Post hoc analyses of surrogate markers of non-alcoholic fatty liver disease (NAFLD) and liver fibrosis in patients with type 2 diabetes in a digitally supported continuous care intervention: an open-label, non-randomised controlled study
dc.contributor.author | Vilar-Gomez, Eduardo | |
dc.contributor.author | Athinarayanan, Shaminie J. | |
dc.contributor.author | Adams, Rebecca N. | |
dc.contributor.author | Hallberg, Sarah J. | |
dc.contributor.author | Bhanpuri, Nasir H. | |
dc.contributor.author | McKenzie, Amy L. | |
dc.contributor.author | Campbell, Wayne W. | |
dc.contributor.author | McCarter, James P. | |
dc.contributor.author | Phinney, Stephen D. | |
dc.contributor.author | Volek, Jeff S. | |
dc.contributor.author | Chalasani, Naga | |
dc.contributor.department | Medicine, School of Medicine | en_US |
dc.date.accessioned | 2019-08-21T20:26:46Z | |
dc.date.available | 2019-08-21T20:26:46Z | |
dc.date.issued | 2019-02-25 | |
dc.description.abstract | OBJECTIVE: One year of comprehensive continuous care intervention (CCI) through nutritional ketosis improves glycosylated haemoglobin(HbA1c), body weight and liver enzymes among patients with type 2 diabetes (T2D). Here, we report the effect of the CCI on surrogate scores of non-alcoholic fatty liver disease (NAFLD) and liver fibrosis. METHODS: This was a non-randomised longitudinal study, including adults with T2D who were self-enrolled to the CCI (n=262) or to receive usual care (UC, n=87) during 1 year. An NAFLD liver fat score (N-LFS) >-0.640 defined the presence of fatty liver. An NAFLD fibrosis score (NFS) of >0.675 identified subjects with advanced fibrosis. Changes in N-LFS and NFS at 1 year were the main endpoints. RESULTS: At baseline, NAFLD was present in 95% of patients in the CCI and 90% of patients in the UC. At 1 year, weight loss of ≥5% was achieved in 79% of patients in the CCI versus 19% of patients in UC (p<0.001). N-LFS mean score was reduced in the CCI group (-1.95±0.22, p<0.001), whereas it was not changed in the UC (0.47±0.41, p=0.26) (CCI vs UC, p<0.001). NFS was reduced in the CCI group (-0.65±0.06, p<0.001) compared with UC (0.26±0.11, p=0.02) (p<0.001 between two groups). In the CCI group, the percentage of individuals with a low probability of advanced fibrosis increased from 18% at baseline to 33% at 1 year (p<0.001). CONCLUSIONS: One year of a digitally supported CCI significantly improved surrogates of NAFLD and advanced fibrosis in patients with T2D. | en_US |
dc.eprint.version | Final published version | en_US |
dc.identifier.citation | Vilar-Gomez, E., Athinarayanan, S. J., Adams, R. N., Hallberg, S. J., Bhanpuri, N. H., McKenzie, A. L., … Chalasani, N. (2019). Post hoc analyses of surrogate markers of non-alcoholic fatty liver disease (NAFLD) and liver fibrosis in patients with type 2 diabetes in a digitally supported continuous care intervention: an open-label, non-randomised controlled study. BMJ open, 9(2), e023597. doi:10.1136/bmjopen-2018-023597 | en_US |
dc.identifier.uri | https://hdl.handle.net/1805/20480 | |
dc.language.iso | en_US | en_US |
dc.publisher | BMJ Publishing Group | en_US |
dc.relation.isversionof | 10.1136/bmjopen-2018-023597 | en_US |
dc.relation.journal | BMJ Open | en_US |
dc.rights | Attribution-NonCommercial 3.0 United States | * |
dc.rights.uri | http://creativecommons.org/licenses/by-nc/3.0/us/ | * |
dc.source | PMC | en_US |
dc.subject | Ketogenic diet | en_US |
dc.subject | Liver fibrosis | en_US |
dc.subject | Non-alcoholic fatty liver disease | en_US |
dc.subject | Type 2 diabetes | en_US |
dc.subject | Very low carb diet | en_US |
dc.subject | Weight loss | en_US |
dc.title | Post hoc analyses of surrogate markers of non-alcoholic fatty liver disease (NAFLD) and liver fibrosis in patients with type 2 diabetes in a digitally supported continuous care intervention: an open-label, non-randomised controlled study | en_US |
dc.type | Article | en_US |