AUTHOR=Martínez-Urbistondo Diego , San-Cristóbal Rodrigo , Villares Paula , Martínez-González Miguel Ángel , Babio Nancy , Corella Dolores , del Val José Luis , Ordovás José Ma , Alonso-Gómez Ángel M. , Wärnberg Julia , Vioque Jesús , Romaguera Dora , López-Miranda José , Estruch Ramon , Tinahones Francisco J. , Lapetra José , Serra-Majem J. Luís , Bueno-Cavanillas Aurora , Tur Josep A. , Marcos Alba , Pintó Xavier , Delgado-Rodríguez Miguel , Matía-Martín Pilar , Vidal Josep , Vázquez Clotilde , Ros Emilio , Bullón Vela María Vanessa , Palau Antoni , Sorli Jose V. , Masagué Marta , Abete Itziar , Moreno-Rodríguez Anai , Candela-García Inma , Konieczna Jadwiga , García-Ríos Antonio , Juárez Oscar Lecea , Portolés Olga , Martín Paco , Goday Albert , Zulet M Ángeles , Vaquero-Luna Jessica , Orea María del Carmen Sayón , Megías Isabel , Baltasar Enric , Martínez J. Alfredo , Daimiel Lidia TITLE=Role of NAFLD on the Health Related QoL Response to Lifestyle in Patients With Metabolic Syndrome: The PREDIMED Plus Cohort JOURNAL=Frontiers in Endocrinology VOLUME=13 YEAR=2022 URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2022.868795 DOI=10.3389/fendo.2022.868795 ISSN=1664-2392 ABSTRACT=Objective

To evaluate the effect of Non-alcoholic fatty liver disease (NAFLD) status in the impact of lifestyle over Health-related quality of life (HRQoL) in patients with metabolic syndrome (MetS).

Methods

Baseline and 1 year follow up data from the PREDIMED-plus cohort (men and women, 55-75 years old with overweight/obesity and MetS) were studied. Adherence to an energy-restricted Mediterranean Diet (er-MeDiet) and Physical Activity (PA) were assessed with a validated screeners. Hepatic steatosis index (HSI) was implemented to evaluate NAFLD while the SF-36 questionnaire provided HRQoL evaluation. Statistical analyses were performed to evaluate the influence of baseline NAFLD on HRQoL as affected by lifestyle during 1 year of follow up.

Results

Data from 5205 patients with mean age of 65 years and a 48% of female participants. Adjusted linear multivariate mixed regression models showed that patients with lower probability of NAFLD (HSI < 36 points) were more responsive to er-MeDiet (β 0.64 vs β 0.05 per er-MeDiet adherence point, p< 0.01) and PA (β 0.05 vs β 0.01 per MET-h/week, p = 0.001) than those with high probability for NAFLD in terms Physical SF-36 summary in the 1 year follow up. 10 points of er-MeDiet adherence and 50 MET-h/week were thresholds for a beneficial effect of lifestyle on HRQoL physical domain in patients with lower probability of NAFLD.

Conclusion

The evaluation of NAFLD by the HSI index in patients with MetS might identify subjects with different prospective sensitivity to lifestyle changes in terms of physical HRQoL (http://www.isrctn.com/ISRCTN89898870).