Effect of a 12-Month Intensive Lifestyle Intervention on Hepatic Steatosis in Adults With Type 2 Diabetes
OBJECTIVE: Weight loss through lifestyle changes is recommended for nonalcoholic fatty liver disease (NAFLD). However, its efficacy in patients with type 2 diabetes is unproven. RESEARCH DESIGN AND METHODS: Look AHEAD (Action for Health in Diabetes) is a 16-center clinical trial with 5,145 overweigh...
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| Veröffentlicht in: | Diabetes care 2010-10, Vol.33 (10), p.2156-2163 |
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| creator | Lazo, Mariana Solga, Steven F Horska, Alena Bonekamp, Susanne Diehl, Anna Mae Brancati, Frederick L Wagenknecht, Lynne E Pi-Sunyer, F. Xavier Kahn, Steven E Clark, Jeanne M |
| description | OBJECTIVE: Weight loss through lifestyle changes is recommended for nonalcoholic fatty liver disease (NAFLD). However, its efficacy in patients with type 2 diabetes is unproven. RESEARCH DESIGN AND METHODS: Look AHEAD (Action for Health in Diabetes) is a 16-center clinical trial with 5,145 overweight or obese adults with type 2 diabetes, who were randomly assigned to an intensive lifestyle intervention (ILI) to induce a minimum weight loss of 7% or a control group who received diabetes support and education (DSE). In the Fatty Liver Ancillary Study, 96 participants completed proton magnetic resonance spectroscopy to quantify hepatic steatosis and tests to exclude other causes of liver disease at baseline and 12 months. We defined steatosis >5.5% as NAFLD. RESULTS: Participants were 49% women and 68% white. The mean age was 61 years, mean BMI was 35 kg/m², mean steatosis was 8.0%, and mean aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were 20.5 and 24.2 units/l, respectively. After 12 months, participants assigned to ILI (n = 46) lost more weight (-8.5 vs. -0.05%; P < 0.01) than those assigned to DSE and had a greater decline in steatosis (-50.8 vs. -22.8%; P = 0.04) and in A1C (-0.7 vs. -0.2%; P = 0.04). There were no significant 12-month changes in AST or ALT levels. At 12 months, 26% of DSE participants and 3% (1 of 31) of ILI participants without NAFLD at baseline developed NAFLD (P < 0.05). CONCLUSIONS: A 12-month intensive lifestyle intervention in patients with type 2 diabetes reduces steatosis and incident NAFLD. |
| doi_str_mv | 10.2337/dc10-0856 |
| format | Article |
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Xavier ; Kahn, Steven E ; Clark, Jeanne M</creator><creatorcontrib>Lazo, Mariana ; Solga, Steven F ; Horska, Alena ; Bonekamp, Susanne ; Diehl, Anna Mae ; Brancati, Frederick L ; Wagenknecht, Lynne E ; Pi-Sunyer, F. Xavier ; Kahn, Steven E ; Clark, Jeanne M ; Fatty Liver Subgroup of the Look AHEAD Research Group ; for the Fatty Liver Subgroup of the Look AHEAD Research Group</creatorcontrib><description>OBJECTIVE: Weight loss through lifestyle changes is recommended for nonalcoholic fatty liver disease (NAFLD). However, its efficacy in patients with type 2 diabetes is unproven. RESEARCH DESIGN AND METHODS: Look AHEAD (Action for Health in Diabetes) is a 16-center clinical trial with 5,145 overweight or obese adults with type 2 diabetes, who were randomly assigned to an intensive lifestyle intervention (ILI) to induce a minimum weight loss of 7% or a control group who received diabetes support and education (DSE). In the Fatty Liver Ancillary Study, 96 participants completed proton magnetic resonance spectroscopy to quantify hepatic steatosis and tests to exclude other causes of liver disease at baseline and 12 months. We defined steatosis >5.5% as NAFLD. RESULTS: Participants were 49% women and 68% white. The mean age was 61 years, mean BMI was 35 kg/m², mean steatosis was 8.0%, and mean aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were 20.5 and 24.2 units/l, respectively. After 12 months, participants assigned to ILI (n = 46) lost more weight (-8.5 vs. -0.05%; P < 0.01) than those assigned to DSE and had a greater decline in steatosis (-50.8 vs. -22.8%; P = 0.04) and in A1C (-0.7 vs. -0.2%; P = 0.04). There were no significant 12-month changes in AST or ALT levels. At 12 months, 26% of DSE participants and 3% (1 of 31) of ILI participants without NAFLD at baseline developed NAFLD (P < 0.05). CONCLUSIONS: A 12-month intensive lifestyle intervention in patients with type 2 diabetes reduces steatosis and incident NAFLD.</description><identifier>ISSN: 0149-5992</identifier><identifier>EISSN: 1935-5548</identifier><identifier>DOI: 10.2337/dc10-0856</identifier><identifier>PMID: 20664019</identifier><identifier>CODEN: DICAD2</identifier><language>eng</language><publisher>Alexandria, VA: American Diabetes Association</publisher><subject>Aged ; Alcohol use ; Biological and medical sciences ; Body Mass Index ; Cholesterol ; Data collection ; Diabetes ; Diabetes Mellitus, Type 2 - complications ; Diabetes Mellitus, Type 2 - metabolism ; Diabetes Mellitus, Type 2 - therapy ; Diabetes therapy ; Diabetes. Impaired glucose tolerance ; Diabetics ; Diet ; Disease ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; Etiopathogenesis. Screening. Investigations. Target tissue resistance ; Fatty Liver - etiology ; Fatty Liver - metabolism ; Fatty Liver - prevention & control ; Female ; Gastrointestinal surgery ; Humans ; Inflammatory bowel disease ; Insulin resistance ; Life Style ; Liver diseases ; Male ; Medical sciences ; Metabolic diseases ; Middle Aged ; Miscellaneous ; Original Research ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Spectrum analysis ; Tropical diseases ; Type 2 diabetes ; Weight loss ; Weight Loss - physiology ; Womens health</subject><ispartof>Diabetes care, 2010-10, Vol.33 (10), p.2156-2163</ispartof><rights>2015 INIST-CNRS</rights><rights>COPYRIGHT 2010 American Diabetes Association</rights><rights>Copyright American Diabetes Association Oct 2010</rights><rights>2010 by the American Diabetes Association.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c560t-a9f5e4224ef5af636d49cb220eaa877f00cbcaa05fc4dda16f5ef2709cb7725c3</citedby><cites>FETCH-LOGICAL-c560t-a9f5e4224ef5af636d49cb220eaa877f00cbcaa05fc4dda16f5ef2709cb7725c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,778,782,883,27911,27912</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23325374$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20664019$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lazo, Mariana</creatorcontrib><creatorcontrib>Solga, Steven F</creatorcontrib><creatorcontrib>Horska, Alena</creatorcontrib><creatorcontrib>Bonekamp, Susanne</creatorcontrib><creatorcontrib>Diehl, Anna Mae</creatorcontrib><creatorcontrib>Brancati, Frederick L</creatorcontrib><creatorcontrib>Wagenknecht, Lynne E</creatorcontrib><creatorcontrib>Pi-Sunyer, F. Xavier</creatorcontrib><creatorcontrib>Kahn, Steven E</creatorcontrib><creatorcontrib>Clark, Jeanne M</creatorcontrib><creatorcontrib>Fatty Liver Subgroup of the Look AHEAD Research Group</creatorcontrib><creatorcontrib>for the Fatty Liver Subgroup of the Look AHEAD Research Group</creatorcontrib><title>Effect of a 12-Month Intensive Lifestyle Intervention on Hepatic Steatosis in Adults With Type 2 Diabetes</title><title>Diabetes care</title><addtitle>Diabetes Care</addtitle><description>OBJECTIVE: Weight loss through lifestyle changes is recommended for nonalcoholic fatty liver disease (NAFLD). However, its efficacy in patients with type 2 diabetes is unproven. RESEARCH DESIGN AND METHODS: Look AHEAD (Action for Health in Diabetes) is a 16-center clinical trial with 5,145 overweight or obese adults with type 2 diabetes, who were randomly assigned to an intensive lifestyle intervention (ILI) to induce a minimum weight loss of 7% or a control group who received diabetes support and education (DSE). In the Fatty Liver Ancillary Study, 96 participants completed proton magnetic resonance spectroscopy to quantify hepatic steatosis and tests to exclude other causes of liver disease at baseline and 12 months. We defined steatosis >5.5% as NAFLD. RESULTS: Participants were 49% women and 68% white. The mean age was 61 years, mean BMI was 35 kg/m², mean steatosis was 8.0%, and mean aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were 20.5 and 24.2 units/l, respectively. After 12 months, participants assigned to ILI (n = 46) lost more weight (-8.5 vs. -0.05%; P < 0.01) than those assigned to DSE and had a greater decline in steatosis (-50.8 vs. -22.8%; P = 0.04) and in A1C (-0.7 vs. -0.2%; P = 0.04). There were no significant 12-month changes in AST or ALT levels. At 12 months, 26% of DSE participants and 3% (1 of 31) of ILI participants without NAFLD at baseline developed NAFLD (P < 0.05). CONCLUSIONS: A 12-month intensive lifestyle intervention in patients with type 2 diabetes reduces steatosis and incident NAFLD.</description><subject>Aged</subject><subject>Alcohol use</subject><subject>Biological and medical sciences</subject><subject>Body Mass Index</subject><subject>Cholesterol</subject><subject>Data collection</subject><subject>Diabetes</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Diabetes Mellitus, Type 2 - metabolism</subject><subject>Diabetes Mellitus, Type 2 - therapy</subject><subject>Diabetes therapy</subject><subject>Diabetes. Impaired glucose tolerance</subject><subject>Diabetics</subject><subject>Diet</subject><subject>Disease</subject><subject>Endocrine pancreas. Apud cells (diseases)</subject><subject>Endocrinopathies</subject><subject>Etiopathogenesis. Screening. Investigations. Target tissue resistance</subject><subject>Fatty Liver - etiology</subject><subject>Fatty Liver - metabolism</subject><subject>Fatty Liver - prevention & control</subject><subject>Female</subject><subject>Gastrointestinal surgery</subject><subject>Humans</subject><subject>Inflammatory bowel disease</subject><subject>Insulin resistance</subject><subject>Life Style</subject><subject>Liver diseases</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Metabolic diseases</subject><subject>Middle Aged</subject><subject>Miscellaneous</subject><subject>Original Research</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Spectrum analysis</subject><subject>Tropical diseases</subject><subject>Type 2 diabetes</subject><subject>Weight loss</subject><subject>Weight Loss - physiology</subject><subject>Womens health</subject><issn>0149-5992</issn><issn>1935-5548</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNpt0l1v0zAUBuAIgVg3uOAPgAVCiIsMxx-Jc4NUjcEmFXGxTVxap85x5ym1S-xW6r-fQ8tgqEqkSPbj18fOKYpXFT1lnDefOlPRkipZPykmVctlKaVQT4sJrURbyrZlR8VxjHeUUiGUel4cMVrXglbtpHDn1qJJJFgCpGLl9-DTLbn0CX10GyQzZzGmbY-_x4YN-uSCJ_m9wBUkZ8hVQkghukicJ9Nu3adIfroccr1dIWHki4M5JowvimcW-ogv99-T4ubr-fXZRTn78e3ybDorjaxpKqG1EgVjAq0EW_O6E62ZM0YRQDWNpdTMDQCV1oiug6rO3LKGZtQ0TBp-Unze5a7W8yV2Jlc8QK9Xg1vCsNUBnH48492tXoSNZq2QlWQ54MM-YAi_1vn0eumiwb4Hj2EddSNrTlVDVZZv_5N3YT34fLqMWilYo8a4dzu0gB618zbkXc0Yqacs_wQlhRBZlQfUAj3mEoNH6_LwI396wOenw6UzBxd83C0wQ4hxQPtwIxXVYxfpsYv02EXZvv73Ch_kn7bJ4P0eQDTQ2wG8cfGv45xJ3oybvtk5C0HDYsjm5orRiueqWqEo4_cffdbP</recordid><startdate>20101001</startdate><enddate>20101001</enddate><creator>Lazo, Mariana</creator><creator>Solga, Steven F</creator><creator>Horska, Alena</creator><creator>Bonekamp, Susanne</creator><creator>Diehl, Anna Mae</creator><creator>Brancati, Frederick L</creator><creator>Wagenknecht, Lynne E</creator><creator>Pi-Sunyer, F. 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Xavier ; Kahn, Steven E ; Clark, Jeanne M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c560t-a9f5e4224ef5af636d49cb220eaa877f00cbcaa05fc4dda16f5ef2709cb7725c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Aged</topic><topic>Alcohol use</topic><topic>Biological and medical sciences</topic><topic>Body Mass Index</topic><topic>Cholesterol</topic><topic>Data collection</topic><topic>Diabetes</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Diabetes Mellitus, Type 2 - metabolism</topic><topic>Diabetes Mellitus, Type 2 - therapy</topic><topic>Diabetes therapy</topic><topic>Diabetes. Impaired glucose tolerance</topic><topic>Diabetics</topic><topic>Diet</topic><topic>Disease</topic><topic>Endocrine pancreas. Apud cells (diseases)</topic><topic>Endocrinopathies</topic><topic>Etiopathogenesis. Screening. Investigations. Target tissue resistance</topic><topic>Fatty Liver - etiology</topic><topic>Fatty Liver - metabolism</topic><topic>Fatty Liver - prevention & control</topic><topic>Female</topic><topic>Gastrointestinal surgery</topic><topic>Humans</topic><topic>Inflammatory bowel disease</topic><topic>Insulin resistance</topic><topic>Life Style</topic><topic>Liver diseases</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Metabolic diseases</topic><topic>Middle Aged</topic><topic>Miscellaneous</topic><topic>Original Research</topic><topic>Public health. Hygiene</topic><topic>Public health. 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Xavier</au><au>Kahn, Steven E</au><au>Clark, Jeanne M</au><aucorp>Fatty Liver Subgroup of the Look AHEAD Research Group</aucorp><aucorp>for the Fatty Liver Subgroup of the Look AHEAD Research Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of a 12-Month Intensive Lifestyle Intervention on Hepatic Steatosis in Adults With Type 2 Diabetes</atitle><jtitle>Diabetes care</jtitle><addtitle>Diabetes Care</addtitle><date>2010-10-01</date><risdate>2010</risdate><volume>33</volume><issue>10</issue><spage>2156</spage><epage>2163</epage><pages>2156-2163</pages><issn>0149-5992</issn><eissn>1935-5548</eissn><coden>DICAD2</coden><abstract>OBJECTIVE: Weight loss through lifestyle changes is recommended for nonalcoholic fatty liver disease (NAFLD). However, its efficacy in patients with type 2 diabetes is unproven. RESEARCH DESIGN AND METHODS: Look AHEAD (Action for Health in Diabetes) is a 16-center clinical trial with 5,145 overweight or obese adults with type 2 diabetes, who were randomly assigned to an intensive lifestyle intervention (ILI) to induce a minimum weight loss of 7% or a control group who received diabetes support and education (DSE). In the Fatty Liver Ancillary Study, 96 participants completed proton magnetic resonance spectroscopy to quantify hepatic steatosis and tests to exclude other causes of liver disease at baseline and 12 months. We defined steatosis >5.5% as NAFLD. RESULTS: Participants were 49% women and 68% white. The mean age was 61 years, mean BMI was 35 kg/m², mean steatosis was 8.0%, and mean aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were 20.5 and 24.2 units/l, respectively. After 12 months, participants assigned to ILI (n = 46) lost more weight (-8.5 vs. -0.05%; P < 0.01) than those assigned to DSE and had a greater decline in steatosis (-50.8 vs. -22.8%; P = 0.04) and in A1C (-0.7 vs. -0.2%; P = 0.04). There were no significant 12-month changes in AST or ALT levels. At 12 months, 26% of DSE participants and 3% (1 of 31) of ILI participants without NAFLD at baseline developed NAFLD (P < 0.05). CONCLUSIONS: A 12-month intensive lifestyle intervention in patients with type 2 diabetes reduces steatosis and incident NAFLD.</abstract><cop>Alexandria, VA</cop><pub>American Diabetes Association</pub><pmid>20664019</pmid><doi>10.2337/dc10-0856</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0149-5992 |
| ispartof | Diabetes care, 2010-10, Vol.33 (10), p.2156-2163 |
| issn | 0149-5992 1935-5548 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_2945152 |
| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Aged Alcohol use Biological and medical sciences Body Mass Index Cholesterol Data collection Diabetes Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - metabolism Diabetes Mellitus, Type 2 - therapy Diabetes therapy Diabetes. Impaired glucose tolerance Diabetics Diet Disease Endocrine pancreas. Apud cells (diseases) Endocrinopathies Etiopathogenesis. Screening. Investigations. Target tissue resistance Fatty Liver - etiology Fatty Liver - metabolism Fatty Liver - prevention & control Female Gastrointestinal surgery Humans Inflammatory bowel disease Insulin resistance Life Style Liver diseases Male Medical sciences Metabolic diseases Middle Aged Miscellaneous Original Research Public health. Hygiene Public health. Hygiene-occupational medicine Spectrum analysis Tropical diseases Type 2 diabetes Weight loss Weight Loss - physiology Womens health |
| title | Effect of a 12-Month Intensive Lifestyle Intervention on Hepatic Steatosis in Adults With Type 2 Diabetes |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-16T03%3A06%3A01IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Effect%20of%20a%2012-Month%20Intensive%20Lifestyle%20Intervention%20on%20Hepatic%20Steatosis%20in%20Adults%20With%20Type%202%20Diabetes&rft.jtitle=Diabetes%20care&rft.au=Lazo,%20Mariana&rft.aucorp=Fatty%20Liver%20Subgroup%20of%20the%20Look%20AHEAD%20Research%20Group&rft.date=2010-10-01&rft.volume=33&rft.issue=10&rft.spage=2156&rft.epage=2163&rft.pages=2156-2163&rft.issn=0149-5992&rft.eissn=1935-5548&rft.coden=DICAD2&rft_id=info:doi/10.2337/dc10-0856&rft_dat=%3Cgale_pubme%3EA240185444%3C/gale_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=759542782&rft_id=info:pmid/20664019&rft_galeid=A240185444&rfr_iscdi=true |