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  • 1
    In: Obesity Science & Practice, Wiley, Vol. 9, No. 3 ( 2023-06), p. 218-225
    Abstract: The Diabetes Prevention Program (DPP) is the gold standard lifestyle modification program that reduces incident type 2 diabetes mellitus. Patients with prediabetes and patients with non‐alcoholic fatty liver disease (NAFLD) often share metabolic features; we hypothesized that the DPP could be adapted and used to improve outcomes in patients with NAFLD. Methods NAFLD patients were recruited into a 1 year modified DPP. Demographics, medical comorbidities, and clinical laboratory values were collected at baseline, 6 and 12 months. The primary endpoint was change in weight at 12 months. Secondary endpoints were changes in hepatic steatosis, metabolic comorbidities, and liver enzymes (per‐protocol basis) and retention at 6 and 12 months. Results Fourteen NAFLD patients enrolled; three dropped out before 6 months. From baseline to 12 months, hepatic steatosis ( p  = 0.03), alanine aminotransferase ( p  = 0.02), aspartate aminotransferase ( p = 0.02), high‐density lipoprotein ( p  = 0.01) and NAFLD fibrosis score ( p   〈  0.001) improved, but low‐density lipoprotein worsened ( p  = 0.04). Conclusion Seventy‐nine percent of patients completed the modified DPP. Patients lost weight and had improvements in five out of six indicators of liver injury and lipid metabolism. Clinical Trial Registry Number NCT04988204.
    Type of Medium: Online Resource
    ISSN: 2055-2238 , 2055-2238
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2836381-4
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  • 2
    In: Journal of Viral Hepatitis, Wiley, Vol. 30, No. 3 ( 2023-03), p. 195-200
    Abstract: Hepatitis D virus (HDV) infection is highly prevalent in patients with chronic hepatitis B (CHB). AASLD guidelines recommend a risk‐based screening approach. Our aim was to ascertain if the risk‐based approach leads to appropriate HDV screening, identify targets to improve screening rates, and study HDV clinical burden. CHB patients screened for HDV from 01/2016 to 12/2021 were identified. Level of training and specialty of providers ordering HDV screening tests were determined. HDV seropositive (HDV+) patient charts were reviewed for the presence of individual risk factors per the AASLD guidelines to determine if they met screening criteria. The severity of liver disease at the time of HDV screening was compared between the HDV+ group and a matched (based on age, hepatitis B e antigen status, BMI and sex) HDV seronegative (HDV−) group. During the study period, 1444/11,190 CHB patients were screened for HDV. Most screening tests were ordered by gastroenterology (90.2%) specialists and attending physicians (80.5%). HDV+ rate was 88/1444 (6%), and 72 HDV+ patients had complete information for analysis. 18% of HDV+ patients would be missed by a risk‐based screening approach due to unreported or negative risk factors (see Table). A significantly higher number of HDV+ patients had developed significant fibrosis ( p  = 0.001) and cirrhosis ( p   〈  0.01) by the time of screening than HDV− ( n  = 67) patients. In conclusion, targeted interventions are needed towards trainees and primary care clinics to improve screening rates. Current risk‐based criteria do not appropriately screen for HDV. It is time for universal screening of HDV in CHB patients.
    Type of Medium: Online Resource
    ISSN: 1352-0504 , 1365-2893
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2007924-2
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