Weight loss in nonalcoholic Fatty liver disease patients in an ambulatory care setting is largely unsuccessful but correlates with frequency of clinic visits.
Weight loss in nonalcoholic Fatty liver disease patients in an ambulatory care setting is largely unsuccessful but correlates with frequency of clinic visits.
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DOI：
10.1371/journal.pone.0111808
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Behari J
中科院分区：
文献类型：
--
作者：
Dudekula A;Rachakonda V;Shaik B;Behari J
非酒精性脂肪性肝病（NALFD）是肝脏疾病的主要原因。减肥可改善NAFLD的临床特征；然而，在研究方案之外，维持减肥效果很差。本研究的目的是表征非住院NAFLD患者长期体重减轻的模式和临床预测因素。我们回顾性分析了2007年5月1日至2013年4月30日在肝脏诊所就诊的924例非肝硬化NAFLD患者。根据USPSTF指南，超重和肥胖患者被建议改变生活方式以减轻体重。主要结局是第一次和最后一次记录访问之间的体重变化百分比：体重变化% = (weightinitial - weightfinal)/(weightinitial)。基线BMI和BMI变化百分比是次要指标。使用逻辑回归确定体重减轻的预测因素。平均基线BMI为33.3±6.6 kg/m2，平均随访时间为17.3±17.6个月。大多数NAFLD患者在基线时属于超重（26.1%）或I级肥胖（30.5%）类别，而体重不足和III级肥胖的患病率较低（分别为0.2%和15.4%）。总体而言，在随访期间，平均体重或BMI没有变化，只有183名患者（19.8%）在随访期间体重减轻至少5%。体重减轻的独立预测因素包括就诊次数和基线BMI，基线BMI较高的患者需要更多的门诊就诊来减轻体重。在非住院治疗的NAFLD患者中，减肥在很大程度上是不成功的。频繁的临床接触与体重减轻有关，特别是在基线BMI高的个体中。需要进一步的研究来确定NAFLD患者有效的减肥策略。
Nonalcoholic fatty liver disease (NALFD) is a leading cause of liver disease. Weight loss improves clinical features of NAFLD; however, maintenance of weight loss outside of investigational protocols is poor. The goals of this study were to characterize patterns and clinical predictors of long-term weight loss in ambulatory patients with NAFLD. We retrospectively reviewed 924 non-cirrhotic patients with NAFLD presenting to a liver clinic from May 1st 2007 to April 30th 2013. Overweight and obese patients were counseled on lifestyle modifications for weight loss as per USPSTF guidelines. The primary outcome was percent weight change between the first and last recorded visits: % weight change = (weightinitial – weightfinal)/(weightinitial). Baseline BMI and percent BMI change were secondary measures. Predictors of weight loss were determined using logistic regression. The mean baseline BMI was 33.3±6.6 kg/m2, and the mean follow-up duration was 17.3±17.6 months. Most patients with NAFLD were in either overweight (26.1%) or class I obesity (30.5%) categories at baseline, while the prevalence of underweight and class III obesity was lower (0.2% and 15.4%, respectively). Overall, there was no change in mean weight or BMI during the follow-up period, and only 183 patients (19.8%) lost at least 5% body weight during the follow up period. Independent predictors of weight loss included number of clinic visits and baseline BMI, and patients with higher baseline BMI required more clinic visits to lose weight. Weight loss is largely unsuccessful in NAFLD patients in the ambulatory care setting. Frequent clinical encounters are associated with weight reduction, especially among individuals with high baseline BMI. Future studies are required to define effective weight loss strategies in NAFLD patients.
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影响因子：
16.2
作者：
Haufe, Sven;Haas, Verena;Engeli, Stefan
通讯作者：
Engeli, Stefan
影响因子：
13.5
作者：
BELLENTANI, S;TIRIBELLI, C;SASSATELLI, R
通讯作者：
SASSATELLI, R
影响因子：
13.5
作者：
Browning, JD;Szczepaniak, LS;Hobbs, HH
通讯作者：
Hobbs, HH
影响因子：
1.7
作者：
Tsai, AG;Wadden, TA;Byrne, KJ
通讯作者：
Byrne, KJ
影响因子：
13.5
作者：
Kugelmas, M;Hill, DB;McClain, CJ
通讯作者：
McClain, CJ