P482 - EFFECT OF DIETARY AND LIFESTYLE MODIFICATION TOGETHER WITH COGNITIVE BEHAVIOURAL THERAPY IN PATIENTS WITH MASLD

P482

EFFECT OF DIETARY AND LIFESTYLE MODIFICATION TOGETHER WITH COGNITIVE BEHAVIOURAL THERAPY IN PATIENTS WITH MASLD

M. Ryšánková^1,*, V. Šmíd¹, J. Klevar¹, I. Málková², L. Lambert³, F. Novák¹, R. Brůha¹

¹4th Department of Internal Medicine, Charles University, 1st Faculty of Medicine and General University Hospital, ²STOB CZ, ³Department of Radiology, Charles University, 1st Faculty of Medicine and General University Hospital, Prague, Czech Republic

Rationale: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a leading cause of chronic liver disease worldwide, strongly associated with type 2 diabetes and obesity. Dietary and lifestyle interventions including cognitive behavioural therapy (CBT) are expected to improve the clinical outcomes, but no long-term randomized trials have been conducted so far.

Methods: This project is evaluating the effect of a complex lifestyle intervention based on CBT and mindful eating in combination with increased physical activity and change in diet in patients with MASLD. Patients were randomized into lifestyle interventional and standard care groups. Subjects in the interventional group were guided with the help of experts to a reduced energy and better dietary composition. Laboratory samples, anthropometric measurements and imaging examinations using ultrasonography with measurements of fibrosis were carried out regularly. The total duration of the study intervention is one year. The primary endpoint is the reduction of liver fat content by nuclear magnetic resonance spectroscopy.

Results: We present preliminary results based on the data from 14 patients who have already completed the whole intervention and 14 patients in standard group (total 50 patients enrolled in both arms). There was a significant reduction in liver fat (16±7 vs. 9±6; %, p<0.05), liver function tests (ALT 0.8±0.3 vs. 0.6±0.2; µkat/L, p=0.02) and parameters of glucose metabolism (glycemia 6.5±1.5 vs. 5.2±0.5; mmol/L, p=0.05; insulinemia 122±41 vs. 86±44; pmol/L, p = 0.009) in the interventional group. In contrast, there was no significant change in these parameters in the standard care group.

Conclusion: The preliminary data show that the dietary and lifestyle modification including CBT may lead to a significant improvement in the patients with MASLD. Larger study is required.

Disclosure of Interest: None declared