Observational Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Nov 28, 2016; 8(33): 1459-1465
Published online Nov 28, 2016. doi: 10.4254/wjh.v8.i33.1459
Neglected features of lifestyle: Their relevance in non-alcoholic fatty liver disease
Francesca M Trovato, Giuseppe Fabio Martines, Daniela Brischetto, Guglielmo Trovato, Daniela Catalano
Francesca M Trovato, Giuseppe Fabio Martines, Daniela Brischetto, Daniela Catalano, Department of Clinical and Experimental Medicine, Postgraduate School of Clinical Echography, the University of Catania, 95100 Catania, Italy
Guglielmo Trovato, Clinical Research and Innovation Project Planning Unit, the School of Medicine and AOU Policlinico, the University of Catania, 95100 Catania, Italy
Daniela Catalano, Department of Medicine, the School of Medicine of the University of Catania, 95100 Catania, Italy
Author contributions: The article was written by the authors stated.
Institutional review board statement: The study and the manuscript were approved by the Institutional Review Board of the Project Office.
Informed consent statement: Written informed consent was obtained from each patient prior to the clinical data recording and before the US procedure, allowing the use of information for teaching and clinical research.
Conflict-of-interest statement: No conflict of interest is declared in this invited manuscript.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Daniela Catalano, MD, Department of Medicine, the School of Medicine of the University of Catania, Policlinico, Via Santa Sofia 78, 95100 Catania, Italy. danielacatalano@unict.it
Telephone: +39-953-781535
Received: May 30, 2016
Peer-review started: May 31, 2016
First decision: July 20, 2016
Revised: August 4, 2016
Accepted: October 22, 2016
Article in press: October 24, 2016
Published online: November 28, 2016
Abstract
AIM

To investigated in non-alcoholic-fatty-liver-disease (NAFLD), with ultrasound (US)-detected fatty liver, and in a group of non-alcoholic and otherwise healthy subjects, relationship of neglected features of lifestyle with NAFLD and obesity.

METHODS

Five hundred and thirty-two NAFLD and 667 non-NAFLD healthy subjects, age 21-60 years were studied. Severity of liver steatosis was assessed by US bright liver score. The adherence to mediterranean diet score (AMDS) was assessed on the basis of a 1-wk recall computerized questionnaire which included a detailed physical activity reports (Baecke questionnaire). The western dietary profile score, as a simplified paradigm of unhealthy diet, a questionnaire quantifying sun exposure score and a sleep habits questionnaires provided a further comprehensive lifestyle assessment.

RESULTS

Body mass index (BMI), insulin resistance (HOMA), and triglycerides, poorer adherence to a mediterranean diet profile, sedentary habits, minor sun exposure and use of “western diet” foods are greater in NAFLD. Multiple linear regression analysis, weighted by years of age, displays BMI, HOMA and AMDS as the most powerful independent predictors of fatty liver severity; however, also the physical activity score, the western diet habit and the sun exposure score are acting inside the model with significant independent effects.

CONCLUSION

Articulated clinical intervention, according to our results, are justified in NAFLD and can be pursued addressing by focused intervention nutritional profile, physical exercise mainly in open-air subsets for enhancing sun exposure and healthier sleep duration and rhythm.

Keywords: Fatty liver, Ultrasound, Diet, Malnutrition, Sleep, Clinical risk management, Health psychology, Sun exposure, Obesity

Core tip: Non-alcoholic-fatty-liver-disease (NAFLD) is a multifactorial condition associated with malnutrition and, mainly, with obesity, sedentary life and insulin resistance; some neglected factor, such as sleep and sun exposure curtailment, along with D vitamin deficiency, are associated with NAFLD; articulated clinical intervention, according to our results, is justified in NAFLD and can be pursued addressing by focused intervention nutritional profile, open-air physical exercise for enhancing sun exposure and healthy behaviour targeted to improved sleep duration and rhythm.