Modification of the diabetes prevention program for the treatment of nonalcoholic fatty liver disease: A pilot study.

Objective: The Diabetes Prevention Program (DPP) is the gold standard lifestyle modification program that reduces incident type 2 diabetes mellitus. Patients with prediabetes and patients with non-alcoholic fatty liver disease (NAFLD) often share metabolic features; we hypothesized that the DPP could be adapted and used to improve outcomes in patients with NAFLD.
Methods: NAFLD patients were recruited into a 1 year modified DPP. Demographics, medical comorbidities, and clinical laboratory values were collected at baseline, 6 and 12 months. The primary endpoint was change in weight at 12 months. Secondary endpoints were changes in hepatic steatosis, metabolic comorbidities, and liver enzymes (per-protocol basis) and retention at 6 and 12 months.
Results: Fourteen NAFLD patients enrolled; three dropped out before 6 months. From baseline to 12 months, hepatic steatosis ( p  = 0.03), alanine aminotransferase ( p  = 0.02), aspartate aminotransferase ( p = 0.02), high-density lipoprotein ( p  = 0.01) and NAFLD fibrosis score ( p  < 0.001) improved, but low-density lipoprotein worsened ( p  = 0.04).
Conclusion: Seventy-nine percent of patients completed the modified DPP. Patients lost weight and had improvements in five out of six indicators of liver injury and lipid metabolism.
Clinical Trial Registry Number: NCT04988204.
Competing Interests: The authors declare no other conflict of interest.
(© 2022 The Authors. Obesity Science & Practice published by World Obesity and The Obesity Society and John Wiley & Sons Ltd.)