Original ResearchFull Report: Clinical—LiverWeight Loss Through Lifestyle Modification Significantly Reduces Features of Nonalcoholic Steatohepatitis
Section snippets
Design
This was a prospective inception cohort “noninterventional” study22, 23 focusing on patients with histologic diagnosis of NASH who started a course of lifestyle modification for 12 months in routine clinical practice. Study follow-up for outcomes began at precisely the same time as initiation of lifestyle intervention. Patients were prospectively and consecutively enrolled in the study after accepting the recommended lifestyle changes plan and fulfilling the selection criteria.
Participants
From June 2009 to
Baseline Characteristic of Participants
Of 349 participants invited to the lifestyle intervention program, 337 agreed and 12 declined. Among those patients who agreed, 44 did not meet our eligibility criteria and were excluded from the study. Thus, a total of 293 subjects were included. During the follow-up, 261 (89%) underwent paired liver biopsies, 24 were lost, and 8 declined to participate in a second liver biopsy (Figure 1). Overall, the mean age of patients was 48.5 years, with a predominance of women (59%). The mean BMI was
Discussion
Although diet and an increased physical activity are well-established therapeutic strategies for conditions such as diabetes and cardiovascular disease, little evidence exists for providing a similar recommendation for NAFLD.35, 36, 37, 38
To the best of our knowledge, this is the first large prospective study conducted in real-world clinical practice that explores the potential benefit of a 12-month of lifestyle intervention on histologic NASH-related features. To date, only a few studies have
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This article has an accompanying continuing medical education activity on page e14. Learning Objective: Upon completion of this CME exam, successful learners will be able to identify associations between different degrees of weight loss induced by lifestyle modifications during 52 weeks and improvements in NASH-related histological outcomes, that will help establish a personalized disease management strategy based on weight-loss goals and patient characteristics in clinical practice.
Conflicts of interest The authors disclose no conflicts.
Funding This work was supported in part by the National Institute of Gastroenterology and Ministry of Health (grant ING-CITMA-2009).