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| 1 | Effect of resistance training on non-alcoholic fatty-liver disease a randomized-clinical trial显示文摘AIM:To evaluate the effect of resistance training(RT)on non alcoholic liver disease(NAFLD)patients.METHODS:A randomized clinical trial enrolling NAFLD patients without secondary liver disease(e.g.,without hepatitis B virus,hepatitis C virus or excessive alcohol consumption).Patients were randomly allocated either to RT,three times weekly,for 3 mo or a control arm consisting of home stretching.The RT included leg press,chest press,seated rowing,latissimus pull down etc.with 8-12 repetitions,3 sets for each exercise,for a total duration of 40 min.Hepatic ultrasound,fasting blood tests,anthropometrics and body composition by dual energy X-ray absorptiometry were assessed.At baseline and follow-up,patients filled out a detailed semi-quantitative food frequency questionnaire reporting their habitual nutritional intake.Steatosis was quantified by the hepatorenal-ultrasound index(HRI)representing the ratio between the brightness level of the liver and the right kidney.The HRI has been previously demonstrated to be highly reproducible and was validated against liver biopsy and proton magnetic resonance spectroscopy.RESULTS:Eighty two patients with primary NAFLD were randomized to receive 3 mo of either RT or stretching.After dropout or exclusion from analysis because of protocol violation(weight change>3 kg),thirty three patients in the RT arm and 31 in the stretching arm completed the study per protocol.All baseline characteristics were similar for the two treatment groups with respect to demographics,anthropometrics and body composition,blood tests and liver steatosis on imaging.HRI score was reduced significantly in the RT arm as compared to the stretching arm(-0.25±0.37 vs-0.05±0.28,P=0.017).The RT arm had a significantly higher reduction in total,trunk and android fat with increase in lean body mass.There was no correlation between the reduction in HRI in the RT arm and weight change during the study,but it was positively correlated with the change in trunk fat(r=0.37,P=0.048).The RT arm had a significant reduction in serum ferritin and total cholesterol.There was no significant difference between arms in dietary changes and these did not correlate with HRI change.CONCLUSION:Three months RT improves hepatic fat content accompanied by favorable changes in body composition and ferritin.RT may serve as a complement to treatment of NAFLD. | Shira Zelber-Sagi Assaf Buch Hanny Yeshua Nahum Vaisman Muriel Webb Gil Harari Ofer Kis Naomi Fliss-Isakov Elena Izkhakov Zamir Halpern Erwin Santo Ran Oren Oren Shibolet | 2014 | World Journal of Gastroenterology2014，20，15： | 17 |
| 2 | Role of illness perception and self-efficacy in lifestyle modification among non-alcoholic fatty liver disease patients显示文摘AIM To describe the relationships between non-alcoholic fatty-liver disease(NAFLD) patient's disease consequences and treatment perceptions, self-efficacy, and healthy lifestyle maintenance. METHODS A cross-sectional study among 146 ultrasound diagnosed NAFLD patients who visited the fatty liver clinic at the TelAviv Medical Center. Eighty-seven of these individuals, participated in a clinical trial of physical activity and underwent fasting blood tests, analyzed at the same lab. Exclusion criteria included positivity for serum HBsA g or anti-HCV antibodies; fatty liver suspected to be secondary to hepatotoxic drugs; excessive alcohol consumption(≥ 30 g/d in men or ≥ 20 g/d in women) and positive markers of genetic or immune-mediated liver diseases. Patients were asked to complete a selfreport structured questionnaire, assembled by the Israeli Center for Disease Control. Nutrition habits were measured using six yes/no questions(0 = no, 1 = yes) adopted from the national survey questionnaire. Participants in the clinical trial completed a detailed semi-quantitative food frequency questionnaire(FFQ) reporting their habitual nutritional intake during the past year. Self-efficacy was assessed by the Self-Efficacy Scale questionnaire, emotional representation, degree of illness understanding, timeline perception, treatment perception and symptoms were measured by the Brief Illness Perception questionnaire. Illness consequences were measured by the Personal Models of Diabetes Interview questionnaire. A path analysis was performed to describe the interrelationships between the patients' illness perceptions, and assess the extent to which the data fit a prediction of nutritional habits.RESULTS The study sample included 54.1% men, with a mean age of 47.76 ± 11.68 years(range: 20-60) and mean body mass index of 31.56 ± 4.6. The average perceived nutrition habits score was 4.73 ± 1.45 on a scale between 0-6, where 6 represents the healthiest eating habits. Most of the study participants(57.2%) did not feel they fully understood what NAFLD is. Better nutritional habits were positively predicted by the degree of illness understanding(β = 0.26; P = 0.002) and selfefficacy(β = 0.25; P = 0.003). Perceptions of more severe illness consequences were related with higher emotional representation(β = 0.55; P < 0.001), which was related with lower self-efficacy(β =-0.17; P = 0.034). The perception of treatment effectiveness was positively related with self-efficacy(β = 0.32; P < 0.001). In accordance with the correlation between self-efficacy and the perceived nutrition habits score, self-efficacy was also correlated with nutrient intake evaluated by the FFQ; negatively with saturated fat(percent of saturated fat calories from total calories)(r =-0.28, P = 0.010) and positively with fiber(r = 0.22, P = 0.047) and vitamin C intake(r = 0.34, P = 0.002). In a sub analysis of the clinical trial participants, objectively measured compliance to physical activity regimen was positively correlated with the self-efficacy level(r = 0.34, P = 0.046). CONCLUSION Self-efficacy and illness understanding are major determinants of lifestyle-modification among NAFLD patients. This information can assist clinicians in improving compliance with lifestyle changes among these patients. | Shira Zelber-Sagi Shiran Bord Gali Dror-Lavi Matthew Lee Smith Samuel D Towne Jr Assaf Buch Muriel Webb Hanny Yeshua Assy Nimer Oren Shibolet | 2017 | World Journal of Gastroenterology2017，23，10： | 6 |
| 3 | Predictors for incidence and remission of NAFLD in the general population during a seven-year prospective follow-up显示文摘 | Shira Zelber-Sagi Roni Lotan Amir Shlomai Muriel Webb Gil Harrari Assaf Buch Dorit Nitzan Kaluski Zamir Halpern Ran Oren | 2012 | Journal of Hepatology2012，，5： | 4 |
| 4 | Non‐alcoholic fatty liver disease independently predicts prediabetes during a 7‐year prospective follow‐up显示文摘 | Shira Zelber‐Sagi Roni Lotan Oren Shibolet Muriel Webb Assaf Buch Dorit Nitzan‐Kaluski Zamir Halpern Erwin Santo Ran Oren | 2013 | Liver Int2013，，9： | 3 |
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