• Norio Akuta, Yusuke Kawamura, Hitomi Sezaki, Kenichi Nakamichi, Eiji Saegusa, Hidetoshi Ogura, Masaki Kato, Etsuko Doi, Naoko Inoue, Tetsuya Hosaka, Satoshi Saitoh, Mariko Kobayashi, Shunichiro Fujiyama, Yasuji Arase, Kenji Ikeda, Yoshiyuki Suzuki, Hiromitsu Kumada, and Fumitaka Suzuki.
• Department of Hepatology, Toranomon Hospital and Okinaka Memorial Institute for Medical Research, Japan.
• Intern. Med. 2024 May 9.

AbstractObjective The long-term impact of personalized diet and exercise programs for steatotic liver disease (SLD) remains unclear. Materials The subjects of this retrospective cohort study included 104 consecutive Japanese patients with SLD. The long-term treatment efficacy of personalized diet and exercise treatment was evaluated two years after the start of observation. Regular and repeated hospitalizations every 6 months (RRH group, n=23) indicated the 4 times of the number of hospitalizations, and irregular hospitalizations (IH group, n=56) showed the 1 to three times. The group without hospitalization was defined as the no hospitalization group (NH group, n=25). To balance confounding biases, the difference in treatment efficacy between the RRH and IH groups was evaluated using propensity score (PS)-matched analysis. A diet of 25 to 30 kcal/kg multiplied by ideal body weight (BW) daily, and aerobic and resistance exercise (exercise intensity of 4 to 5 metabolic equivalents daily, respectively) was performed for 6 days. Results At 2 years compared to baseline, the decrease rates of liver function tests, HbA1c, and physical findings in the RRH group were significantly higher than those in the NH or IH groups by multiple comparisons. According to the liver function tests and physical findings, the rate of decrease in the RRH group (17 cases) was significantly higher than that in the IH group (17 cases) using a PS-matched analysis. Conclusion The present study indicated the long-term favorable efficacy of personalized diet and exercise programs for SLD. In particular, this RRH program was effective in improving the findings of liver function tests and might help to sustain diet and exercise.

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