يتناول هذا البروتوكول مرض الكبد الدهني المرتبط بالخلل الأيضي (MASLD) لدى المرضى الذين يعانون من زيادة الوزن أو السمنة — المحدد بمؤشر كتلة الجسم ≥25 كغ/م² لدى غير الآسيويين، أو ≥23 كغ/م² لدى الأشخاص من أصل آسيوي.
DOI: 10.1016/j.jhep.2024.04.031
In adults with MASLD and overweight, dietary and behavioural therapy-induced weight loss should aim at a sustained reduction of >5% to reduce liver fat, 7–10% to improve liver inflammation, and >10% to improve fibrosis (LoE 2, strong recommendation, strong consensus).
Overweight: BMI of 25–29.9 kg/m² (non-Asian) or 23–24.9 (Asian). Obesity: >30 kg/m² (non-Asian), >25 kg/m² (Asian).
In adults with non-cirrhotic MASLD who have an approved indication, bariatric surgery should be considered, because it can induce long-term beneficial effects on the liver and is associated with remission of type 2 diabetes and improvement of cardiometabolic risk factors (LoE 3, strong recommendation, strong consensus).
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