{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T14:14:52Z","timestamp":1792419292687,"version":"4.5.0"},"reference-count":56,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,10,16]],"date-time":"2023-10-16T00:00:00Z","timestamp":1697414400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The long\u2010term results of web\u2010based behavioural intervention in non\u2010alcoholic fatty liver disease (NAFLD) have not been described in patients followed in specialised centres.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To analyse the long\u2010term effectiveness of web education compared with the results achieved by a group\u2010based behavioural intervention in the same years 2012\u20132014.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We followed 679 patients with NAFLD (web\u2010based,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009290; group\u2010based,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009389) for 5\u2009years. Weight loss \u226510% was the primary outcome; secondary outcomes were attrition, changes in liver enzymes and in biomarkers of steatosis (Fatty liver Index) and fibrosis (Fibrosis\u20104 index).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The cohorts differed in age, education, working status and presence of diabetes. Attrition was higher in the web\u2010based cohort (hazard ratio: 1.53; 95% CI: 1.24\u20131.88), but not different after adjustment for confounders. Among patients in active follow\u2010up, 50% lost \u22655% of initial body weight and 19% lost \u226510%, without difference between cohorts. Alanine aminotransferase levels fell to within the normal range in 51% and 45% of web\u2010 and group\u2010based cohorts, respectively. Fatty Liver Index declined progressively and, by year 5, it ruled out steatosis in 4.8%, whereas 24.9% were in the indeterminate range. Fibrosis\u20104 index increased in both cohorts, driven by age, but the prevalence of cases ruling\u2010in advanced fibrosis remained very low (around 1%). Improvements in the class of both surrogate biomarkers were associated with \u22655% weight loss.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although burdened by attrition, web\u2010based behavioural intervention is feasible and effective in NAFLD, expanding the cohort involved in behavioural programs and reducing the risk of progressive disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/apt.17768","type":"journal-article","created":{"date-parts":[[2023,10,16]],"date-time":"2023-10-16T10:54:16Z","timestamp":1697453656000},"page":"249-259","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Long\u2010term follow\u2010up of web\u2010based and group\u2010based behavioural intervention in\n                    <scp>NAFLD<\/scp>\n                    in a real world clinical setting"],"prefix":"10.1111","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7040-6466","authenticated-orcid":false,"given":"Maria Letizia","family":"Petroni","sequence":"first","affiliation":[{"name":"IRCCS\u2010Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1724-498X","authenticated-orcid":false,"given":"Santo","family":"Colosimo","sequence":"additional","affiliation":[{"name":"IRCCS\u2010Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7735-7847","authenticated-orcid":false,"given":"Lucia","family":"Brodosi","sequence":"additional","affiliation":[{"name":"IRCCS\u2010Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7245-4445","authenticated-orcid":false,"given":"Angelo","family":"Armandi","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Division of Gastroenterology and Hepatology A.O. Citt\u00e0 della Salute e della Scienza di Torino, University of Turin  Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6925-5712","authenticated-orcid":false,"given":"Flavio","family":"Bertini","sequence":"additional","affiliation":[{"name":"Department of Mathematical, Physical and Computer Sciences University of Parma  Parma Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4748-6867","authenticated-orcid":false,"given":"Danilo","family":"Montesi","sequence":"additional","affiliation":[{"name":"Department of Computer Science and Engineering Alma Mater University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0502-4381","authenticated-orcid":false,"given":"Elisabetta","family":"Bugianesi","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Division of Gastroenterology and Hepatology A.O. Citt\u00e0 della Salute e della Scienza di Torino, University of Turin  Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2407-9860","authenticated-orcid":false,"given":"Giulio","family":"Marchesini","sequence":"additional","affiliation":[{"name":"IRCCS\u2010Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,10,16]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/HEP.0000000000000004"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhepr.2020.100142"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.numecd.2020.02.016"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m4747"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/cob.12183"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.2147\/DMSOTT.S13860"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2012.11.031"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620\u2010019\u201005700\u20109"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0000000000000075"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.2196\/23786"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.9751"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.2196\/23473"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2022.918982"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.appet.2015.07.008"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc17\u20100303"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.numecd.2008.06.004"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2018.07.013"},{"key":"e_1_2_9_19_1","volume-title":"Motivational interviewing","author":"Miller WR","year":"2002"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003\u20104819\u2010137\u20101\u2010200207020\u201000006"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u2010230X\u20106\u201033"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.21669"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2015.11.004"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468\u20101253(23)00141\u20103"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000001606"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2020.06.007"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/HEP.0000000000000323"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.6688"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200105033441801"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa012512"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2017.04.033"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.9609"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu12123634"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12170\u2010021\u201000680\u2010w"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.15427"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102796.2005.01524.x"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/edm2.82"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu12123881"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhepr.2021.100322"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.15209"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu15030792"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022-006X.65.1.79"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1159\/000441366"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g2646"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1111\/obr.13483"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102362.2008.01929.x"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2018.08.011"},{"key":"e_1_2_9_48_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2015.04.005"},{"key":"e_1_2_9_49_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.17374"},{"key":"e_1_2_9_50_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.13974"},{"key":"e_1_2_9_51_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11695\u2010022\u201006380\u20107"},{"key":"e_1_2_9_52_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28416"},{"key":"e_1_2_9_53_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl\u20102018\u2010317593"},{"key":"e_1_2_9_54_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.25772"},{"key":"e_1_2_9_55_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc19\u20101113"},{"key":"e_1_2_9_56_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2019.08.027"},{"key":"e_1_2_9_57_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41575\u2010021\u201000523\u20104"}],"container-title":["Alimentary Pharmacology &amp; Therapeutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apt.17768","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,4]],"date-time":"2024-06-04T02:23:07Z","timestamp":1717467787000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/apt.17768"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,16]]},"references-count":56,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,1]]}},"alternative-id":["10.1111\/apt.17768"],"URL":"https:\/\/doi.org\/10.1111\/apt.17768","archive":["Portico"],"relation":{},"ISSN":["0269-2813","1365-2036"],"issn-type":[{"value":"0269-2813","type":"print"},{"value":"1365-2036","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,16]]},"assertion":[{"value":"2023-09-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-10-04","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-10-16","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}