Top line:
Participation in a liver fibrosis screening program can lead to sustained improvements in alcohol intake, diet, weight, and physical activity in individuals at risk for alcohol-related liver disease (ALD) or metabolic dysfunction-associated fatty liver disease (MASLD). be connected.
methodology:
- Researchers conducted a prospective, single-center study in the Danish general population at risk for ALD or MASLD.
- “At-risk ALD” was defined as current or past alcohol consumption of more than 14 units per week for women and 21 units for men for 5 years or more. “MASLD at risk” was defined as having at least one of the following: obesity, type 2 diabetes, or metabolic syndrome and no long-term excessive alcohol consumption.
- Participants were screened for liver fibrosis using transient elastography (TE) and considered positive if TE ≥ 8 kPa. Liver health results and lifestyle advice were also provided.
- Participants completed surveys one week and six months later to assess self-reported lifestyle changes. A subgroup underwent reexamination and clinical investigation after 2 years.
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- Of 4796 participants (median age 58 years, 52% male), 1850 were at risk for ALD and 2946 were at risk for MASLD. 10% of the ALD group and 7% of the MASLD group screened positive for fibrosis.
- In the ALD group, heavy drinking decreased from 46% at baseline to 32% at 6 months. Only 15% of participants reported an increase in alcohol consumption. Among high-risk drinkers, a positive screening test was associated with abstinence or reduced alcohol consumption (odds ratio) [OR]2.45), on the other hand, the test was not negative.
- After 2 years, heavy drinking decreased from 52% to 41% in a subgroup of 752 patients with ALD, and a positive screen again predicted abstinence or reduced alcohol use (OR, 1.84).
- MASLD participants showed lifestyle improvements after 6 months (35% improved their diet, 22% exercised more, and 13% reported weight loss of 5% or more), with improvements compared to those who screened positive. It was most noticeable in negative subjects (19% negative). 12% each).
in fact:
“Thus, the act of participating in a liver fibrosis screening program can be seen as a catalyst for behavior change and enhance existing motivation for lifestyle improvement,” the authors concluded.
sauce:
Dr. Maria Kjærgaard from Odense University Hospital and the University of Southern Denmark led the study, which was published online on December 26, 2023. Clinical gastroenterology and hepatology.
Limitations:
The researchers found evidence of selection bias, especially as participants in the ALD group were particularly likely to be motivated to change their lifestyle. We also detected a short-term recall bias in the ALD group regarding reported alcohol use after screening, both at his 1st week and at his 6th month. Furthermore, the data show a decrease in the number of people who screened positive in the ALD group, which may overestimate the effectiveness of screening.
Disclosure:
This research was funded through the DECIDE project of the Novo Nordisk Foundation, through the LiverScreen project of the European Union’s Horizon 2020 research and innovation programme, and by the University of Southern Denmark, Odense University Hospital and the Research Foundation of the Southern Denmark Region. I did.
Most authors had no conflicts of interest to disclose. Five received commissions from the industry. Full disclosure was included in the paper.
