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Takahata Y, Takahashi A, Anzai Y, Abe N, Sugaya T, Fujita M, Hayashi M, Abe K, Ohira H. Lifestyle factors affecting new-onset nonalcoholic fatty liver disease. Prev Med Rep 2024; 37:102577. [PMID: 38282666 PMCID: PMC10810835 DOI: 10.1016/j.pmedr.2023.102577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 12/22/2023] [Accepted: 12/22/2023] [Indexed: 01/30/2024] Open
Abstract
Evidence for the influence of lifestyle factors on nonalcoholic fatty liver disease (NAFLD) onset is limited because the association between lifestyle factors and NAFLD has been reported mostly in cross-sectional studies. Our purpose was to elucidate which lifestyle factors are associated with NAFLD onset by performing a longitudinal study. This was a longitudinal study of 1,713 Japanese participants who underwent multiple health checkups from June 2013 to the end of March 2018 and were not diagnosed with NAFLD at the first health checkup at Watari Hospital in Fukushima, Japan. Baseline characteristics, including lifestyle factors, were compared among participants with and without NAFLD. Cox proportional hazards models were used to identify the association between lifestyle factors and NAFLD onset. Among the 1,713 participants, 420 (24.5 %) developed NAFLD during the observation period (median 47 months). There were significant differences in body mass index and hepatobiliary enzyme levels between participants with and without NAFLD. In Cox proportional hazards models, eating between meals (hazard ratio (HR): 2.08, 95 % confidence interval (CI): 1.25-3.45, p < 0.01) and eating fast (HR: 1.59, 95 % CI: 1.26-2.00, p < 0.01) were risk factors for NAFLD onset in men and women, respectively. Moreover, fast walking was a protective factor against NAFLD onset in women (HR: 0.76, 95 % CI: 0.60-0.96, p = 0.02). These findings could help to identify patients at risk and prevent future NAFLD onset.
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Affiliation(s)
- Yosuke Takahata
- Department of Gastroenterology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Atsushi Takahashi
- Department of Gastroenterology, Fukushima Medical University School of Medicine, Fukushima, Japan
- Department of Gastroenterology, Watari Hospital, Fukushima, Japan
| | - Yukio Anzai
- Department of Gastroenterology, Watari Hospital, Fukushima, Japan
| | - Naoto Abe
- Department of Gastroenterology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Tatsuro Sugaya
- Department of Gastroenterology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Masashi Fujita
- Department of Gastroenterology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Manabu Hayashi
- Department of Gastroenterology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Kazumichi Abe
- Department of Gastroenterology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hiromasa Ohira
- Department of Gastroenterology, Fukushima Medical University School of Medicine, Fukushima, Japan
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Zhao J, Wang Q, Zhao X, Wu L, Li J, Zhang W, Xu S, Han C, Du Y, Tong X, Duan W, Cao D, Ren H, Zhao X, Ou X, Jia J, You H. Electro-acupuncture reduced steatosis on MRI-PDFF in patients with non-alcoholic steatohepatitis: a randomized controlled pilot clinical trial. Chin Med 2023; 18:19. [PMID: 36829229 PMCID: PMC9950708 DOI: 10.1186/s13020-023-00724-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Accepted: 02/07/2023] [Indexed: 02/26/2023] Open
Abstract
BACKGROUND Non-alcoholic steatohepatitis (NASH) had not yet been approved therapy. Electro-acupuncture (EA) has been reported to have potential efficacy. However, high-quality clinical evidence was still lacking. METHODS NASH patients were randomized and allocated to either sham acupuncture (SA) or EA group in a 1:1 ratio, with the patient blinded. Each patient received 36 sessions of SA or EA treatment over 12 weeks, followed by additional 4 weeks. The primary outcome was the changes in relative liver fat content measured by magnetic resonance imaging proton density fat fraction (MRI-PDFF). RESULTS A total of 60 patients were enrolled. From baseline to week 12, the reduction of relative liver fat content measured by MRI-PDFF in the EA group (- 33.6%, quantile range: - 52.9%, - 22.7%) was significantly more significant than that in the SA group (- 15.8%, quantile range: - 36.1%, - 2.7%) (p = 0.022). Furthermore, the EA group had more patients who achieved MRI-PDFF to 30% reduction at week 12 (53.3% vs. 25.9%, p = 0.035). EA treatment also significantly reduced body weight (- 3.0 vs. + 0.1 kg, p = 0.034) and BMI (- 1.5 vs. - 0.2 kg/m2, p = 0.013) at week 16. Except for AST (- 27.4 vs. - 16.2 U/L, p = 0.015), other biochemical varieties, including ALT, fasting-glucose, cholesterol, and triglyceride, showed no statistically significant difference. Both groups measured no significant changes in liver stiffness by magnetic resonance elastography (MRE). There were no serious adverse events in either group. CONCLUSIONS Twelve weeks of EA effectively and safely reduces relative liver fat content in NASH patients. Further multicenter randomized controlled studies are needed. Trial registration Chinese Clinical Trial Registry, ChiCTR2100046617. Registered 23 May 2021, http://www.chictr.org.cn/edit.aspx?pid=127023&htm=4.
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Affiliation(s)
- Jingjie Zhao
- grid.24696.3f0000 0004 0369 153XLiver Research Center, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center of Digestive Diseases, No. 95 Yong-an Road, Xi-Cheng District, Beijing, 100050 China ,grid.24696.3f0000 0004 0369 153XClinical Center for Metabolic Associated Fatty Liver Disease, Capital Medical University, Beijing, China ,grid.411610.30000 0004 1764 2878Department of Traditional Chinese Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Qianyi Wang
- grid.24696.3f0000 0004 0369 153XLiver Research Center, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center of Digestive Diseases, No. 95 Yong-an Road, Xi-Cheng District, Beijing, 100050 China ,grid.24696.3f0000 0004 0369 153XClinical Center for Metabolic Associated Fatty Liver Disease, Capital Medical University, Beijing, China
| | - Xinyu Zhao
- grid.24696.3f0000 0004 0369 153XClinical Center for Metabolic Associated Fatty Liver Disease, Capital Medical University, Beijing, China ,grid.411610.30000 0004 1764 2878Clinical Epidemiology and EBM Unit, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Lina Wu
- grid.24696.3f0000 0004 0369 153XLiver Research Center, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center of Digestive Diseases, No. 95 Yong-an Road, Xi-Cheng District, Beijing, 100050 China
| | - Juanjuan Li
- grid.411610.30000 0004 1764 2878Department of Traditional Chinese Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Wen Zhang
- grid.24696.3f0000 0004 0369 153XLiver Research Center, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center of Digestive Diseases, No. 95 Yong-an Road, Xi-Cheng District, Beijing, 100050 China
| | - Shuai Xu
- grid.411610.30000 0004 1764 2878Department of Traditional Chinese Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Chaoru Han
- grid.411610.30000 0004 1764 2878Department of Traditional Chinese Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Yi Du
- grid.411610.30000 0004 1764 2878Department of Traditional Chinese Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xiaofei Tong
- grid.24696.3f0000 0004 0369 153XLiver Research Center, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center of Digestive Diseases, No. 95 Yong-an Road, Xi-Cheng District, Beijing, 100050 China ,grid.24696.3f0000 0004 0369 153XClinical Center for Metabolic Associated Fatty Liver Disease, Capital Medical University, Beijing, China
| | - Weijia Duan
- grid.24696.3f0000 0004 0369 153XLiver Research Center, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center of Digestive Diseases, No. 95 Yong-an Road, Xi-Cheng District, Beijing, 100050 China
| | - Di Cao
- grid.411610.30000 0004 1764 2878Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Hao Ren
- grid.411610.30000 0004 1764 2878Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xinyan Zhao
- grid.24696.3f0000 0004 0369 153XLiver Research Center, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center of Digestive Diseases, No. 95 Yong-an Road, Xi-Cheng District, Beijing, 100050 China
| | - Xiaojuan Ou
- grid.24696.3f0000 0004 0369 153XLiver Research Center, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center of Digestive Diseases, No. 95 Yong-an Road, Xi-Cheng District, Beijing, 100050 China
| | - Jidong Jia
- grid.24696.3f0000 0004 0369 153XLiver Research Center, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center of Digestive Diseases, No. 95 Yong-an Road, Xi-Cheng District, Beijing, 100050 China
| | - Hong You
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center of Digestive Diseases, No. 95 Yong-an Road, Xi-Cheng District, Beijing, 100050, China. .,Clinical Center for Metabolic Associated Fatty Liver Disease, Capital Medical University, Beijing, China.
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Lifestyle Intervention for Patients with Nonalcoholic Fatty Liver Disease: A Randomized Clinical Trial Based on the Theory of Planned Behavior. BIOMED RESEARCH INTERNATIONAL 2022; 2022:3465980. [PMID: 36132088 PMCID: PMC9484896 DOI: 10.1155/2022/3465980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 07/23/2022] [Accepted: 08/16/2022] [Indexed: 11/26/2022]
Abstract
Introduction Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease, accounting for about 25% and 33% of the world's adult population and Iranians, respectively. There is currently no effective therapeutic agent available for the treatment of NAFLD. However, lifestyle modifications aimed at weight loss have been introduced as a cornerstone of NAFLD management. The aim of the present study was to evaluate the effect of educational intervention on lifestyle and anthropometric indices in patients with NAFLD. Methods The randomized controlled clinical trial was performed on 87 overweight or obese patients with NAFLD, including intervention (n = 42) and control (n = 45) groups. The intervention received 8 training sessions based on theory of planned behavior (TPB), while the control groups received nutritional and physical activity recommendations from their internal specialist and nutritionist. Analyses were carried out based on data collected from TPB constructs and anthropometric indices (weight, body mass index (BMI), waist size, and waist-hip ratio (WHR)) at three stages (before intervention and two and 12 weeks after the intervention), as well as data obtained from liver enzymes (alanine aminotransferase (ALT) and aspartate aminotransferase (AST)), and ultrasound-based grading of NAFLD at two stages (before and 12 weeks after the intervention). Results After the intervention, a significant difference was found between the intervention and control groups, resulting in the increased mean scores of TPB constructs, decreased liver enzymes, and decreased degree of NAFLD ultrasound. In addition, the intervention group experienced more activity and healthy diet as compared with the control group. Anthropometric indices showed only a significant decrease in BMI in the intervention group (p < 0.05). Conclusions TPB-based training, as compared with traditional training, is a more effective and cost-effective strategy for altering nutritional behavior and physical activity of patients with NAFLD.
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