ArticleLiver international : official journal of the International Association for the Study of the Liver2022
Knowledge of liver fibrosis stage among adults with NAFLD/NASH improves adherence to lifestyle changes.
Article in Liver international : official journal of the International Association for the Study of the Liver, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06826807 (Hepatic Elastography-Enhanced Lifestyle Modification in Patients With Metabolic Dysfunction-Associated Steatotic Liver Disease), which is not on this map. Cited by 21 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Hepatic Elastography-Enhanced Lifestyle Modification in Patients With Metabolic Dysfunction-Associated Steatotic Liver Disease: A Randomized Controlled Trial
Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 49 citations in OpenAlex.
- Attrition in Digital Self-Management Interventions for Patients With Metabolic Dysfunction Associated Steatotic Liver Disease (MASLD): Mixed Methods Systematic Review.Journal of medical Internet research · 2026Pooled it
- Global prevalence of advanced fibrosis in patients with type 2 diabetes mellitus: a systematic review and meta-analysis.Journal of gastroenterology and hepatology · 2024Pooled it
- Feasibility study of a behavioral lifestyle intervention for Hispanic/Latino patients with metabolic dysfunction-associated steatotic liver disease.BMC public health · 2026Trial
- Lessons learned from viral hepatitis testing that inform law and policy responses to steatotic liver disease.Nature reviews. Gastroenterology & hepatology · 2026Review
- Population perspectives on benefits and harms of screening for metabolic dysfunction-associated steatotic liver disease.Hepatology (Baltimore, Md.) · 2026Article
- Risk stratification of MASLD/MASH in type 2 diabetes: a pragmatic endocrinology outpatient pathway.Frontiers in endocrinology · 2026Review
- Cost-Effectiveness of MASH Diagnosis and Management Approaches Among Those With Type 2 Diabetes.JAMA network open · 2025Article
- Challenges and needs in the management of non-alcoholic fatty liver disease from the perspective of gastroenterology and hepatology specialists: a qualitative study.BMC gastroenterology · 2025Article
- The importance of patient engagement in the multimodal treatment of MASLD.Communications medicine · 2025Review
- Reply to correspondence on "Current burden of steatotic liver disease and fibrosis among adults in the United States, 2017-2023".Clinical and molecular hepatology · 2025Article
- A European Survey to Identify Challenges in the Management of Metabolic Dysfunction-Associated Steatotic Liver Disease.Liver international : official journal of the International Association for the Study of the Liver · 2025Article
- Value of Mac-2 Binding Protein Glycosylation Isomer (M2BPGi) in Assessing Liver Fibrosis in Metabolic Dysfunction-Associated Liver Disease: A Comprehensive Review of its Serum Biomarker Role.Current protein & peptide science · 2025Review
- A clinical decision support tool for metabolic dysfunction-associated steatohepatitis in real-world clinical settings: a mixed-method implementation research study protocol.Journal of comparative effectiveness research · 2024Article
- Food inequity and insecurity and MASLD: burden, challenges, and interventions.Nature reviews. Gastroenterology & hepatology · 2024Review
- Evaluation of ChatGPT as a Counselling Tool for Italian-Speaking MASLD Patients: Assessment of Accuracy, Completeness and Comprehensibility.Journal of personalized medicine · 2024Article
- Practical Lifestyle Management of Nonalcoholic Fatty Liver Disease for Busy Clinicians.Diabetes spectrum : a publication of the American Diabetes Association · 2024Article
- Prevalence and Crucial Parameters in Diabesity-Related Liver Fibrosis: A Preliminary Study.Journal of clinical medicine · 2023Article
- Measuring NAFLD models of care.Nature reviews. Gastroenterology & hepatology · 2023Article
- Screening for Liver Fibrosis in the General Population: Where Do We Stand in 2022?Diagnostics (Basel, Switzerland) · 2022Review
- High Meat Consumption Is Prospectively Associated with the Risk of Non-Alcoholic Fatty Liver Disease and Presumed Significant Fibrosis.Nutrients · 2022Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND &
aimsThough lifestyle interventions can reverse disease progression in people with non-alcoholic fatty liver disease/non-alcoholic steatohepatitis (NAFLD/NASH), unawareness about disease severity might compromise behavioural changes. Data from this first international cross-sectional survey of individuals with NAFLD/NASH were used to identify correlates of both unawareness about fibrosis stage and its association with adherence to lifestyle adjustments.
methodsAdults with NAFLD/NASH registered on the platform Carenity were invited to participate in an online 20-min, six-section survey in Canada, France, Germany, Italy, Spain and the United Kingdom to describe their experience with NAFLD/NASH and its care (N = 1411). Weighted binary and multinomial logistic regressions were performed to estimate the effect of explanatory variables on unawareness of fibrosis stage and poor adherence to lifestyle changes respectively.
resultsIn the study group, 15.5% had obesity and 59.2% did not know their fibrosis stage. After multiple adjustments, individuals with a body mass index (BMI) ≥35 were over twice as likely to not know their fibrosis stage. People with a BMI >30 had a threefold higher risk of having poor adherence to lifestyle changes. Unawareness about fibrosis stage was also significantly associated with poor adherence to lifestyle adjustments.
conclusionsAs fibrosis stage is becoming the main predictor of NAFLD progression, improving patient-provider communication-especially for people with obesity-about liver fibrosis stage, its associated risks and how to mitigate them, is needed. Training for healthcare professionals and promoting patient educational programmes to support behaviour changes should also be included in the liver health agenda.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.