SAT-672 Very Low-Calorie Diet Reduces Liver Steatosis in Women with Obesity and Metabolic Dysfunction-Associated Steatotic Liver Disease

Abstract Disclosure: E. Chen: None. L. Sun: None. D.D. Bagar: None. C. Shelsky: None. A. Sanchez: None. A. Vikram: None. R. Gaddam: None. M. Correia: None. Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD) is defined as fat infiltration of >5% of hepatic volume and is a common complication of obesity that can progress to liver cirrhosis. Management of MASLD relies on weight loss of at least 10%. Very-low calorie diets (VLCD) are manufactured replacement meals that limit calorie intake to 800 kcal/day. Individuals with obesity who consume VLCD can lose more than 10% of their baseline weight. Thus, we hypothesized that VLCD can acutely reduce liver steatosis measured with transient elastography (FibroScan) in subjects with obesity and MASLD. Methods: We treated 10 women [Age 47 years ± 3.7] with obesity [BMI 42.3 kg/m2 ± 1.5] and MASLD [Controlled attenuation parameter (CAP) 344.9 dB/m ± 13.8] for 8 weeks with VLCD. FibroScan data was obtained before and after the intervention along with vital signs, waist circumference, body fat percentage measured by bioimpedance, and pertinent labs, including plasma microRNAs (pending). Results: Adherence to VLCD averaged 79%. Weight decreased by 12.72 kg [± 1.1] or 11% from baseline (p < 0.0001). Waist circumference decreased by 9.25 cm [± 1.5] (p = 0.0002). Neck circumference decreased by 2.1 cm [± 0.2] (p < 0.0001). Body fat percentage decreased by 2% [± 0.5] (p = 0.0006). Systolic and diastolic blood pressures decreased by 12.7 mmHg [± 3.6] and 9 mmHg [± 1.6] respectively (p = 0.061 and 0.0004). HbA1c decreased by 0.32 [± 0.066] (p = 0.0009), HOMA-IR declined by 1.95 [± 0.69] (p = 0.02), and triglycerides declined by 36.6 [± 11.63] (p = 0.012). Fasting glucose, ALT, AST and creatinine did not change. FibroScan showed a decrease in CAP of 106.1 dB/m [± 16.3] (p = 0.0001), indicating substantial reduction of liver steatosis. Liver stiffness did not change significantly. Conclusions: These results suggest that VLCD is effective for acute reduction of liver steatosis. Additionally, this study confirms that VLCD safely and effectively reduces weight, blood pressure, HbA1c, and insulin resistance, at least in the short term. Historically, weight regain is common after completion of VLCD; however, anti-obesity medications may help with the prevention of weight regain, a hypothesis that needs to be tested in the future. In conclusion, VLCD can acutely improve MASLD, but its chronic effect on fat liver content remains to be established. Presentation: Saturday, July 12, 2025