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非酒精性脂肪性肝病患者的体重减轻初步试验,采用家庭为基础的生活方式改变干预措施,由多学科医务人员合作提供。

A pilot trial of body weight reduction for nonalcoholic fatty liver disease with a home-based lifestyle modification intervention delivered in collaboration with interdisciplinary medical staff.

机构信息

Department of Internal Medicine, Saga Medical School, Nabeshima, Saga, Japan.

出版信息

J Gastroenterol. 2009;44(12):1203-8. doi: 10.1007/s00535-009-0115-x. Epub 2009 Sep 1.

Abstract

BACKGROUND

Nonalcoholic fatty liver disease (NAFLD) is a hepatic manifestation of the metabolic syndrome. The aim of this study was to evaluate a 6-month home-based lifestyle modification intervention delivered in collaboration with physicians, hygienists, registered dietitians, and nurses.

METHODS

Outpatients with NAFLD diagnosed by abdominal ultrasonography were eligible for this study. Abdominal computed tomography (CT) scan evaluated liver fat deposition by the liver-spleen ratio (L/S ratio) and visceral fat accumulation as the visceral fat area (VFA; cm(2)). During the 6-month home-based lifestyle modification intervention, each patient was examined by physicians, nurses, hygienists, and registered dietitians, who provided individualized advice to the patients. Patients recorded their daily weight for self-control of weight with recommended diet and exercise regimens.

RESULTS

Sixty-seven NAFLD patients were enrolled in this study and 22 patients (32.8%) completed the 6-month intervention. Nineteen of the 22 patients achieved significant improvements in body weight, body mass index (BMI), waist circumference, VFA, L/S ratio, and systolic blood pressure, with improved laboratory data. Overall, 39 patients withdrew from the intervention. The mean age of the patients who withdrew was 50.0 +/- 11.0 years, which was significantly younger than that of the patients who were followed up (60.1 +/- 10.1 years; P < 0.01).

CONCLUSIONS

The reduction in body weight achieved by NAFLD patients during the 6-month intervention was associated with improved fat deposition and liver function. This intervention offers a practical approach for treating a large number of NAFLD patients with lifestyle modification therapy.

摘要

背景

非酒精性脂肪性肝病(NAFLD)是代谢综合征的肝脏表现。本研究旨在评估一种 6 个月的家庭生活方式改变干预措施,该措施由医生、保健员、注册营养师和护士合作实施。

方法

通过腹部超声诊断为 NAFLD 的门诊患者有资格参加本研究。腹部计算机断层扫描(CT)扫描通过肝脾比值(L/S 比值)评估肝脏脂肪沉积,通过内脏脂肪面积(VFA;cm²)评估内脏脂肪积聚。在 6 个月的家庭生活方式改变干预期间,每位患者都由医生、护士、保健员和注册营养师进行检查,他们为患者提供个性化的建议。患者记录自己的日常体重,以根据推荐的饮食和运动方案自我控制体重。

结果

本研究共纳入 67 例 NAFLD 患者,22 例(32.8%)完成了 6 个月的干预。22 例患者中有 19 例在体重、体重指数(BMI)、腰围、VFA、L/S 比值和收缩压方面取得显著改善,实验室数据也得到改善。总体而言,39 例患者退出了干预。退出干预的患者平均年龄为 50.0±11.0 岁,明显低于随访患者的年龄(60.1±10.1 岁;P<0.01)。

结论

NAFLD 患者在 6 个月干预期间减轻的体重与脂肪沉积和肝功能改善有关。这种干预为通过生活方式改变治疗大量 NAFLD 患者提供了一种实用的方法。

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