00a0group interaction. The change (\u0394) in RMR was significantly associated with \u0394FM, \u0394FFM, and baseline RMR, while metabolic adaptation was significantly associated with female sex and \u0394FM only. <jats:italic toggle=\"yes\">Conclusion:<\/jats:italic> Hepatic steatosis is associated with a greater reduction in FM, which predicts RMR decline and a higher metabolic adaptation after weight loss, potentially increasing the risk of long\u2010term weight regain.<\/jats:p>","DOI":"10.1002\/hep4.1414","type":"journal-article","created":{"date-parts":[[2019,8,21]],"date-time":"2019-08-21T12:43:29Z","timestamp":1566391409000},"page":"1347-1355","source":"Crossref","is-referenced-by-count":12,"title":["Impact of Hepatic Steatosis on Resting Metabolic Rate and Metabolic Adaptation in Response to Intentional Weight Loss"],"prefix":"10.1097","volume":"3","author":[{"given":"Vikrant P.","family":"Rachakonda","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine,University of Pittsburgh School of Medicine,Pittsburgh,PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James P.","family":"DeLany","sequence":"additional","affiliation":[{"name":"Translational Research Institute for Metabolism and Diabetes,AdventHealth,Orlando,FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin E.","family":"Kershaw","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Medicine,University of Pittsburgh School of Medicine,Pittsburgh,PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaideep","family":"Behari","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine,University of Pittsburgh School of 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