Efficacy of dietary and physical activity intervention in non-alcoholic fatty liver disease: a systematic review.
Efficacy of dietary and physical activity intervention in non-alcoholic fatty liver disease: a systematic review.
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DOI：
10.1136/bmjgast-2017-000139
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发表时间：
2017
影响因子：
3.1
通讯作者：
Moore JB
中科院分区：
文献类型：
--
作者：
Kenneally S;Sier JH;Moore JB
非酒精性脂肪性肝病（NAFLD）是全球慢性肝病最常见的原因，在许多成年人群中的患病率超过30%。与肥胖密切相关，通过饮食和体育活动减肥是其管理的支柱。然而，减肥可能很难实现和维持，并且不确定哪种生活方式的改变最有效。这项工作的目的是系统地评估随机对照试验，评估旨在减少脂肪变性或NAFLD活动标志物的饮食，运动或联合干预措施。检索了Medline、Scopus和科克伦数据库，检索时间为1980年1月1日至2016年7月31日，以获得评估饮食、减肥、运动或其任何组合对成人NAFLD疾病标志物影响的干预试验。使用美国饮食协会质量标准检查表评估发表偏倚风险和研究质量。在识别的1710条记录中，24篇文章符合纳入和排除标准; 6篇评估了使用饮食限制的体重减轻，10篇评估了运动，8篇是联合干预。虽然所有试验都表明脂肪变性和/或NAFLD活动标志物显著减少，但联合干预似乎对改善NAFLD最有效。结果表明，建议使用每天比计算的能量需求少500千卡的适度低热量饮食，结合每周3-5天30-60分钟的运动，减轻5-10%的体重。 我们的结论是，在试验环境中可以实现这种体重减轻，但在临床环境中具有挑战性。为了仅通过生活方式改变来管理NAFLD，可能需要在专科诊所进行高强度的多学科干预。本系统综述方案在PROSPERO前瞻性注册为CRD 42016032764。
Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease worldwide, with prevalence above 30% in many adult populations. Strongly associated with obesity, weight loss through diet and physical activity is the mainstay of its management. Weight loss can be difficult to achieve and maintain however, and uncertainty exists as to which lifestyle changes are most effective. The aim of this work was to systematically evaluate randomised controlled trials assessing diet, exercise or combination interventions aimed at reducing steatosis or markers of NAFLD activity. Medline, Scopus and Cochrane databases were searched from 1 January 1980 through to 31 July 2016, for intervention trials assessing the effects of diet, weight loss, exercise or any combination thereof, on NAFLD disease markers in human adults. Risk of publication bias and study quality was assessed using the American Dietetic Association Quality Criteria Checklist. From a total of 1710 identified records, 24 articles met the inclusion and exclusion criteria; 6 assessed weight loss using dietary restriction, 10 assessed exercise and 8 were combination interventions. While all of the trials demonstrated significant reduction in steatosis and/or markers of NAFLD activity, combination interventions appear to be the most effective at improving NAFLD. Results suggest that 5–10% weight loss using a modestly hypocaloric diet of 500 kcal less per day than calculated energy requirement, in combination with 30–60 min exercise on 3–5 days per week should be recommended. We conclude this amount of weight loss is achievable in the trial setting but is challenging in the clinical environment. High-intensity, multidisciplinary intervention in specialist clinics is likely to be required in order to manage NAFLD by lifestyle modification alone. This systematic review protocol was registered prospectively at PROSPERO as CRD42016032764.
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影响因子：
5.1
作者：
Balducci, Stefano;Cardelli, Patrizia;Pugliese, Giuseppe
通讯作者：
Pugliese, Giuseppe
DOI：
10.1136/bmj.b2535
发表时间：
2009-07-21
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Moher D;Liberati A;Tetzlaff J;Altman DG;PRISMA Group
通讯作者：
PRISMA Group
影响因子：
9.8
作者：
Katsagoni, Christina N.;Georgoulis, Michael;Kontogianni, Meropi D.
通讯作者：
Kontogianni, Meropi D.
影响因子：
4.4
作者：
Kani, Ali Hashemi;Alavian, Seyed Moayed;Azadbakht, Leila
通讯作者：
Azadbakht, Leila
影响因子：
25.7
作者：
Keating, Shelley E.;Hackett, Daniel A.;Johnson, Nathan A.
通讯作者：
Johnson, Nathan A.