Objective To evaluate the effectiveness of a community-based management intervention based on the Information-Motivation-Behavioral Skills (IMB) model in ameliorating non-alcoholic fatty liver disease (NAFLD), providing a reference for exploring the health management pathways for NAFLD in primary health service centers.
Methods Between January and April 2023, 714 NAFLD patients aged 50–69 years and diagnosed during physical examinations were recruited from the Community Health Service Center of Dongzha Street in Jiaxing, Zhejiang. The participants were randomly allocated into a control group (n = 357) and an intervention group (n = 357). The control group received health education manuals, while the intervention group additional received a comprehensive lifestyle intervention based on the IMB model. The controlled attenuation parameter (CAP), liver stiffness measurement (LSM), body weight, body mass index (BMI), waist circumference, total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and fasting blood glucose (GLU) were compared between the two groups before and after the 1-year intervention.
Results The CAP, LSM, body weight, BMI, waist circumference, TC, TG, LDL-C, HDL-C, AST, ALT, and GLU in the control and intervention groups before intervention were (280.75 ± 35.45) and (287.07 ± 37.81) dB/m, (5.83 ± 2.00) and (5.66 ± 1.86) kPa, (67.85 ± 9.90) and (67.64 ± 9.61) kg, (25.99 ± 2.88) and (26.22 ± 2.98), (89.27 ± 8.12) and (88.85 ± 7.98) cm, (5.10 ± 0.97) and (5.18 ± 1.08) mmol/L, (2.35 ± 1.58) and (2.44 ± 2.45) mmol/L, (2.83 ± 0.73) and (2.88 ± 0.77) mmol/L, (1.28 ± 0.33) and (1.28 ± 0.33) mmol/L, (24.31 ± 9.39) and (24.88 ± 9.38) U/L, (26.47 ± 17.68) and (26.84 ± 15.04) U/L, and (6.29 ± 1.84) and (6.40 ± 2.27) mmol/L, respectively. After intervention, the values were (277.06 ± 43.59) and (265.34 ± 41.39) dB/m, (5.57 ± 1.76) and (5.30±1.75) kPa, (66.05 ± 9.79) and (64.11 ± 10.11) kg, (25.38 ± 2.91) and (25.10 ± 3.03), (88.01 ± 8.06) and (85.30 ± 8.93) cm, (5.17 ± 1.17) and (5.01 ± 1.08) mmol/L, (2.26 ± 1.90) and (1.98 ± 1.48) mmol/L, (2.97 ± 0.80) and (2.89 ± 0.79) mmol/L, (1.38 ± 0.34) and (1.44 ± 0.33) mmol/L, (22.80 ± 8.39) and (22.25 ± 6.74) U/L, (24.87 ± 13.52) and (23.85 ± 13.05) U/L, (6.21 ± 1.61) and (5.98 ± 1.51) mmol/L respectively. The control group of NAFLD patients showed differences in LSM, body weight, BMI, waist circumference, LDL-C, HDL-C, AST, and ALT before and after intervention (all P < 0.05). The intervention group of NAFLD patients showed differences in CAP, LSM, body weight, BMI, waist circumference, TC, TG, HDL-C, AST, ALT, and GLU before and after intervention (all P < 0.01). Before intervention, the two groups showed differences in CAP (t = −2.214, P = 0.027). After intervention, the two groups of NAFLD patients showed differences in CAP, body weight, waist circumference, TG, and HDL-C (all P < 0.05).
Conclusions The community-based management intervention based on the IMB model effectively reduced hepatic steatosis, body weight, and waist circumference and recovered serum levels of lipids such as TG and HDL-C in NAFLD patients.
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