1. Introduction
NAFLD, Non-Alcoholic Fatty Liver Disease, fibrosis
LIVER FIBROSIS, FIBROSIS, LIVER DISEASE, SECONDARY, CHRONIC LIVER DISEASE
Background: Non-Alcoholic Fatty Liver Disease (NAFLD) is one the most prevalent causes of chronic liver disease worldwide. In the absence of an approved drug treatment, lifestyle modification is the first intervention strategy. This study aimed to estimate the main effect of two different physical activity (PA) programs, and a Low-Glycemic-Index Mediterranean Diet (LGIMD), or their combined effect on liver fibrosis parameters in subjects with NAFLD. Methods: Subjects with moderate or severe NAFLD grade of severity (n = 144) were randomly assigned to six intervention arms for three months: LGIMD, PA programs, and their combination. Data were collected at baseline, 45 days, and 90 days. Transient elastography was performed to assess the outcome. Results: at 90 days, a statistically significant reduction in kPa was found among subjects following LGMID (−2.85, 95% CI −5.24, −0.45) and those following an LGIMD plus PA1 (−2.37, 95% CI −4.39, −0.35) and LGIMD plus Pa2 (−2.21, 95% CI −4.10, −0.32). The contrast between time 2 and time 1 of the LGIMD plus PA2 treatment showed a statistically significant increase, and vice versa: the contrast between time 3 and time 2 of the same treatment showed a statistically significant reduction. The PA1 and PA2 arms also showed reduced kPa, although the results did not reach statistical significance. Conclusions: The intervention arms, LGIMD, LGIMD+PA1, and LGIMD+PA2, reduced the fibrosis score.Non-Alcoholic Fatty Liver Disease (NAFLD) is the most common liver disease, affecting about one third of the world’s population [Since 2010, the Laboratory of Epidemiology and Statistics at IRCCS “S. de Bellis” has been studying the effects of lifestyle changes on NAFLD. We have studied several aspects of these changes including the effects of an LGIMD alone [In this context, we hypothesized that an aerobic or resistance PA program and LGIMD could have a positive effect on liver fibrosis parameters in subjects with NAFLD. In this study, as secondary analysis, we aimed to estimate the effects of a 3-month program of aerobic and resistance PA alone or combined with LGIMD, compared with LGIMD alone on the kPa, as measured by transient elastography.