Cargando…

Lifestyle Intervention in NAFLD: Long-Term Diabetes Incidence in Subjects Treated by Web- and Group-Based Programs

Background: Behavioral programs are needed for prevention and treatment of NAFLD and the effectiveness of a web-based intervention (WBI) is similar to a standard group-based intervention (GBI) on liver disease biomarkers. Objective: We aimed to test the long-term effectiveness of both programs on di...

Descripción completa

Detalles Bibliográficos
Autores principales: Petroni, Maria Letizia, Brodosi, Lucia, Armandi, Angelo, Marchignoli, Francesca, Bugianesi, Elisabetta, Marchesini, Giulio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9919358/
https://www.ncbi.nlm.nih.gov/pubmed/36771497
http://dx.doi.org/10.3390/nu15030792
_version_ 1784886804904673280
author Petroni, Maria Letizia
Brodosi, Lucia
Armandi, Angelo
Marchignoli, Francesca
Bugianesi, Elisabetta
Marchesini, Giulio
author_facet Petroni, Maria Letizia
Brodosi, Lucia
Armandi, Angelo
Marchignoli, Francesca
Bugianesi, Elisabetta
Marchesini, Giulio
author_sort Petroni, Maria Letizia
collection PubMed
description Background: Behavioral programs are needed for prevention and treatment of NAFLD and the effectiveness of a web-based intervention (WBI) is similar to a standard group-based intervention (GBI) on liver disease biomarkers. Objective: We aimed to test the long-term effectiveness of both programs on diabetes incidence, a common outcome in NAFLD progression. Methods: 546 NAFLD individuals (212 WBI, 334 GBI) were followed up to 60 months with regular 6- to 12-month hospital visits. The two cohorts differed in several socio-demographic and clinical data. In the course of the years, the average BMI similarly decreased in both cohorts, by 5% or more in 24.4% and by 10% or more in 16.5% of cases available at follow-up. After excluding 183 cases with diabetes at entry, diabetes was newly diagnosed in 48 cases during follow-up (31 (16.6% of cases without diabetes at entry) in the GBI cohort vs. 17 (9.7%) in WBI; p = 0.073). Time to diabetes was similar in the two cohorts (mean, 31 ± 18 months since enrollment). At multivariable regression analysis, incident diabetes was significantly associated with prediabetes (odds ratio (OR) 4.40; 95% confidence interval (CI) 1.97–9.81; p < 0.001), percent weight change (OR 0.57; 95% CI 0.41–0.79; p < 0.001) and higher education (OR 0.49; 95% CI 0.27–0.86; p = 0.014), with no effect of other baseline socio-demographic, behavioral and clinical data, and of the type of intervention. The importance of weight change on incident diabetes were confirmed in a sensitivity analysis limited to individuals who completed the follow-up. Conclusion: In individuals with NAFLD, WBI is as effective as GBI on the pending long-term risk of diabetes, via similar results on weight change.
format Online
Article
Text
id pubmed-9919358
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-99193582023-02-12 Lifestyle Intervention in NAFLD: Long-Term Diabetes Incidence in Subjects Treated by Web- and Group-Based Programs Petroni, Maria Letizia Brodosi, Lucia Armandi, Angelo Marchignoli, Francesca Bugianesi, Elisabetta Marchesini, Giulio Nutrients Article Background: Behavioral programs are needed for prevention and treatment of NAFLD and the effectiveness of a web-based intervention (WBI) is similar to a standard group-based intervention (GBI) on liver disease biomarkers. Objective: We aimed to test the long-term effectiveness of both programs on diabetes incidence, a common outcome in NAFLD progression. Methods: 546 NAFLD individuals (212 WBI, 334 GBI) were followed up to 60 months with regular 6- to 12-month hospital visits. The two cohorts differed in several socio-demographic and clinical data. In the course of the years, the average BMI similarly decreased in both cohorts, by 5% or more in 24.4% and by 10% or more in 16.5% of cases available at follow-up. After excluding 183 cases with diabetes at entry, diabetes was newly diagnosed in 48 cases during follow-up (31 (16.6% of cases without diabetes at entry) in the GBI cohort vs. 17 (9.7%) in WBI; p = 0.073). Time to diabetes was similar in the two cohorts (mean, 31 ± 18 months since enrollment). At multivariable regression analysis, incident diabetes was significantly associated with prediabetes (odds ratio (OR) 4.40; 95% confidence interval (CI) 1.97–9.81; p < 0.001), percent weight change (OR 0.57; 95% CI 0.41–0.79; p < 0.001) and higher education (OR 0.49; 95% CI 0.27–0.86; p = 0.014), with no effect of other baseline socio-demographic, behavioral and clinical data, and of the type of intervention. The importance of weight change on incident diabetes were confirmed in a sensitivity analysis limited to individuals who completed the follow-up. Conclusion: In individuals with NAFLD, WBI is as effective as GBI on the pending long-term risk of diabetes, via similar results on weight change. MDPI 2023-02-03 /pmc/articles/PMC9919358/ /pubmed/36771497 http://dx.doi.org/10.3390/nu15030792 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Petroni, Maria Letizia
Brodosi, Lucia
Armandi, Angelo
Marchignoli, Francesca
Bugianesi, Elisabetta
Marchesini, Giulio
Lifestyle Intervention in NAFLD: Long-Term Diabetes Incidence in Subjects Treated by Web- and Group-Based Programs
title Lifestyle Intervention in NAFLD: Long-Term Diabetes Incidence in Subjects Treated by Web- and Group-Based Programs
title_full Lifestyle Intervention in NAFLD: Long-Term Diabetes Incidence in Subjects Treated by Web- and Group-Based Programs
title_fullStr Lifestyle Intervention in NAFLD: Long-Term Diabetes Incidence in Subjects Treated by Web- and Group-Based Programs
title_full_unstemmed Lifestyle Intervention in NAFLD: Long-Term Diabetes Incidence in Subjects Treated by Web- and Group-Based Programs
title_short Lifestyle Intervention in NAFLD: Long-Term Diabetes Incidence in Subjects Treated by Web- and Group-Based Programs
title_sort lifestyle intervention in nafld: long-term diabetes incidence in subjects treated by web- and group-based programs
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9919358/
https://www.ncbi.nlm.nih.gov/pubmed/36771497
http://dx.doi.org/10.3390/nu15030792
work_keys_str_mv AT petronimarialetizia lifestyleinterventioninnafldlongtermdiabetesincidenceinsubjectstreatedbywebandgroupbasedprograms
AT brodosilucia lifestyleinterventioninnafldlongtermdiabetesincidenceinsubjectstreatedbywebandgroupbasedprograms
AT armandiangelo lifestyleinterventioninnafldlongtermdiabetesincidenceinsubjectstreatedbywebandgroupbasedprograms
AT marchignolifrancesca lifestyleinterventioninnafldlongtermdiabetesincidenceinsubjectstreatedbywebandgroupbasedprograms
AT bugianesielisabetta lifestyleinterventioninnafldlongtermdiabetesincidenceinsubjectstreatedbywebandgroupbasedprograms
AT marchesinigiulio lifestyleinterventioninnafldlongtermdiabetesincidenceinsubjectstreatedbywebandgroupbasedprograms