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Treatment efficacy of diet and exercise program for fatty liver and pretreatment predictors.

AIMS: Both diet and exercise counseling are recommended for patients with fatty liver, including NAFLD, to achieve weight loss goals. However, data evaluating treatment efficacy are limited.

METHODS: The subjects of this retrospective cohort study were 186 consecutive Japanese cases with fatty liver diagnosed by abdominal ultrasonography. Treatment efficacy and predictive factors of "Hospitalization Program for Improvement Purpose for Fatty Liver" as a combined diet and aerobic and resistance exercise program were evaluated according to hospitalization group (153 cases) or no hospitalization group (33 cases). To balance the confounding biases, treatment efficacy was evaluated using propensity score (PS)-matched analysis. In the hospitalization group, a diet of 25 to 30 kcal/kg multiplied by ideal body weight (BW) daily and aerobic and resistance exercise (exercise intensity of 4 to 5 metabolic equivalents daily, respectively) were performed for 6 days.

RESULTS: In liver function tests and BW at 6 months compared to baseline, the decrease rates of the hospitalization group (24 cases) were significantly higher than those of the no hospitalization group (24 cases), using PS-matched analysis. In markers of glycolipid metabolism and ferritin levels, the rates of the hospitalization group were not different from those of the no hospitalization group. In the hospitalization group (153 cases), multivariate regression analysis identified the etiology of non-NAFLD, the presence of diabetes mellitus, and large waist circumference as independent predictors of decreased rates of HbA1c levels.

CONCLUSION: Diet and exercise program for fatty liver improved liver function tests and BW. Further study should be performed to develop a feasible and suitable program. This article is protected by copyright. All rights reserved.

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