A 24-week dietary and physical activity lifestyle intervention reduces hepatic insulin resistance in the obese with chronic hepatitis C
Background/Aims Obesity‐ and virus‐mediated insulin resistance (IR) are associated with adverse hepatic and metabolic outcomes in chronic hepatitis C (CHC). This study evaluates the tolerability and effects of a dietary and physical activity (PA) intervention in obese patients with insulin‐resistant...
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| Veröffentlicht in: | Liver international 2013-03, Vol.33 (3), p.410-419 |
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| creator | Pattullo, Venessa Duarte-Rojo, Andres Soliman, Wael Vargas-Vorackova, Florencia Sockalingam, Sanjeev Fantus, Ivan G. Allard, Johane Heathcote, Jenny |
| description | Background/Aims
Obesity‐ and virus‐mediated insulin resistance (IR) are associated with adverse hepatic and metabolic outcomes in chronic hepatitis C (CHC). This study evaluates the tolerability and effects of a dietary and physical activity (PA) intervention in obese patients with insulin‐resistant CHC.
Methods
Obese patients (body mass index, BMI ≥30 kg/m2) with CHC were recruited prospectively. Non‐diabetic patients with IR (homeostasis model assessment of IR, HOMA‐IR >2.0) proceeded to a 24‐week lifestyle intervention comprising pedometer monitored increase in PA (≥10 000 steps/day) and an individualised dietary plan.
Results
Ten non‐cirrhotic and six cirrhotic patients [age 52 ± 8.5 years, BMI 35.9 (31.46–38.21)kg/m2] were recruited, of whom all 16 (100%) completed the 24‐week protocol. Increase in PA from 6853 (2440–9533) to 10 697 (7959–13566) steps/day (P = 0.001) and reduction in caloric intake from 2263 (1805.4–2697.0) to 1281 (1099.5–1856.3) kcal/day (equivalent to reduction of median 33% (25.3–49.8%), P |
| doi_str_mv | 10.1111/liv.12041 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1323798859</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1323798859</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3961-c87739f1b811434d48c98ab93d42f8823165cd0f8f10038da0cfc0595be549013</originalsourceid><addsrcrecordid>eNqFkc1u1DAUhS0EoqWw4AWQl7BI658ktpfVCErLCCRU6NJynBvF1JMMtjNDnoDXxkPa2SG8sXX9nSPdcxB6Tck5zefCu905ZaSkT9ApLYUsOOP06fHN-Al6EeMPQqhSFX2OThhnQirJTtHvS8zKYg9wj1sHyYQZm6HF236OzhqPjU1u59KMvesgptkDdkOCsIMhuXHAAdrJQsQ9bE1yNn_GybvDPLqYzGAPPE494LGBCHjvUo9tH8Yhw4souYhXL9GzzvgIrx7uM_Ttw_vb1cdi_eXqenW5LixXNS2sFIKrjjaS0pKXbSmtkqZRvC1ZJ2Veu65sSzrZUUK4bA2xnSWVqhqoSkUoP0NvF99tGH9OeSO9cdGC92aAcYqa5uiEkrJS_0eZFFJKLnhG3y2oDWOMATq9DW6Tw9SU6ENFOlek_1aU2TcPtlOzgfZIPnaSgYsF2DsP87-d9Pr6-6NlsShy5PDrqDDhXteCi0rffb7SN_XNuv56d6s_8T-Hkqr9</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1287888373</pqid></control><display><type>article</type><title>A 24-week dietary and physical activity lifestyle intervention reduces hepatic insulin resistance in the obese with chronic hepatitis C</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Pattullo, Venessa ; Duarte-Rojo, Andres ; Soliman, Wael ; Vargas-Vorackova, Florencia ; Sockalingam, Sanjeev ; Fantus, Ivan G. ; Allard, Johane ; Heathcote, Jenny</creator><creatorcontrib>Pattullo, Venessa ; Duarte-Rojo, Andres ; Soliman, Wael ; Vargas-Vorackova, Florencia ; Sockalingam, Sanjeev ; Fantus, Ivan G. ; Allard, Johane ; Heathcote, Jenny</creatorcontrib><description>Background/Aims
Obesity‐ and virus‐mediated insulin resistance (IR) are associated with adverse hepatic and metabolic outcomes in chronic hepatitis C (CHC). This study evaluates the tolerability and effects of a dietary and physical activity (PA) intervention in obese patients with insulin‐resistant CHC.
Methods
Obese patients (body mass index, BMI ≥30 kg/m2) with CHC were recruited prospectively. Non‐diabetic patients with IR (homeostasis model assessment of IR, HOMA‐IR >2.0) proceeded to a 24‐week lifestyle intervention comprising pedometer monitored increase in PA (≥10 000 steps/day) and an individualised dietary plan.
Results
Ten non‐cirrhotic and six cirrhotic patients [age 52 ± 8.5 years, BMI 35.9 (31.46–38.21)kg/m2] were recruited, of whom all 16 (100%) completed the 24‐week protocol. Increase in PA from 6853 (2440–9533) to 10 697 (7959–13566) steps/day (P = 0.001) and reduction in caloric intake from 2263 (1805.4–2697.0) to 1281 (1099.5–1856.3) kcal/day (equivalent to reduction of median 33% (25.3–49.8%), P < 0.001) were achieved. These behaviour changes led to a BMI reduction to 31.21 (28.72–36.10) (P < 0.001) and the HOMA‐IR fell from 3.62 (2.75–4.87) to 2.08 (1.82–3.59) (P = 0.002). The hepatic insulin sensitivity index (ISI) improved significantly, but the skeletal muscle ISI did not. At week 24, 8/16 (50%) patients were no longer insulin‐resistant (P = 0.008).
Conclusions
This 24‐week intervention reduced BMI and reversed IR in significant proportion of patients. Such adjunctive therapy may improve hepatic and metabolic status in obese insulin‐resistant CHC.</description><identifier>ISSN: 1478-3223</identifier><identifier>EISSN: 1478-3231</identifier><identifier>DOI: 10.1111/liv.12041</identifier><identifier>PMID: 23278982</identifier><language>eng</language><publisher>United States: Blackwell Publishing Ltd</publisher><subject>Age ; Anthropometry ; Basal Metabolism ; behaviour modification ; Blood Pressure ; Body Mass Index ; diet ; exercise ; Exercise Therapy - methods ; Female ; Hepatitis C ; Hepatitis C, Chronic - complications ; Hepatitis C, Chronic - pathology ; Homeostasis ; Humans ; Insulin ; insulin resistance ; Insulin Resistance - physiology ; Liver ; Male ; Middle Aged ; Motor Activity - physiology ; Obesity ; Obesity - complications ; Obesity - diet therapy ; Obesity - therapy ; Ontario ; Physical activity ; Prospective Studies ; Skeletal muscle ; Statistics, Nonparametric</subject><ispartof>Liver international, 2013-03, Vol.33 (3), p.410-419</ispartof><rights>2012 John Wiley & Sons A/S</rights><rights>2012 John Wiley & Sons A/S.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3961-c87739f1b811434d48c98ab93d42f8823165cd0f8f10038da0cfc0595be549013</citedby><cites>FETCH-LOGICAL-c3961-c87739f1b811434d48c98ab93d42f8823165cd0f8f10038da0cfc0595be549013</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fliv.12041$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fliv.12041$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23278982$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pattullo, Venessa</creatorcontrib><creatorcontrib>Duarte-Rojo, Andres</creatorcontrib><creatorcontrib>Soliman, Wael</creatorcontrib><creatorcontrib>Vargas-Vorackova, Florencia</creatorcontrib><creatorcontrib>Sockalingam, Sanjeev</creatorcontrib><creatorcontrib>Fantus, Ivan G.</creatorcontrib><creatorcontrib>Allard, Johane</creatorcontrib><creatorcontrib>Heathcote, Jenny</creatorcontrib><title>A 24-week dietary and physical activity lifestyle intervention reduces hepatic insulin resistance in the obese with chronic hepatitis C</title><title>Liver international</title><addtitle>Liver Int</addtitle><description>Background/Aims
Obesity‐ and virus‐mediated insulin resistance (IR) are associated with adverse hepatic and metabolic outcomes in chronic hepatitis C (CHC). This study evaluates the tolerability and effects of a dietary and physical activity (PA) intervention in obese patients with insulin‐resistant CHC.
Methods
Obese patients (body mass index, BMI ≥30 kg/m2) with CHC were recruited prospectively. Non‐diabetic patients with IR (homeostasis model assessment of IR, HOMA‐IR >2.0) proceeded to a 24‐week lifestyle intervention comprising pedometer monitored increase in PA (≥10 000 steps/day) and an individualised dietary plan.
Results
Ten non‐cirrhotic and six cirrhotic patients [age 52 ± 8.5 years, BMI 35.9 (31.46–38.21)kg/m2] were recruited, of whom all 16 (100%) completed the 24‐week protocol. Increase in PA from 6853 (2440–9533) to 10 697 (7959–13566) steps/day (P = 0.001) and reduction in caloric intake from 2263 (1805.4–2697.0) to 1281 (1099.5–1856.3) kcal/day (equivalent to reduction of median 33% (25.3–49.8%), P < 0.001) were achieved. These behaviour changes led to a BMI reduction to 31.21 (28.72–36.10) (P < 0.001) and the HOMA‐IR fell from 3.62 (2.75–4.87) to 2.08 (1.82–3.59) (P = 0.002). The hepatic insulin sensitivity index (ISI) improved significantly, but the skeletal muscle ISI did not. At week 24, 8/16 (50%) patients were no longer insulin‐resistant (P = 0.008).
Conclusions
This 24‐week intervention reduced BMI and reversed IR in significant proportion of patients. Such adjunctive therapy may improve hepatic and metabolic status in obese insulin‐resistant CHC.</description><subject>Age</subject><subject>Anthropometry</subject><subject>Basal Metabolism</subject><subject>behaviour modification</subject><subject>Blood Pressure</subject><subject>Body Mass Index</subject><subject>diet</subject><subject>exercise</subject><subject>Exercise Therapy - methods</subject><subject>Female</subject><subject>Hepatitis C</subject><subject>Hepatitis C, Chronic - complications</subject><subject>Hepatitis C, Chronic - pathology</subject><subject>Homeostasis</subject><subject>Humans</subject><subject>Insulin</subject><subject>insulin resistance</subject><subject>Insulin Resistance - physiology</subject><subject>Liver</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Motor Activity - physiology</subject><subject>Obesity</subject><subject>Obesity - complications</subject><subject>Obesity - diet therapy</subject><subject>Obesity - therapy</subject><subject>Ontario</subject><subject>Physical activity</subject><subject>Prospective Studies</subject><subject>Skeletal muscle</subject><subject>Statistics, Nonparametric</subject><issn>1478-3223</issn><issn>1478-3231</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkc1u1DAUhS0EoqWw4AWQl7BI658ktpfVCErLCCRU6NJynBvF1JMMtjNDnoDXxkPa2SG8sXX9nSPdcxB6Tck5zefCu905ZaSkT9ApLYUsOOP06fHN-Al6EeMPQqhSFX2OThhnQirJTtHvS8zKYg9wj1sHyYQZm6HF236OzhqPjU1u59KMvesgptkDdkOCsIMhuXHAAdrJQsQ9bE1yNn_GybvDPLqYzGAPPE494LGBCHjvUo9tH8Yhw4souYhXL9GzzvgIrx7uM_Ttw_vb1cdi_eXqenW5LixXNS2sFIKrjjaS0pKXbSmtkqZRvC1ZJ2Veu65sSzrZUUK4bA2xnSWVqhqoSkUoP0NvF99tGH9OeSO9cdGC92aAcYqa5uiEkrJS_0eZFFJKLnhG3y2oDWOMATq9DW6Tw9SU6ENFOlek_1aU2TcPtlOzgfZIPnaSgYsF2DsP87-d9Pr6-6NlsShy5PDrqDDhXteCi0rffb7SN_XNuv56d6s_8T-Hkqr9</recordid><startdate>201303</startdate><enddate>201303</enddate><creator>Pattullo, Venessa</creator><creator>Duarte-Rojo, Andres</creator><creator>Soliman, Wael</creator><creator>Vargas-Vorackova, Florencia</creator><creator>Sockalingam, Sanjeev</creator><creator>Fantus, Ivan G.</creator><creator>Allard, Johane</creator><creator>Heathcote, Jenny</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7U9</scope><scope>H94</scope></search><sort><creationdate>201303</creationdate><title>A 24-week dietary and physical activity lifestyle intervention reduces hepatic insulin resistance in the obese with chronic hepatitis C</title><author>Pattullo, Venessa ; Duarte-Rojo, Andres ; Soliman, Wael ; Vargas-Vorackova, Florencia ; Sockalingam, Sanjeev ; Fantus, Ivan G. ; Allard, Johane ; Heathcote, Jenny</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3961-c87739f1b811434d48c98ab93d42f8823165cd0f8f10038da0cfc0595be549013</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Age</topic><topic>Anthropometry</topic><topic>Basal Metabolism</topic><topic>behaviour modification</topic><topic>Blood Pressure</topic><topic>Body Mass Index</topic><topic>diet</topic><topic>exercise</topic><topic>Exercise Therapy - methods</topic><topic>Female</topic><topic>Hepatitis C</topic><topic>Hepatitis C, Chronic - complications</topic><topic>Hepatitis C, Chronic - pathology</topic><topic>Homeostasis</topic><topic>Humans</topic><topic>Insulin</topic><topic>insulin resistance</topic><topic>Insulin Resistance - physiology</topic><topic>Liver</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Motor Activity - physiology</topic><topic>Obesity</topic><topic>Obesity - complications</topic><topic>Obesity - diet therapy</topic><topic>Obesity - therapy</topic><topic>Ontario</topic><topic>Physical activity</topic><topic>Prospective Studies</topic><topic>Skeletal muscle</topic><topic>Statistics, Nonparametric</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pattullo, Venessa</creatorcontrib><creatorcontrib>Duarte-Rojo, Andres</creatorcontrib><creatorcontrib>Soliman, Wael</creatorcontrib><creatorcontrib>Vargas-Vorackova, Florencia</creatorcontrib><creatorcontrib>Sockalingam, Sanjeev</creatorcontrib><creatorcontrib>Fantus, Ivan G.</creatorcontrib><creatorcontrib>Allard, Johane</creatorcontrib><creatorcontrib>Heathcote, Jenny</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><jtitle>Liver international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pattullo, Venessa</au><au>Duarte-Rojo, Andres</au><au>Soliman, Wael</au><au>Vargas-Vorackova, Florencia</au><au>Sockalingam, Sanjeev</au><au>Fantus, Ivan G.</au><au>Allard, Johane</au><au>Heathcote, Jenny</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A 24-week dietary and physical activity lifestyle intervention reduces hepatic insulin resistance in the obese with chronic hepatitis C</atitle><jtitle>Liver international</jtitle><addtitle>Liver Int</addtitle><date>2013-03</date><risdate>2013</risdate><volume>33</volume><issue>3</issue><spage>410</spage><epage>419</epage><pages>410-419</pages><issn>1478-3223</issn><eissn>1478-3231</eissn><abstract>Background/Aims
Obesity‐ and virus‐mediated insulin resistance (IR) are associated with adverse hepatic and metabolic outcomes in chronic hepatitis C (CHC). This study evaluates the tolerability and effects of a dietary and physical activity (PA) intervention in obese patients with insulin‐resistant CHC.
Methods
Obese patients (body mass index, BMI ≥30 kg/m2) with CHC were recruited prospectively. Non‐diabetic patients with IR (homeostasis model assessment of IR, HOMA‐IR >2.0) proceeded to a 24‐week lifestyle intervention comprising pedometer monitored increase in PA (≥10 000 steps/day) and an individualised dietary plan.
Results
Ten non‐cirrhotic and six cirrhotic patients [age 52 ± 8.5 years, BMI 35.9 (31.46–38.21)kg/m2] were recruited, of whom all 16 (100%) completed the 24‐week protocol. Increase in PA from 6853 (2440–9533) to 10 697 (7959–13566) steps/day (P = 0.001) and reduction in caloric intake from 2263 (1805.4–2697.0) to 1281 (1099.5–1856.3) kcal/day (equivalent to reduction of median 33% (25.3–49.8%), P < 0.001) were achieved. These behaviour changes led to a BMI reduction to 31.21 (28.72–36.10) (P < 0.001) and the HOMA‐IR fell from 3.62 (2.75–4.87) to 2.08 (1.82–3.59) (P = 0.002). The hepatic insulin sensitivity index (ISI) improved significantly, but the skeletal muscle ISI did not. At week 24, 8/16 (50%) patients were no longer insulin‐resistant (P = 0.008).
Conclusions
This 24‐week intervention reduced BMI and reversed IR in significant proportion of patients. Such adjunctive therapy may improve hepatic and metabolic status in obese insulin‐resistant CHC.</abstract><cop>United States</cop><pub>Blackwell Publishing Ltd</pub><pmid>23278982</pmid><doi>10.1111/liv.12041</doi><tpages>10</tpages></addata></record> |
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| ispartof | Liver international, 2013-03, Vol.33 (3), p.410-419 |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Age Anthropometry Basal Metabolism behaviour modification Blood Pressure Body Mass Index diet exercise Exercise Therapy - methods Female Hepatitis C Hepatitis C, Chronic - complications Hepatitis C, Chronic - pathology Homeostasis Humans Insulin insulin resistance Insulin Resistance - physiology Liver Male Middle Aged Motor Activity - physiology Obesity Obesity - complications Obesity - diet therapy Obesity - therapy Ontario Physical activity Prospective Studies Skeletal muscle Statistics, Nonparametric |
| title | A 24-week dietary and physical activity lifestyle intervention reduces hepatic insulin resistance in the obese with chronic hepatitis C |
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