Behavioral weight-loss interventions for patients with NAFLD: A systematic scoping review.
Behavioral weight-loss interventions for patients with NAFLD: A systematic scoping review.
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DOI：
10.1097/hc9.0000000000000224
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发表时间：
2023-08-01
影响因子：
5.1
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中科院分区：
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临床上显著的体重减轻——这需要持续的饮食和身体活动的改变——是治疗NAFLD的核心。虽然行为干预在促进初级预防人群减肥方面已被证明有效，但在需要减肥治疗的NAFLD患者中数据有限。我们对NAFLD患者的特征、减肥结果和干预措施成功的决定因素进行了范围审查，以绘制现有数据。我们检索了Medline， EMBASE, Cochrane， PsycINFO和Web of Science从成立到2023年1月1日，以确定在行为减肥干预中报告NAFLD成人体重减轻的出版物。我们总结了干预措施，如果参与者的平均体重比基线下降≥5%，或≥50%的参与者达到了这一目标，则将干预措施分类为成功。我们纳入了28项研究：10项随机对照试验、10项准实验研究和8项观察性研究。干预方式、持续时间和咨询频率各不相同；其中12人成功。电话干预的保留率最高，而“现实世界”面对面干预的保留率最低。女性、年轻和/或有多种代谢疾病的患者最有可能退出。成功的干预包括两周一次的咨询、特定的体育活动、卡路里目标、行为理论基础、促进目标设定、自我监控和解决问题。关于NAFLD的行为减肥干预的数据有限。需要研究开发适用于不同患者群体的有效干预措施，并最大限度地提高依从性，特别是糖尿病患者、女性和年轻患者。
Clinically significant weight loss—which requires sustained dietary and physical activity changes—is central to treating NAFLD. Although behavioral interventions have demonstrated effectiveness in promoting weight loss among primary prevention populations, the data are limited among patients with NAFLD who need weight loss for treatment. We undertook this scoping review to map the existing data on the characteristics, weight-loss outcomes, and determinants of success of interventions evaluated among patients with NAFLD. We searched Medline, EMBASE, Cochrane, PsycINFO, and Web of Science from inception to January 1, 2023 to identify publications reporting weight loss among adults with NAFLD in behavioral weight-loss interventions. We summarized interventions and classified them as successful if there was an average weight loss of ≥ 5% from baseline across enrolled participants or achieved by ≥ 50% of enrolled participants. We included 28 studies: 10 randomized control trials, ten quasi-experimental, and 8 observational studies. Intervention delivery, duration, and counseling frequency varied; 12 were successful. Retention was highest among telephone interventions and lowest among “real-world” face-to-face interventions. Patients who were women, younger, and/or had multiple metabolic conditions were most likely to dropout. Successful interventions had biweekly counseling, specific physical activity, and calorie targets, behavioral theory grounding, and promoted goal-setting, self-monitoring, and problem-solving. There are limited data on behavioral weight-loss interventions in NAFLD. Research is needed to develop effective interventions generalizable to diverse patient populations and that maximize adherence, particularly among patients who are diabetic, women, and younger.