Screening to reveal liver fibrosis was associated with lifestyle modifications such as reducing calorie and alcohol intake and increasing physical activity in people at risk for liver disease. These lifestyle changes, which were initially self-reported six months after the scan, were maintained for two years, according to study results published in Clinical Gastroenterology & Hepatology.
Chronic hepatitis B or C, fatty liver disease, or heavy alcohol consumption can lead to liver fibrosis, cirrhosis, and even liver cancer over time. Metabolic dysfunction-associated fatty liver disease (MASLD; formerly known as nonalcoholic fatty liver disease) is often associated with obesity, type 2 diabetes, and other metabolic abnormalities. Until the recent approval of Rezdifla (Resmetilom), there were no approved drug treatments. In compliance with MASLD, management has relied on lifestyle changes such as diet, exercise, and weight loss.
If liver fibrosis is diagnosed early, it may lead to changes in eating, drinking, and exercise habits. Dr. Maria Kjaergaard and colleagues at Odense University Hospital in Denmark conducted a screening trial of people at risk for MASLD, or alcohol-related liver disease (ALD). All participants were provided with advice on healthy lifestyle changes.
The research team used transient elastography (FibroScan) to analyze self-reported changes in diet, alcohol intake, exercise, and weight after screening. They assessed lifestyle changes using electronic questionnaires after 1 week and 6 months. A small subgroup also underwent reassessment after 2 years.
Researchers recruited 2,946 people at risk for MASLD and 1,850 people at risk for ALD. Approximately half are men, and the average age is 58 years old. Of this population, 383 (8%) tested positive for liver fibrosis (7% in the MASLD group and 10% in the ALD group). Approximately 87% and 84% of the participants completed the questionnaires one week after his and six months after he, respectively.
Among people at risk for MASLD, 26% adopted better diets or reduced calorie intake one week after screening, and that percentage rose to 35% after six months. In addition, 12% increased their exercise level in one week, and after six months he rose to 22%. Six months after fibrosis diagnosis, 13% had lost more than 5% of their baseline weight, and 3% had lost more than 10% of their baseline weight.
Among people at risk for ALD, excessive alcohol consumption decreased from 46% at baseline to 32% six months after liver testing. Regardless of fibrosis status, only 15% reported drinking more alcohol after screening. However, high-risk drinkers who tested positive for fibrosis were more likely to reduce their alcohol intake or even quit after six months.
In a smaller subgroup of 752 people, excessive alcohol consumption decreased from 52% to 41% two years after diagnosis. A positive fibrosis test remained a predictor of reduced drinking or abstinence 2 years later.
“Screening for liver fibrosis is associated with sustained improvements in alcohol intake, diet, weight, and physical activity in at-risk ALD and MASLD,” the researchers wrote. “Screening programs have the potential to combine early detection of advanced fibrosis with increased motivation for lifestyle changes, and thus may act as part of prevention, early detection, and treatment.”
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For more news on alcohol-related liver disease, click here.