Cognitive-behavioral treatment of nonalcoholic fatty liver disease: A propensity score-adjusted observational study

Moscatiello, Simona, Di Luzio, Raffaella, Bugianesi, Elisabetta, Suppini, Alessandro, Hickman, Ingrid J., Di Domizio, Silvia, Dalle Grave, Riccardo and Marchesini, Giulio (2011) Cognitive-behavioral treatment of nonalcoholic fatty liver disease: A propensity score-adjusted observational study. Obesity, 19 4: 763-770. doi:10.1038/oby.2010.254

Author Moscatiello, Simona
Di Luzio, Raffaella
Bugianesi, Elisabetta
Suppini, Alessandro
Hickman, Ingrid J.
Di Domizio, Silvia
Dalle Grave, Riccardo
Marchesini, Giulio
Title Cognitive-behavioral treatment of nonalcoholic fatty liver disease: A propensity score-adjusted observational study
Journal name Obesity   Check publisher's open access policy
ISSN 1930-7381
Publication date 2011-04
Year available 2010
Sub-type Article (original research)
DOI 10.1038/oby.2010.254
Volume 19
Issue 4
Start page 763
End page 770
Total pages 8
Place of publication New York, NY, U.S.A.
Publisher Nature Publishing Group
Collection year 2011
Language eng
Formatted abstract
The effectiveness of cognitive-behavior treatment (CBT) in nonalcoholic fatty liver disease (NAFLD), largely related to overweight/obesity and considered the hepatic expression of the metabolic syndrome (MS), has so far been tested in very limited samples. In a tertiary referral center, consecutively observed NAFLD subjects were offered a CBT program aimed at weight loss and increased physical activity, based on 13 group sessions; 68 cases entered the treatment protocol, those who refused (n = 82) were given recommendations for diet and physical activity. Treatment goals (weight loss ≥7% initial body weight, normalization of liver enzymes, and improved parameters of MS) were tested by logistic regression at 6 months (all cases) and at 2 years, both on intention-to-treat and in completers (Diet, 78; CBT, 65). The results were adjusted for the propensity score of attending the CBT program, based on civil, anthropometric and clinical variables. At baseline the CBT group had a larger prevalence of obesity and more severe insulin resistance (homeostasis model assessment (HOMA)). At follow-up, CBT was associated with a higher probability of weight loss and normal liver enzymes (6-month: odds ratio (OR), 2.56; 95% confidence interval (CI), 1.15-5.69; 2-year intention-to-treat: OR, 3.57, 95% CI, 1.59-8.00), after adjustment for propensity and changes in body weight. A similar trend was observed in the outcome goals of insulin resistance and the score of MS, which were both reduced. In conclusion, subjects with NAFLD participating in a CBT program significantly improve their general and liver parameters. The beneficial effects are largely maintained at 2-year follow-up, in keeping with the lifestyle-related pathogenesis of disease.
Keyword Liver Diseases
Cognitive-behavioural treatment
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes epub only; Received 28 January 2010; Accepted 9 September 2010; Published online 21 October 2010.

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2011 Collection
School of Human Movement and Nutrition Sciences Publications
UQ Diamantina Institute Publications
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Created: Thu, 24 Feb 2011, 14:12:20 EST by Kylie Hengst on behalf of School of Human Movement and Nutrition Sciences