Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of California San Diego, 9350 Campus Point Dr Ste 2B #0975, San Diego, CA, USA.
Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
Sci Rep. 2024 Mar 28;14(1):7452. doi: 10.1038/s41598-024-57722-7.
Identifying effective, feasible, low-cost interventions that promote sustainable lifestyle changes in nonalcoholic fatty liver disease (NAFLD) is a key unmet need. The aim of this study was to assess predictors of lifestyle practice patterns of NAFLD patients and evaluate the implementation of a mobile technology-based intervention. We prospectively enrolled adults with NAFLD (diagnosed by imaging or biopsy). Individuals with additional liver diseases or decompensated cirrhosis were excluded. Patient were randomized to usual care or a FitBit based program for 6-months. We obtained anthropometrics, labs, vibration controlled transient elastography (VCTE), health-related quality of life (HRQOL), physical activity, diet and motivation to change data. 70 patients were enrolled, 33% with cirrhosis. Median age was 52.1 years, 47% males, 83% white, body mass index 32.3, liver stiffness 7.6 kPa, controlled attenuation parameter 319 db/m, and 50% had diabetes. Baseline HRQOL was 5.4/7 and independently negatively correlated with level of concern about their disease and positively with physical function. Younger age was independently associated with unhealthy diets whereas diabetes was independently associated with unhealthy diets and higher VCTE kPa. 6-month follow-up data available on 31 patients showed trends in improvement in weight. In a cohort of NAFLD patients, we identified independent correlates of lifestyle behaviors and HRQOL. Implementation of interventions that improve physical function may improve HRQOL in NAFLD. Younger patients and those with diabetes appeared to have the greatest need for dietary interventions. Structured mobile technology lifestyle interventions using Fitbit and personalized coaching showed promise but require further validation with a focus on sustainability of intervention and improvement in outcomes.
确定有效的、可行的、低成本的干预措施，以促进非酒精性脂肪性肝病（NAFLD）患者可持续的生活方式改变，是一个关键的未满足需求。本研究的目的是评估 NAFLD 患者生活方式实践模式的预测因素，并评估基于移动技术的干预措施的实施情况。我们前瞻性地招募了患有 NAFLD 的成年人（通过影像学或活检诊断）。排除了有其他肝脏疾病或失代偿性肝硬化的患者。患者被随机分配到常规护理或基于 FitBit 的方案中，为期 6 个月。我们获取了人体测量学、实验室、振动控制瞬态弹性成像（VCTE）、健康相关生活质量（HRQOL）、身体活动、饮食和改变动机的数据。共纳入 70 例患者，33%的患者患有肝硬化。中位年龄为 52.1 岁，47%为男性，83%为白人，体重指数为 32.3，肝硬度为 7.6kPa，受控衰减参数为 319db/m，50%的患者患有糖尿病。基线 HRQOL 为 5.4/7，与对疾病的关注程度呈负相关，与身体功能呈正相关。年龄较轻与不健康饮食独立相关，而糖尿病与不健康饮食和更高的 VCTE kPa 独立相关。31 例患者的 6 个月随访数据显示体重呈改善趋势。在 NAFLD 患者队列中，我们确定了生活方式行为和 HRQOL 的独立相关因素。改善身体功能的干预措施可能会改善 NAFLD 的 HRQOL。年轻患者和患有糖尿病的患者似乎对饮食干预的需求最大。使用 Fitbit 和个性化指导的结构化移动技术生活方式干预措施显示出前景，但需要进一步验证，重点是干预的可持续性和结局的改善。
