Patient compliance level as a basis for personalization of non-drug treatment of non-alcoholic fatty liver disease

Abstract

The purpose — to determine the effect of patient’s compliance level on the appointment of personalized non-drug treatment of non-alcoholic fatty liver disease (NAFLD). Material and methods. 208 patients with excess body mass were examined, 177 patients with excess fat mass (according to the bioimpedance analyses) were included into the study. The patients (n = 93) were divided into groups according to their compliance level: Group 1 (n = 31, 33.3%) — low level; Group 2 (n = 38, 40.9%) — average level; Group 3 (n = 24, 25.8%) — high level of compliance. The period of observation was 3 months. The treatment program was selected depending on the compliance and physical activity levels. The control group (n = 84) included patients without personalized treatment. The unified diagnostic algorithm applied to all patients included biochemical blood test parameters, quantitative ultrasound steatometry within the combined elastography and dual-energy X-ray absorptiometry in the «Whole body» mode. Results. Groups of patients were formed according to the NAFLD stage: hepatic steatosis (n = 23, 24.7%), steatohepatitis with liver fibrosis F0-F1 (n = 41, 44.1%), steatohepatitis with liver fibrosis F2-F3 (n = 27, 29%), liver cirrhosis F4 (n = 2, 2.2%). The connection was revealed between the NAFLD stage decrease in the direction “fibrosis ^ steatohepatitis ^ steatosis” (with a fat mass index decrease) and the compliance level, which served as the basis for the non-drug treatment tactics. Conclusion. A preliminary assessment of the patient’s compliance for the NAFLD non-drug treatment is effective for the progressing along the disease stages of reduction of clinical and morphological manifestations. Quantitative ultrasound steatometry with dual¬energy X-ray absorptiometry in the ««Whole body» mode can be used in patients refusing liver biopsy.