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Multicenter Study
. 2024 May 27;14(1):33.
doi: 10.1038/s41387-024-00294-2.

The influence of acute lifestyle changes on NAFLD evolution in a multicentre cohort: a matter of body composition

Marcello Dallio  1 , Moris Sangineto  2 , Mario Romeo  3 , Marina Cipullo  1 , Annachiara Coppola  1 , Simone Mammone  1 , Giuseppe Di Gioia  2 , Mario Masarone  4 , Marcello Persico  4 , Gaetano Serviddio  2 , Alessandro Federico  1
Affiliations
Multicenter Study

The influence of acute lifestyle changes on NAFLD evolution in a multicentre cohort: a matter of body composition

Marcello Dallio et al. Nutr Diabetes. .

Abstract

Background: Unhealthy lifestyles represent a key element fueling Non-alcoholic fatty liver disease (NAFLD) onset and worsening. We aimed to evaluate the effects of forced acute lifestyle changes on NAFLD evolution.

Methods: 187 NAFLD patients were followed two years pre- and two years during the lockdown social restrictions in three Italian medical centers. For each patient, biochemical, clinical, non-invasive liver fibrosis, nutritional, and body composition data were collected.

Results: An increase in fats and carbohydrate intake associated with impaired weekly physical activity during the lockdown was demonstrated as well as an increase in body mass index and waist-hip-ratio (p < 0.0001 for all). Total cholesterol, low-density lipoprotein, high-density lipoprotein, triglycerides, glucose, insulin, homeostatic model assessment for insulin resistance, and transaminases worsened during the lockdown (glucose: p = 0.0007; p < 0.0001 for the others). Moreover, NAFLD fibrosis score, liver stiffness, and controlled attenuation parameter were also impaired during the same period (p < 0.0001 for all). The bioelectrical impedance analysis (BIA) evidenced an increase of fat mass (FM), and a reduction of free fat mass (FFM) and body cell mass (BCM) (p < 0.0001 for all). The lockdown overall hepatocellular carcinoma (HCC) and Milan-out HCC occurrence revealed Hazard Ratio (HR): 2.398, 95% Confidence Interval (CI):1.16-5, p = 0.02, and HR:5.931, CI:2-17.6, p = 0.008 respectively. A liver disease stage and comorbidities independent association between both the assessed outcomes and body composition analysis in terms of mean values and variation (T1-T2 Δ) was demonstrated.

Conclusions: The acute lifestyle changes impacted NAFLD evolution via body composition modifications negatively influencing the HCC occurrence.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1. Study design flowchart.
ALT Alanine Aminotransferase, AST Aspartate aminotransferase, BMI Body Mass Index, CAP Controlled Attenuation Parameter, FPG Fasting Plasma Glucose, HCC Hepatocellular carcinoma, HDL High-density lipoprotein, HOMA-IR Homeostatic model assessment for insulin resistance, LDL Low-density lipoprotein, NAFLD Non-alcoholic fatty liver disease, PLT Platelet count, TG triglycerides, WHR Waist-hip ratio.
Fig. 2
Fig. 2. Hepatopathy progression non-invasive tools modifications.
A LSM: Liver stiffness measurement, B CAP: Controlled attenuation parameter, C NFS: NAFLD Fibrosis score comparison among the three study time points by using ANOVA and Tukey post hoc analysis. kPa: Kilopascal; db/m: decibel/meter. *p < 0.0001.
Fig. 3
Fig. 3. Hepatocellular Carcinoma occurrence in the period preceding the lockdown and during the lockdown.
The Kaplan-Meier Log-Rank Test analysis comparing the HCC overall (A) and Milan-out criteria at diagnosis (B) occurrence pre- vs during the lockdown.
Fig. 4
Fig. 4. Body composition variables and relative association with Hepatocellular Carcinoma occurrence during the lockdown.
Adjusted Odds Ratios for bioimpedance analysis factors’ variations on hepatocellular carcinoma (HCC) overall (A) and Milan-out criteria at diagnosis (B) occurrence during the lockdown period.
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References

    1. Younossi Z, Anstee QM, Marietti M, Hardy T, Henry L, Eslam M, et al. Global burden of NAFLD and NASH: trends, predictions, risk factors and prevention. Nat Rev Gastroenterol Hepatol. 2018;15:11–20. doi: 10.1038/nrgastro.2017.109. - DOI - PubMed
    1. Younossi ZM, Koenig AB, Abdelatif D, Fazel Y, Henry L, Wymer M. Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatol (Baltim, Md) 2016;64:73–84. doi: 10.1002/hep.28431. - DOI - PubMed
    1. Cohen JC, Boerwinkle E, Mosley TH, Jr., Hobbs HH. Sequence variations in PCSK9, low LDL, and protection against coronary heart disease. N. Engl J Med. 2006;354:1264–72. doi: 10.1056/NEJMoa054013. - DOI - PubMed
    1. Sinn DH, Kang D, Chang Y, Ryu S, Gu S, Kim H, et al. Non-alcoholic fatty liver disease and progression of coronary artery calcium score: a retrospective cohort study. Gut. 2017;66:323–9. doi: 10.1136/gutjnl-2016-311854. - DOI - PubMed
    1. Rosato V, Masarone M, Dallio M, Federico A, Aglitti A, Persico M. NAFLD and extra-hepatic comorbidities: current evidence on a multi-organ metabolic syndrome. Int J Environ Res Public Health. 2019;16:3415. doi: 10.3390/ijerph16183415. - DOI - PMC - PubMed

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