{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T16:19:06Z","timestamp":1791994746794,"version":"4.4.0"},"reference-count":34,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,1,4]],"date-time":"2021-01-04T00:00:00Z","timestamp":1609718400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Obesity Science &amp; Practice"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Weight loss is recommended as the primary treatment for nonalcoholic fatty liver disease (NAFLD). However, the magnitude and velocity of hepatic steatosis resolution with weight loss is unclear, making it difficult to counsel patients seeking weight loss for treatment of NAFLD. The aim of this study was to determine the rate of hepatic steatosis improvement and stool microbiome changes associated with rapid diet\u2010induced weight loss in NAFLD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Fourteen NAFLD patients (mean\u00a0\u00b1\u00a0standard deviation, body mass index [BMI] 36.4\u00a0\u00b1\u00a04\u00a0kg\/m<jats:sup>2<\/jats:sup>) enrolled in a 12\u2010week meal replacement program underwent frequent measurement of Fibroscan\u2010controlled attenuation parameter (CAP). Magnetic resonance imaging (MRI\u2010Dixon method) for hepatic fat quantitation and stool microbiome analysis (16S rRNA gene sequencing) were completed in 11 subjects at baseline and Week 12.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At Week 12, mean (95% confidence interval) weight loss was \u221213.4 (\u221215.2, \u221211.5)% and CAP score \u221226.6 (\u221235.6, \u221217.6)% (both <jats:italic>Ps<\/jats:italic>\u00a0&lt;\u00a00.001). CAP scores changed at a rate of \u22124.9\u00a0dB\/m\/kg (\u221230.1\u00a0dB\/m per unit BMI) in Weeks 1\u20134 and \u22120.6\u00a0dB\/m\/kg (\u22122.4\u00a0dB\/m per unit BMI) in Weeks 8\u201312. MRI\u2010determined hepatic fat fraction decreased by \u221274.1% (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001) at a rate of \u22120.51%\/kg (\u22123.19% per unit BMI), with complete steatosis resolution in 90% patients. BMI change was associated with decreased stool microbial diversity (coefficient\u00a0=\u00a00.17; Shannon Index), increased abundance of <jats:italic>Prevotella_9<\/jats:italic> (Bacteroidetes; coefficient\u00a0=\u00a00.96) and decreased abundance of <jats:italic>Phascolarctobacterium<\/jats:italic> (Firmicutes; coefficient\u00a0=\u00a0\u22120.42) (both <jats:italic>Ps<\/jats:italic>\u00a0&lt;\u00a00.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Diet\u2010induced intensive weight loss is associated with rapid improvement and complete resolution of hepatic steatosis and decreased stool microbial diversity. These findings highlight the dynamic nature of hepatic fat and may help clinicians to develop evidence\u2010based treatment goals for patients with NAFLD and obesity who undertake weight loss interventions. Further research is warranted to understand the effects of intensive weight loss and gut microbiome changes on long\u2010term NAFLD resolution.<\/jats:p><\/jats:sec>","DOI":"10.1002\/osp4.476","type":"journal-article","created":{"date-parts":[[2020,12,20]],"date-time":"2020-12-20T13:50:23Z","timestamp":1608472223000},"page":"217-225","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Dynamics of hepatic steatosis resolution and changes in gut microbiome with weight loss in nonalcoholic fatty liver disease"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8077-5137","authenticated-orcid":false,"given":"Jaideep","family":"Behari","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology, Hepatology, and Nutrition University of Pittsburgh School of Medicine  Pittsburgh Pennsylvania USA"},{"name":"Pittsburgh Liver Research Center University of Pittsburgh  Pittsburgh Pennsylvania USA"},{"name":"Cancer Epidemiology and Prevention Program University of Pittsburgh Medical Center Hillman Cancer Center  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Graham","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology, Hepatology, and Nutrition University of Pittsburgh School of Medicine  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renwei","family":"Wang","sequence":"additional","affiliation":[{"name":"Cancer Epidemiology and Prevention Program University of Pittsburgh Medical Center Hillman Cancer Center  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5036-0640","authenticated-orcid":false,"given":"Claudiu","family":"Schirda","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Pittsburgh School of Medicine  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir A.","family":"Borhani","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Pittsburgh School of Medicine  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara A.","family":"Meth\u00e9","sequence":"additional","affiliation":[{"name":"Center for Medicine and the Microbiome University of Pittsburgh  Pittsburgh Pennsylvania USA"},{"name":"Division of Pulmonary, Allergy and Critical Care Medicine University of Pittsburgh School of Medicine  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelvin","family":"Li","sequence":"additional","affiliation":[{"name":"Center for Medicine and the Microbiome University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison","family":"Morris","sequence":"additional","affiliation":[{"name":"Center for Medicine and the Microbiome University of Pittsburgh  Pittsburgh Pennsylvania USA"},{"name":"Division of Pulmonary, Allergy and Critical Care Medicine University of Pittsburgh School of Medicine  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hung N.","family":"Luu","sequence":"additional","affiliation":[{"name":"Cancer Epidemiology and Prevention Program University of Pittsburgh Medical Center Hillman Cancer Center  Pittsburgh Pennsylvania USA"},{"name":"Department of Epidemiology, Graduate School of Public Health University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina","family":"Palmieri","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology, Hepatology, and Nutrition 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