Liver and Bile
Clin Gastroenterol Hepatol. 2024;22(5):1037–47.e9
Screening for fibrosis promotes lifestyle changes: A prospective cohort study in 4796 individuals
Background and aims: Early detection of liver fibrosis is believed to promote lifestyle changes. The authors evaluated self-reported changes in alcohol intake, diet, exercise, and weight after participating in a screening study for liver fibrosis.
Methods: They conducted a prospective screening study of individuals at risk of alcohol-related liver disease (ALD) or metabolic dysfunction-associated steatotic liver disease (MASLD). Lifestyle advice was provided to all participants and lifestyle changes were evaluated by questionnaires after 1 week and 6 months, with re-examination of a subgroup after 2 years.
Results: A total of 1850 at risk of ALD and 2946 at risk of MASLD were included, of whom 383 (8%) were screening-positive (transient elastography ≥ 8 kPa). A total of 84% replied to the 6-month questionnaire. In ALD participants, excessive drinking decreased from 46% to 32% after 6 months. Only 15% reported increased drinking, without differences between screening-positive and -negative individuals (p = 0.698). In high-risk drinkers, a positive screening test predicted abstinence or decreased alcohol use after 6 months (odds ratio [OR] = 2.45; 95% confidence interval [CI]: 1.32–4.57; p = 0.005). After 2 years, excessive drinking decreased from 52% to 41% in a subgroup of 752 individuals and a positive screening test predicted abstinence or decreased alcohol use after 2 years (OR = 1.84; 95% CI: 1.09–3.11, p = 0.023). MASLD participants showed similar improvements: 35% improved their diet, 22% exercised more, and 13% reported a weight loss ≥ 5% after 6 months.
Conclusions: Screening for liver fibrosis is associated with sustained improvements in alcohol consumption, diet, weight, and exercise in at-risk alcohol-related liver disease and metabolic dysfunction-associated steatotic liver disease. The changes are most pronounced in screening-positive participants but not limited to this group.