Z Gastroenterol 2013; 51 - A67
DOI: 10.1055/s-0033-1347442

Non-alcoholic fatty liver disease in clinical practice – one year outpatient clinic and NAFLD lifestyle educational program (NALEP) experience in Vienna

S Traussnigg 1, C Kienbacher 1, I Weiß 1, P Hillebrand 1, H Hofer 1, M Trauner 1
  • 1MUW – KIM III – Abt. f. Gastroenterologie und Hepatologie, Wien, Austria

Background: Non-alcoholic steatohepatitis (NASH) is a chronic and progressive liver disease strongly associated with the metabolic syndrome (MS). The only established therapies are life style intervention and treatment of participating metabolic disorders like dyslipidemia and diabetes.

Aims/Methods: All patients at the Vienna NAFLD outpatients clinic were offered the possibility to join a monthly NAFLD lifestyle educational program (NALEP) especially developed by our dietitians. We retrospectively analyzed the data available for up to six months after the first intervention.

Results: To date, 48 patients participated in NALEP. Follow-up data are available of 35 patients (17 female, 18 male). Median age was 51 years (26 – 75), median BMI 29 (21 – 40). Liver biopsy within 6 months before NALEP was performed in 21 patients (NASH n = 19). In fifteen patients NAFLD was diagnosed by ultrasound, presence of MS and/or elevated transaminases after exclusion of other liver diseases.

Thirteen patients had previously or newly diagnosed type 2 diabetes and all patients dyslipidemia. If needed, patients were treated simultaneously with metformin (n = 11, 6 de novo) or statins (n = 21, 12 de novo). Patients were also advised to engage in physical training at least 3 times a week for 30 – 60 minutes.

Median follow-up (FU) was 4.3 months with FU at 3 months (FU3/n = 35) and 6 months (FU6/n = 18). BMI significantly decreased at FU3 and FU6 (-5%; p = 0.001). Serum liver parameters decreased and often normalized within the observation period from baseline to FU3 and FU6 (median AST 49/32/34 IU/L; ALT 75/45/45 IU/L; GGT 176/90/75 IU/L; p = 0.01). Serum cholesterol and triglycerides also significantly dropped from median 213 and 206 mg/dl, respectively at baseline, to 186 and 130 mg/dl at FU 6 (p = 0.05).

Conclusions: Lifestyle intervention with close and continuous follow-ups effectively improved body weight, liver enzymes and metabolic parameters. In clinical practice this could minimize patients in need of drug interventions.