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Lifestyle interventions for patients with nonalcoholic fatty liver disease: a network meta-analysis.
Zou, Tian-Tian; Zhang, Chao; Zhou, Yi-Fan; Han, Yi-Jing; Xiong, Jiao-Jiao; Wu, Xi-Xi; Chen, Yong-Ping; Zheng, Ming-Hua.
Afiliação
  • Zou TT; Department of Hepatology, NAFLD Research Center.
  • Zhang C; School of the Second Clinical Medical Sciences.
  • Zhou YF; Center for Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, Shiyan, China.
  • Han YJ; Department of Hepatology, NAFLD Research Center.
  • Xiong JJ; School of the First Clinical Medical Sciences.
  • Wu XX; Department of Hepatology, NAFLD Research Center.
  • Chen YP; School of the First Clinical Medical Sciences.
  • Zheng MH; Department of Hepatology, NAFLD Research Center.
Eur J Gastroenterol Hepatol ; 30(7): 747-755, 2018 07.
Article em En | MEDLINE | ID: mdl-29683979
Lifestyle interventions remain the first-line therapy for nonalcoholic fatty liver disease (NAFLD). This study aims to evaluate the individual impact of exercise and/or dietary interventions on the level of alanine aminotransferase (ALT), aspartate aminotransferase (AST), homeostasis model of assessment for insulin resistance index (HOMA-IR), and BMI. Randomized-controlled trials from patients diagnosed with NAFLD were included in the meta-analysis if they reported the associations between changes in ALT, AST, HOMA-IR, or BMI and types of lifestyle interventions. Nineteen eligible articles were included. Compared with observation, aerobic exercise training (AEx) plus diet [weighted mean difference (WMD)=-25.85; 95% confidence interval (CI): -43.90 to -7.80], AEx (WMD=-8.81; 95% CI: -20.22-2.60) and diet (WMD=-11.85; 95% CI: -47.65-24.95) showed significant efficacy in the improvement of ALT levels. Also AST, AEx plus diet showed a significant tendency to reduce AST levels. In addition, progressive resistance training (WMD=-1.70; 95% CI: -5.61-2.21) led to the most obvious reduction in HOMA-IR compared with observation, but appeared to show no significant effect in BMI (WMD=0.27; 95% CI: -0.48 to -0.07), whereas AEx plus diet (WMD=-0.96; 95% CI: -1.54 to -0.38 and WMD=-1.96; 95% CI: -2.79 to -1.12) showed great efficacy both in the improvement of HOMA-IR and BMI. AEx plus diet is the most effective intervention in the management of patients with NAFLD. Dietary intervention may be more effective in the improvements of aminotransferases, whereas exercise shows superiority in improving insulin sensitivity and reduction of BMI.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Comportamento de Redução do Risco / Hepatopatia Gordurosa não Alcoólica / Estilo de Vida Saudável Tipo de estudo: Clinical_trials / Diagnostic_studies / Etiology_studies / Prognostic_studies / Risk_factors_studies / Systematic_reviews Limite: Humans Idioma: En Ano de publicação: 2018 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Comportamento de Redução do Risco / Hepatopatia Gordurosa não Alcoólica / Estilo de Vida Saudável Tipo de estudo: Clinical_trials / Diagnostic_studies / Etiology_studies / Prognostic_studies / Risk_factors_studies / Systematic_reviews Limite: Humans Idioma: En Ano de publicação: 2018 Tipo de documento: Article