Martínez-Urbistondo, DiegoVal, José Luis delMasagué, MartaGoday Arno, AlbertoBaltasar, EnricDaimiel, Lidia2023-02-092023-02-092022Martínez-Urbistondo D, San Cristóbal R, Villares P, Martínez-González MÁ, Babio N, Corella D, et al. Role of NAFLD on the health related QoL response to lifestyle in patients with metabolic syndrome: the PREDIMED plus cohort. Front Endocrinol (Lausanne). 2022 Jun 29; 13: 868795. DOI: 10.3389/fendo.2022.8687951664-2392http://hdl.handle.net/10230/55679Objective: to evaluate the effect of Non-alcoholic fatty liver disease (NAFLD) status in the impact of lifestyle over Health-related quality of life (HRQoL) in patients with metabolic syndrome (MetS). Methods: baseline and 1 year follow up data from the PREDIMED-plus cohort (men and women, 55-75 years old with overweight/obesity and MetS) were studied. Adherence to an energy-restricted Mediterranean Diet (er-MeDiet) and Physical Activity (PA) were assessed with a validated screeners. Hepatic steatosis index (HSI) was implemented to evaluate NAFLD while the SF-36 questionnaire provided HRQoL evaluation. Statistical analyses were performed to evaluate the influence of baseline NAFLD on HRQoL as affected by lifestyle during 1 year of follow up. Results: data from 5205 patients with mean age of 65 years and a 48% of female participants. Adjusted linear multivariate mixed regression models showed that patients with lower probability of NAFLD (HSI < 36 points) were more responsive to er-MeDiet (β 0.64 vs β 0.05 per er-MeDiet adherence point, p< 0.01) and PA (β 0.05 vs β 0.01 per MET-h/week, p = 0.001) than those with high probability for NAFLD in terms Physical SF-36 summary in the 1 year follow up. 10 points of er-MeDiet adherence and 50 MET-h/week were thresholds for a beneficial effect of lifestyle on HRQoL physical domain in patients with lower probability of NAFLD. Conclusion: the evaluation of NAFLD by the HSI index in patients with MetS might identify subjects with different prospective sensitivity to lifestyle changes in terms of physical HRQoL (http://www.isrctn.com/ISRCTN89898870).application/pdfengCopyright © 2022 Martínez-Urbistondo, San-Cristóbal, Villares, Martínez-González, Babio, Corella, del Val, Ordovás, Alonso-Gómez, Wärnberg, Vioque, Romaguera, López-Miranda, Estruch, Tinahones, Lapetra, Serra-Majem, Bueno-Cavanillas, Tur, Marcos, Pintó, Delgado-Rodríguez, Matía-Martín, Vidal, Vázquez, Ros, Bullón Vela, Palau, Sorli, Masagué, Abete, Moreno-Rodríguez, Candela-García, Konieczna, García-Ríos, Juárez, Portolés, Martín, Goday, Zulet, Vaquero-Luna, Orea, Megías, Baltasar, Martínez and Daimiel. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) http://creativecommons.org/licenses/by/4.0/. The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these termsRole of NAFLD on the health related QoL response to lifestyle in patients with metabolic syndrome: the PREDIMED plus cohortinfo:eu-repo/semantics/articlehttp://dx.doi.org/10.3389/fendo.2022.868795HRQoLNAFLDMediterranean dietMetabolic syndromePhysical activityinfo:eu-repo/semantics/openAccess