Liver fibrosis screening linked to lifestyle changes in individuals at risk for ALD, MASLD
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Key takeaways:
- After screening, excessive drinking decreased from 46% to 32% at 6 months among those at risk for ALD.
- After 6 months, 13% of those at risk for metabolic dysfunction-associated liver disease reported a weight loss of 5%.
Screening for liver fibrosis was associated with improved self-reported alcohol consumption, diet, exercise and weight after 6 months among patients at risk for liver disease, with lifestyle changes persisting through 2 years.
“The AASLD and EASL practice guidance documents on MASLD and ALD/MetALD recommend targeted screening for liver fibrosis in at-risk groups, to allow for early intervention to stop progression,” Maria Kjaergaard, MD, of the Fibrosis Fatty Liver and Steatohepatitis Research Center at Odense University Hospital, and colleagues wrote in Clinical Gastroenterology and Hepatology. “In liver disease, few studies have investigated whether knowledge on liver disease can be used as a tool to initiate lifestyle changes, but they are limited by small sample sizes and high attrition rates.”
In a prospective, single-center study, researchers assessed short- and long-term outcomes of screening for liver fibrosis among 4,796 individuals (median age, 58 years; 52% men) at-risk for alcohol-related liver disease (ALD; n = 1,850) or metabolic dysfunction-associated steatotic liver disease (n = 2,946).
Following screening via transient elastography, participants received their results as well as standardized lifestyle intervention advice. They were then asked to complete electronic questionnaires at 1 week and 6 months regarding changes in alcohol intake, diet, exercise and weight.
According to results, 10% of participants in the ALD group and 7% in the MASLD group screened positive at baseline, most of whom were men with obesity who also were metabolically unhealthy. Questionnaire response rates were 87% at 1 week and 84% at 6 months.
Researchers reported that excessive drinking decreased from 46% to 32% at 6 months among patients at risk for ALD. Fifteen percent reported increased alcohol intake with no difference between those who screened positive vs. those who screened negative. A positive screening test predicted abstinence or decreased alcohol use at 6 months among high-risk drinkers (OR = 2.45; 95% CI, 1.32-4.57).
Researchers noted similar improvement among participants at risk for MASLD, with 26% reporting reduced calorie intake or a healthier diet at week 1 compared with 35% at 6 months, as well as increased exercise, which improved from 12% to 22%. After 6 months, 13% reported weight loss of at least 5% from baseline, 7% reported a weight loss of at least 7% and 3% exceeded 10%.
Of a subgroup of 752 participants who were interviewed 2 years after the screening visit, excessive drinking decreased from 52% to 41%. Moreover, after 2 years the association between a positive screening test and predicted abstinence/decrease alcohol use persisted (OR = 1.84; 95% CI, 1.09-3.11).
“Participants screened for liver fibrosis report improved alcohol consumption, diet, exercise and weight after 6 months and 2 years,” Kjaergaard and colleagues concluded. “A screening program may combine early detection of advanced fibrosis with increased motivation to lifestyle changes, and may consequently act as both prevention, early detection and part of the treatment.”
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