Department of Medical and Surgical Sciences, "Alma Mater" University, Bologna, Italy.
Gastroenterology Section, DiBiMIS, University of Palermo, Palermo, Italy.
Curr Pharm Des. 2020;26(10):1110-1118. doi: 10.2174/1381612826666200204095401.
Lifestyle interventions aimed at weight loss have been associated with improved liver enzymes, reduced intrahepatic triglyceride content, and improved histology (including reduced fibrosis stage).
To revise the evidence on the beneficial effects of lifestyle changes accumulated since 2015, following the publication of the pivotal Cuban experience with histologic outcome.
A PubMed search covering the period 2015 to July 2019 was carried out. All retrieved references were analyzed and double-checked by authors.
20 new studies were identified; in addition, two relevant studies provided new evidence. Thirteen studies were classified as randomized, controlled studies, three as proof-of-concept/pilot studies, four as cohort observational studies. In an attempt to maintain a closer contact between participants and the treatment center, a study implemented regular phone calls, another an e-mail service, a third was based on text messages, and finally, a study was totally web-based. Notably, the web-based treatment, accessed following intense motivational interviewing, was not less effective than a standard group-based behavior program.
Lifestyle changes should form the basis of any NAFLD intervention. Information technology provides the opportunity to expand treatment, bypassing job and time constraints in younger patients, and to maintain long-term contact between patients and therapists in the NAFLD population.
旨在减肥的生活方式干预与改善的肝酶、减少肝内甘油三酯含量和改善组织学（包括减少纤维化分期）有关。
根据古巴在组织学结果方面的关键经验发表后，自 2015 年以来，对生活方式改变的有益效果的累积证据进行修订。
对 2015 年至 2019 年 7 月期间进行了 PubMed 检索。对所有检索到的参考文献进行了分析，并由作者进行了双重检查。
确定了 20 项新的研究；此外，两项相关研究提供了新的证据。13 项研究被归类为随机对照研究，3 项为概念验证/试点研究，4 项为队列观察研究。为了保持参与者与治疗中心之间更密切的联系，一项研究实施了定期电话，另一项研究提供了电子邮件服务，第三项研究基于短信，最后一项研究完全基于网络。值得注意的是，基于网络的治疗，在接受强烈的动机访谈后，与标准的基于小组的行为方案一样有效。
生活方式的改变应该成为任何非酒精性脂肪性肝病干预的基础。信息技术提供了扩大治疗的机会，可以绕过年轻患者的工作和时间限制，并在非酒精性脂肪性肝病患者中保持患者和治疗师之间的长期联系。
