| Title: |
Long-term follow-up of web-based and group-based behavioural intervention in NAFLD in a real world clinical setting |
| Authors: |
Petroni, Maria Letizia; Colosimo, Santo; Brodosi, Lucia; Armandi, Angelo; Bertini, Flavio; Montesi, Danilo; Bugianesi, Elisabetta; Marchesini, Giulio |
| Contributors: |
Petroni, Maria Letizia; Colosimo, Santo; Brodosi, Lucia; Armandi, Angelo; Bertini, Flavio; Montesi, Danilo; Bugianesi, Elisabetta; Marchesini, Giulio |
| Publication Year: |
2024 |
| Collection: |
IRIS Università degli Studi di Bologna (CRIS - Current Research Information System) |
| Subject Terms: |
attrition; behaviour; biomarker; fibrosi; liver enzyme; steatosi; weight loss |
| Description: |
Background: The long-term results of web-based behavioural intervention in non-alcoholic fatty liver disease (NAFLD) have not been described in patients followed in specialised centres. Aims: To analyse the long-term effectiveness of web education compared with the results achieved by a group-based behavioural intervention in the same years 2012-2014. Methods: We followed 679 patients with NAFLD (web-based, n = 290; group-based, n = 389) for 5 years. Weight loss ≥10% was the primary outcome; secondary outcomes were attrition, changes in liver enzymes and in biomarkers of steatosis (Fatty liver Index) and fibrosis (Fibrosis-4 index). Results: The cohorts differed in age, education, working status and presence of diabetes. Attrition was higher in the web-based cohort (hazard ratio: 1.53; 95% CI: 1.24-1.88), but not different after adjustment for confounders. Among patients in active follow-up, 50% lost ≥5% of initial body weight and 19% lost ≥10%, without difference between cohorts. Alanine aminotransferase levels fell to within the normal range in 51% and 45% of web- and group-based cohorts, respectively. Fatty Liver Index declined progressively and, by year 5, it ruled out steatosis in 4.8%, whereas 24.9% were in the indeterminate range. Fibrosis-4 index increased in both cohorts, driven by age, but the prevalence of cases ruling-in advanced fibrosis remained very low (around 1%). Improvements in the class of both surrogate biomarkers were associated with ≥5% weight loss. Conclusions: Although burdened by attrition, web-based behavioural intervention is feasible and effective in NAFLD, expanding the cohort involved in behavioural programs and reducing the risk of progressive disease. |
| Document Type: |
article in journal/newspaper |
| File Description: |
ELETTRONICO |
| Language: |
English |
| Relation: |
info:eu-repo/semantics/altIdentifier/pmid/37843741; info:eu-repo/semantics/altIdentifier/wos/WOS:001084832100001; volume:59; issue:2; firstpage:249; lastpage:259; numberofpages:11; journal:ALIMENTARY PHARMACOLOGY AND THERAPEUTICS; https://hdl.handle.net/11585/946665 |
| DOI: |
10.1111/apt.17768 |
| Availability: |
https://hdl.handle.net/11585/946665; https://doi.org/10.1111/apt.17768; https://onlinelibrary.wiley.com/doi/10.1111/apt.17768 |
| Rights: |
info:eu-repo/semantics/openAccess |
| Accession Number: |
edsbas.685E2BC3 |
| Database: |
BASE |