{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T22:29:03Z","timestamp":1769552943175,"version":"3.49.0"},"reference-count":34,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,3,5]],"date-time":"2023-03-05T00:00:00Z","timestamp":1677974400000},"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":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>Recently, pemafibrate and a low\u2010carbohydrate diet (LCD) have each been reported to improve fatty liver disease. However, it is unclear whether their combination improves fatty liver disease and is equally effective in obese and non\u2010obese patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In 38 metabolic\u2010associated fatty liver disease (MAFLD) patients, classified by baseline body mass index (BMI), changes in laboratory values, magnetic resonance elastography (MRE), and magnetic resonance imaging\u2010proton density fat fraction (MRI\u2010PDFF) were studied after 1\u00a0year of combined pemafibrate plus mild LCD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The combination treatment resulted in weight loss (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.002), improvement in hepatobiliary enzymes (\u03b3\u2010glutamyl transferase, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.027; aspartate aminotransferase, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001; alanine transaminase [ALT], <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001), and improvement in liver fibrosis markers (FIB\u20104 index, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.032; 7\u00a0s domain of type IV collagen, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.002; M2BPGi, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). Vibration\u2010controlled transient elastography improved from 8.8 to 6.9\u00a0kPa (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) and MRE improved from 3.1 to 2.8\u00a0kPa (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.017) in the liver stiffness. MRI\u2010PDFF improved from 16.6% to 12.3% in liver steatosis (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.007). In patients with a BMI of 25 or higher, improvements of ALT (<jats:italic>r<\/jats:italic>\u00a0=\u00a00.659, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) and MRI\u2010PDFF (<jats:italic>r<\/jats:italic>\u00a0=\u00a00.784, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) were significantly correlated with weight loss. However, in patients with a BMI below 25, the improvements of ALT or PDFF were not accompanied by weight loss.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Combined treatment with pemafibrate and a low\u2010carbohydrate diet resulted in weight loss and improvements in ALT, MRE, and MRI\u2010PDFF in MAFLD patients. Although such improvements were associated with weight loss in obese patients, the improvements were observed irrespective of weight loss in non\u2010obese patients, indicating this combination can be effective both in obese and non\u2010obese MAFLD patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.16154","type":"journal-article","created":{"date-parts":[[2023,2,22]],"date-time":"2023-02-22T05:02:06Z","timestamp":1677042126000},"page":"921-929","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Effect of a combination of pemafibrate and a mild low\u2010carbohydrate diet on obese and non\u2010obese patients with metabolic\u2010associated fatty liver disease"],"prefix":"10.1111","volume":"38","author":[{"given":"Yuichiro","family":"Suzuki","sequence":"first","affiliation":[{"name":"First Department of Internal Medicine, Faculty of Medicine University of Yamanashi  Yamanashi 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