THE ISSUE OF ADHERENCE TO TREATMENT OF OBESE PATIENTS IN COMBINATION WITH NON-ALCOHOLIC FATTY LIVER DISEASE

Abstract

The aim – to study the effect of adherence to treatment in patients with obesity in combination with NAFLD on the effectiveness of treatment of NAFLD Materials that methods. 93 patients with obesity 1,2,3 degrees (BMI = 30-44.9 kg \ m2) in combination with NAFLD were examined. The patients were divided into two groups by randomization. They were offered a comprehensive weight loss program consisting of 5 visits over 12 weeks. The comprehensive weight loss program included: a reduction in the energy diet by 500 kcal from physiological daily energy expenditure and a moderate physical activity of 150-200 min per week. The patients of the first group adhered to the comprehensive weight loss program and received pioglitazone 15 mg / day. Patients of the second group adhered only to comprehensive weight loss program. We studied adherence to treatment in two groups of patients using self-report questionnare. The survey on Obesity WGO recommendations was also conducted. All patients underwent anthropometric measurements, laboratory and instrumental examination. Results. The comparative analysis revealed that patients with obesity and NAFLD in group 1, who followed a comprehensive weight loss program and received pioglitazone at a daily dose of 15 mg, had significantly better adherence rates (70.4%) (p <0, 05) compared with patients in Group 2 (59.6%) who followed only a comprehensive weight loss program. It was found that in patients of group 1, controlled attenuation parameter had a strong negative correlation with the level of adherence to treatment (r = -0,71), compared with patients in group 2, where there was an medium negative correlation (r = -0.56). It was found that the level of adherence to treatment had a medium negative correlation with the number of previous attempts to lose weight (r = -0.52) and the duration of obesity (r = -0.49). Conclusions. Patients who received pioglitazone 15 mg / day in addition to comprehensive weight loss program were likely to have better adherence rates and, as a consequence, a more significant decrease in steatosis. It is revealed that the level of adherence to treatment depends on the number of previous attempts to lose weight and the duration of obesity.

Keywords

• pioglitazone, ultrasound steatometry, controlled attenuation parameter (cap), motivation