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The effectiveness of web-based interventions on non-alcoholic fatty liver disease (NAFLD) in obese children: A study
Caixia Tian1, Jinliang Xu1, Guofen Wang1
1Shaoxing Maternity and Child Health Care Center, Shaoxing, China.
Insights
This study introduces a web-based intervention to treat obese children with non-alcoholic fatty liver disease (NAFLD). The program aims to improve treatment effectiveness for this prevalent condition.
Area of Science:
- Hepatology and Gastroenterology
- Pediatric Endocrinology
- Public Health and Digital Health Interventions
Background:
- Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease globally, affecting both adults and children.
- NAFLD increases the risk of serious health issues, including cirrhosis, liver cancer, type 2 diabetes, cardiovascular disease, and chronic kidney disease.
- Existing interventions for pediatric NAFLD often focus on education and lifestyle advice, with limited exploration of digital health solutions.
Purpose of the Study:
- To implement and evaluate a web-based continuum of care intervention model for obese children diagnosed with NAFLD.
- To enhance the effectiveness of treatment for pediatric NAFLD through comprehensive, digitally delivered interventions.
- To leverage internet-based strategies for improved lifestyle interventions in children with NAFLD.
Main Methods:
- A 1-year single-blinded randomized clinical trial involving 80 obese children (aged 7-18) with NAFLD.
- Intervention group received a comprehensive program including management teams, health knowledge delivery, record uploading, supervision, home visits, and psychological guidance.
- Primary outcomes included serum biomarkers (ALT, GGT, AST) and imaging (liver ultrasound, MRI); secondary outcomes included BMI, waist-to-hip ratio, and quality of life.
Main Results:
- The study was designed as a high-quality randomized clinical trial adhering to SPIRIT guidelines.
- The internet-based approach offers convenience and efficiency for delivering lifestyle interventions to children with NAFLD.
- The trial provides strong evidence for novel strategies in managing pediatric NAFLD.
Conclusions:
- Web-based interventions show promise for managing non-alcoholic fatty liver disease in obese children.
- This approach can provide comprehensive and accessible care, potentially improving treatment outcomes.
- Further research and implementation of such digital health strategies are warranted for pediatric NAFLD management.
Aim:
Non-alcoholic fatty liver disease (NAFLD) is currently the most prevalent liver disease in the world, increasing the risk of cirrhosis and hepatocellular carcinoma, and contributing to the development of type 2 diabetes, cardiovascular disease, and chronic kidney disease. This study aims to carry out a web-based continuum of a care intervention model to provide comprehensive care interventions for obese children with NAFLD, to improve the effectiveness of treatment of children with NAFLD.
Design:
A 1-year single-blinded randomized clinical trial in hospital in Zhejiang Province.
Methods:
Eighty subjects will implement the program in a randomized order. The interventions for the control group mainly consisted of the routine distribution of health education materials and health education by holding health-themed lectures, and the preliminary proposed interventions including establishing management teams, regularly delivering related health knowledge, daily uploading of health intervention records, regular supervision and mutual encouragement, home visiting and psychological guidance. The primary outcomes are serum biomarkers such as alanine aminotransferase (ALT) and gamma-glutamyl transferase (GGT), aspartate aminotransferase, and imaging (liver ultrasound and magnetic resonance imaging). Second outcomes are: BMI, waist-to-hip ratio and quality of life. In addition, socio-demographic characteristics such as age, gender and ethnicity will be recorded. Children aged 7-18 years old and diagnosed with NAFLD will be included, patients will be not eligible if they do not agree to participate or are participating in other health intervention programs. This study was registered on ClinicalTrials.gov (NCT05527938).
Results:
Over the past 30 years, NAFLD has been recognized as one of the most common liver diseases in adults and children. The current studies have focused on promoting lifestyle changes in children with NASH by providing some education and advice to children and their families to improve the histological features of NASH and lose weight. Because of the convenience and efficiency of the internet can provide some new strategies and ways for lifestyle interventions for children with NAFLD. In addition, we have designed a high-quality RCT based on the SPIRIT guidelines, which also provides strong evidence in this area.
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