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These inconsistencies may also be due to variations in the extent and severity of the initial liver pathology. In one series, one third of the patients had significant fibrosis or cirrhosis,9 in contrast to another study where biopsies revealed only steatosis in almost all patients.10 In our group, underlying conditions were carefully excluded and the patients (according to the representative liver histology obtained in a third) composition d had only steatosis, some inflammation (in half) and low-grade fibrosis. Previous studies in which the natural course composition d of the disease is described were not aimed at examining the effect of therapeutic interventions.5–10 However, composition d there are data suggesting that diet-induced weight reduction leads to biochemical and histological improvement.35,36 As the present study was designed to evaluate the effect on the liver of improvement of the metabolic profile, each patient was referred to a dietician for individualized counselling and follow-up.
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