Frontiers in Endocrinology (Jun 2022)

Role of NAFLD on the Health Related QoL Response to Lifestyle in Patients With Metabolic Syndrome: The PREDIMED Plus Cohort

  • Diego Martínez-Urbistondo,
  • Rodrigo San-Cristóbal,
  • Paula Villares,
  • Miguel Ángel Martínez-González,
  • Miguel Ángel Martínez-González,
  • Miguel Ángel Martínez-González,
  • Nancy Babio,
  • Nancy Babio,
  • Nancy Babio,
  • Dolores Corella,
  • Dolores Corella,
  • José Luis del Val,
  • José Luis del Val,
  • José Ma Ordovás,
  • José Ma Ordovás,
  • Ángel M. Alonso-Gómez,
  • Ángel M. Alonso-Gómez,
  • Julia Wärnberg,
  • Julia Wärnberg,
  • Jesús Vioque,
  • Jesús Vioque,
  • Dora Romaguera,
  • Dora Romaguera,
  • José López-Miranda,
  • José López-Miranda,
  • Ramon Estruch,
  • Ramon Estruch,
  • Francisco J. Tinahones,
  • Francisco J. Tinahones,
  • José Lapetra,
  • José Lapetra,
  • J. Luís Serra-Majem,
  • J. Luís Serra-Majem,
  • Aurora Bueno-Cavanillas,
  • Aurora Bueno-Cavanillas,
  • Josep A. Tur,
  • Josep A. Tur,
  • Alba Marcos,
  • Alba Marcos,
  • Xavier Pintó,
  • Xavier Pintó,
  • Miguel Delgado-Rodríguez,
  • Miguel Delgado-Rodríguez,
  • Pilar Matía-Martín,
  • Josep Vidal,
  • Josep Vidal,
  • Clotilde Vázquez,
  • Clotilde Vázquez,
  • Emilio Ros,
  • Emilio Ros,
  • María Vanessa Bullón Vela,
  • María Vanessa Bullón Vela,
  • Antoni Palau,
  • Antoni Palau,
  • Antoni Palau,
  • Jose V. Sorli,
  • Jose V. Sorli,
  • Marta Masagué,
  • Marta Masagué,
  • Itziar Abete,
  • Itziar Abete,
  • Anai Moreno-Rodríguez,
  • Anai Moreno-Rodríguez,
  • Inma Candela-García,
  • Jadwiga Konieczna,
  • Jadwiga Konieczna,
  • Antonio García-Ríos,
  • Antonio García-Ríos,
  • Oscar Lecea Juárez,
  • Oscar Lecea Juárez,
  • Olga Portolés,
  • Olga Portolés,
  • Paco Martín,
  • Paco Martín,
  • Paco Martín,
  • Albert Goday,
  • Albert Goday,
  • Albert Goday,
  • M Ángeles Zulet,
  • M Ángeles Zulet,
  • Jessica Vaquero-Luna,
  • Jessica Vaquero-Luna,
  • María del Carmen Sayón Orea,
  • María del Carmen Sayón Orea,
  • Isabel Megías,
  • Isabel Megías,
  • Isabel Megías,
  • Enric Baltasar,
  • Enric Baltasar,
  • J. Alfredo Martínez,
  • J. Alfredo Martínez,
  • J. Alfredo Martínez,
  • Lidia Daimiel

DOI
https://doi.org/10.3389/fendo.2022.868795
Journal volume & issue
Vol. 13

Abstract

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ObjectiveTo 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).MethodsBaseline 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.ResultsData 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.ConclusionThe 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).

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