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Abstracts of the 22
nd
National Congress of Digestive Diseases / Digestive and Liver Disease 48S2 (2016) e67–e231
Table 1
HBsAg levels in different subgroups of patients
HBsAg
HBsAg
pre-therapy
last determination
(mean value ± SD)
(mean value ± SD) p value
NUC therapy (no. of patients)
Tenofovir (56)
3295 ± 4506
1863 ± 3511
0.07
Entecavir (22)
4701 ± 6966
1874 ± 2984
<0.05
Lamivudine (17)
2458 ± 3427
1261 ± 3146
0.7
Liver disease (no. of patients)
Chronic Hepatitis B (64) 3590 ± 5254
1510 ± 2437
<0.05
Cirrhosis (31)
3224 ± 4599
2271 ± 4627
0.9
IFN therapy (no. of patients)
Previous IFN (34)
4820 ± 6781
2311± 244
<0.05
No IFN (61)
2719 ± 5026
1450 ± 2753
0,06
Overall (95 patients)
3471 ± 5028
1758 ± 3308
<0.001
Of particular interest, HBsAg seroclearance occurred in 19% of
patients (18/95 patients). Moreover, HBsAg seroconversion to HBsAb
occurred in 3/18 patients, in which undetectable HBsAg value was
evidenced at least two years before the seroconversion. In these 3
patients NUC therapy was stopped, and until now none relapsed.
Conclusions:
The results of this study suggest a role of on-treatment
HBsAg quantification in the management of NUC-treated patients.
If validated, prospectively in a larger patient cohort, HBsAg
measurement would be a useful parameter to optimize antiviral
treatment schedule.
OC.03.2
THE PRESENCE OF WHITE MATTER LESIONS IS ASSOCIATED WITH
THE HISTOLOGICAL SEVERITY OF NON-ALCOHOLIC FATTY LIVER
DISEASE
Petta S.*
5
, Tuttolomondo A.
1
, Gagliardo C.
2
, Zafonte R.
3
,
Brancatelli G.
2
, Cabibi D.
4
, Camma’ C.
5
, Della Corte V.
1
, Di Marco V.
5
,
Galvano L.
3
, La Tona G.
2
, Licata A.
5
, Magliozzo F.
3
, Maida C.
1
,
Marchesini G.
6
, Merlino G.
3
, Midiri M.
2
, Parrinello G.
1
, Torres D.
1
,
Pinto A.
1
, Craxi’ A.
5
1
Dipartimento Biomedico di Medicina Interna e Specialistica (Di.
Bi.M.I.S), Universita` di Palermo, Palermo, Italia, PALERMO, Italy,
2
Sezione di Scienze Radiologiche, Dipartimento di Biopatologia
e Biotecnologie Mediche (DI.BI.MED.); Universita` degli Studi di
Palermo, Palermo, Italia, PALERMO, Italy,
3
MEDICINA GENERALE
PALERMO, PALERMO, Italy,
4
Cattedra di Anatomia Patologica,
University of Palermo, Italy, PALERMO, Italy,
5
SEZIONE DI
GASTROENTEROLOGIA, Di.Bi.M.I.S. Univeristy of Palermo, PALERMO,
Italy,
6
Dipartimento di Scienze Mediche e Chirurgiche, “Alma Mater
Studiorum,” Università di Bologna, Italy., BOLOGNA, Italy
Background and aim:
Nonalcoholic fatty liver disease (NAFLD)
has been associated with increased cardiovascular risk, including
coronary artery disease and cerebrovascular events. No studies
however assessed the potential relationship between NAFLD and
subclinical cerebrovascular alterations. We tested the correlation
between NAFLD and its histological severity with vascular white
matter lesions (WML) in patients with biopsy-proven NAFLD and in
non steatosic controls.
Material and methods:
Data were recorded in 79 consecutive
biopsy-proven NAFLD, and in 82 controls with normal ALT and no
history of chronic liver diseases, without ultrasonographic evidence
of steatosis and liver stiffness value<6 KPa. All subjects underwent
magnetic resonance assessment and WML were classified according
to the Fazekas score as absent (0/III), or present (mild I/III; moderate
II/III, and severe I/III). For the purpose of analyses, all controls were
considered without NASH and without F2-F4 liver fibrosis.
Results:
WML were found in 26.7% of the entire cohort (43/161).
The prevalence was similar in NAFLD vs. no-NAFLD (29.1% VS 24.3%;
p=0.49), but higher in NASH vs. no-NASH (37.7% vs 21.2%, p=0.02)
and F2-F4 vs. F0-F1 fibrosis (47.3% vs 20.3%,p=0.001). In both the
entire cohort and in NAFLD, only female gender (OR 4.37, 95%CI 1.79-
10.6, =0.001; and OR 5.21, 95%CI 1.39-19.6, p=0.01), age>45 years (OR
3.09, 95%CI 1.06-9.06, p=0.03; and OR 11.1, 95%CI 1.14-108.7, p=0.03),
and F2-F4 fibrosis (OR 3.36, 95%CI 1.29-8.73, p=0.01; and OR 5.34.
95%CI 1.40-20.3, p=0.01) were independently associated with WML
by multivariate analysis. Among NAFLD, the prevalence of WML
progressively increased from patients without (1/18; 5.5%), or with
one (1/17, 5.8%), to those with two (9/30; 30%) and further to those
with three (12/14; 85.7%) risk factors.
Conclusions:
The presence of WML is not associated with NAFLD,
but with metabolic diseases in general, and histological severity of
NAFLD. Clinical implications of this issue need to be assessed by
longitudinal studies.
OC.03.3
NUNA NUTRITIONAL NAVIGATOR SMARTPHONE FREE
APPLICATION FOR IMPROVING ADHERENCE TO MEDITERRANEAN
DIET AND REDUCING BODY WEIGHT IN NON-ALCOHOLIC FATTY
LIVER DISEASE PATIENTS: A PILOT STUDY
Tozzi A.*
2
, De Franco M.
1
, Giangrandi I.
1
, Novara E.
1
, Sofi F.
1
, Casini A.
1
1
Azienda Ospedaliero Universitaria Careggi, Firenze, Italy,
2
Nuovo
Ospedale San Giuseppe ASL11 Empoli, Empoli, Italy
Background and aim:
Non-alcoholic fatty liver disease (NAFLD)
represents the most common chronic liver disease in Western
countries and diet and obesity play a key role in its development. An
inverse association between NAFLD severity and greater adherence
to Mediterranean Diet (MD) has been reported, indicating this
dietary pattern as a new therapeutic option.
Unfortunately environmental factors often encourage impulse
purchases which in turn worsen the quality of patient’s grocery
shopping, home stored food and, finally, dietary habits.
NUNA Nutritional Navigator smartphone free application is the tool
for applying a new environmental educational method assuming
that patients can get a better diet by improving the quality of grocery
shopping choices and home stored food.
The aim of this study was to investigate whether NUNA free was able
to improve adherence to the MD in NAFLD patients.
Material and methods:
NUNA is able to recognize foods, record
items and calculate nutrients and MD adherence score. A pantry
pyramidal graphic is provided: green and yellow colored for higher
scores, red colored for low ones. NUNA is also able to help in choosing
foods. Once a food item is selected, a dynamic and smart traffic
light advice is provided: green and yellow mean “purchase”; red
means “do not purchase”. Colors are managed by an algorithm and
change in relationship to the user’s nutritional needs, the nutritional
composition of the selected item and the overall pantry quality.
We conducted a cohort trial involving 8 NAFLD patients who had a
body-mass index (BMI) of at least 25. Patients received counseling
on lifestyle modification and were invited to download NUNA and
to use it for 8 weeks. Adherence to the MD was assessed using a
recently posteriori adaptation of the Mediterranean diet score of
Sofi et al (Sofi-MDS). The coprimary end points were the change in
Sofi-MDS and in body weight.
Results:
Half of the patients were women. At baseline, the mean
age of the patients was 55 (r: 21-73) years, the mean weight was
83,2 ±14,6 (range: 61-101,6) kg, the mean BMI was 30,7 ±6,6 (range:
23,4-44); the mean Sofi-MDS was 11,2 ±1,3 (range: 10-13). At week
8, Sofi-MDS increased of 2,8 points (p=0,001) and patients had lost a
mean of 2,5 kg of body weight (p=0,005) and 1,1 points of their BMI
(p=0,008).