{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T22:16:26Z","timestamp":1793225786011,"version":"4.5.0"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2017,3,6]],"date-time":"2017-03-06T00:00:00Z","timestamp":1488758400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1"},{"start":{"date-parts":[[2017,3,6]],"date-time":"2017-03-06T00:00:00Z","timestamp":1488758400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatology"],"published-print":{"date-parts":[[2017,4]]},"abstract":"<jats:p>\n                    Obesity increases the risk of clinical decompensation in cirrhosis, possibly by increasing portal pressure. Whether weight reduction can be safely achieved through lifestyle (LS) changes (diet and exercise) in overweight\/obese patients with cirrhosis, and if weight loss reduces portal pressure in this setting, is unknown. This prospective, multicentric, uncontrolled pilot study enrolled patients with compensated cirrhosis, portal hypertension (hepatic venous pressure gradient [HVPG] \u22656 mm Hg), and body mass index (BMI) \u226526 kg\/m\n                    <jats:sup>2<\/jats:sup>\n                    in an intensive 16\u2010week LS intervention program (personalized hypocaloric normoproteic diet and 60 min\/wk of supervised physical activity). We measured HVPG, body weight (BW) and composition, adipokines, health\u2010related quality of life, and safety data before and after the intervention. Changes in HVPG and BW were predefined as clinically relevant if \u226510% and \u22655%, respectively. Safety and BW were reassessed after 6 months. 60 patients were included and 50 completed the study (56 \u00b1 8 years old; 62% male; nonalcoholic steatohepatitis etiology 24%; BMI 33.3 \u00b1 3.2 kg\/m\n                    <jats:sup>2<\/jats:sup>\n                    ; Child A 92%; HVPG \u226510 mm Hg, 72%). LS intervention significantly decreased BW (average, \u20135.0 \u00b1 4.0 kg;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; 0.0001), by \u22655% in 52% and \u226510% in 16%. HVPG also significantly decreased (from 13.9 \u00b1 5.6 to 12.3 \u00b1 5.2 mm Hg;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; 0.0001), by \u226510% in 42% and \u226520% in 24%. A \u226510% BW loss was associated with a greater decrease in HVPG (\u201323.7 \u00b1 19.9% vs. \u20138.2 \u00b1 16.6%;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.024). No episodes of clinical decompensation occurred. Weight loss achieved at 16 weeks was maintained at 6 months; Child and Model for End\u2010Stage Liver Disease scores did not change.\n                    <jats:italic toggle=\"yes\">Conclusion<\/jats:italic>\n                    : Sixteen weeks of diet and moderate exercise were safe and reduced BW and portal pressure in overweight\/obese patients with cirrhosis and portal hypertension. (H\n                    <jats:sc>epatology<\/jats:sc>\n                    2017;65:1293\u20101305).\n                  <\/jats:p>","DOI":"10.1002\/hep.28992","type":"journal-article","created":{"date-parts":[[2016,12,20]],"date-time":"2016-12-20T18:02:49Z","timestamp":1482256969000},"page":"1293-1305","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":299,"title":["Effects of an intensive lifestyle intervention program on portal hypertension in patients with cirrhosis and obesity: The SportDiet study"],"prefix":"10.1097","volume":"65","author":[{"given":"Annalisa","family":"Berzigotti","sequence":"first","affiliation":[{"name":"CIBERehd,Instituto de Salud Carlos III,Madrid,Spain"},{"name":"Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Clinic, IDIBAPS,University of Barcelona,Barcelona,Spain"},{"name":"Swiss Liver Center, Hepatology, University Clinic for Visceral Surgery and Medicine, Inselspital,University of Bern,Bern,Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agust\u00edn","family":"Albillos","sequence":"additional","affiliation":[{"name":"CIBERehd,Instituto de Salud Carlos III,Madrid,Spain"},{"name":"Hospital Universitario Ram\u00f3n y Cajal,Madrid,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Candid","family":"Villanueva","sequence":"additional","affiliation":[{"name":"CIBERehd,Instituto de Salud Carlos III,Madrid,Spain"},{"name":"Hospital Santa Creu i Sant Pau,Barcelona,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan","family":"Genesc\u00e1","sequence":"additional","affiliation":[{"name":"CIBERehd,Instituto de Salud Carlos III,Madrid,Spain"},{"name":"Hospital Universitari Vall d'Hebron,Barcelona,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alba","family":"Ardevol","sequence":"additional","affiliation":[{"name":"CIBERehd,Instituto de Salud Carlos III,Madrid,Spain"},{"name":"Hospital Santa Creu i Sant Pau,Barcelona,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvador","family":"August\u00edn","sequence":"additional","affiliation":[{"name":"CIBERehd,Instituto de Salud Carlos III,Madrid,Spain"},{"name":"Hospital Universitari Vall d'Hebron,Barcelona,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose Luis","family":"Calleja","sequence":"additional","affiliation":[{"name":"CIBERehd,Instituto de Salud Carlos III,Madrid,Spain"},{"name":"Hospital Puerta de Hierro,Madrid,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael","family":"Ba\u00f1ares","sequence":"additional","affiliation":[{"name":"CIBERehd,Instituto de Salud Carlos III,Madrid,Spain"},{"name":"Hospital General Universitario Gregorio Mara\u00f1on,Madrid,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Carlos","family":"Garc\u00eda\u2010Pag\u00e1n","sequence":"additional","affiliation":[{"name":"CIBERehd,Instituto de Salud Carlos III,Madrid,Spain"},{"name":"Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Clinic, IDIBAPS,University of Barcelona,Barcelona,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco","family":"Mesonero","sequence":"additional","affiliation":[{"name":"CIBERehd,Instituto de Salud Carlos III,Madrid,Spain"},{"name":"Hospital Universitario Ram\u00f3n y Cajal,Madrid,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaime","family":"Bosch","sequence":"additional","affiliation":[{"name":"CIBERehd,Instituto de Salud Carlos III,Madrid,Spain"},{"name":"Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Clinic, IDIBAPS,University of Barcelona,Barcelona,Spain"},{"name":"Swiss Liver Center, Hepatology, University Clinic for Visceral Surgery and Medicine, Inselspital,University of Bern,Bern,Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the Ciberehd SportDiet Collaborative Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2017,3,6]]},"reference":[{"key":"hep28992-bib-0001-20241017","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1002\/hep.24418","article-title":"Obesity is an independent risk factor for clinical decompensation in patients with cirrhosis","volume":"54","year":"2011","journal-title":"Hepatology"},{"key":"hep28992-bib-0002-20241017","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1053\/j.gastro.2009.05.007","article-title":"Weight\u2010related effects on disease progression in the hepatitis C antiviral long\u2010term treatment against cirrhosis trial","volume":"137","year":"2009","journal-title":"Gastroenterology"},{"issue":"1 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