THE IMPACT OF AN EDUCATIONAL PROGRAM IN THE MANAGEMENT OF PATIENTS WITH CHRONIC HEPATITIS C
Introduction: This study was designed to measure the impact of lifestyle changes, involving a diet therapy and physical exercises in patients with chronic hepatitis C (CHC). Methods: The study was conducted during January 2008 - December 2009 at ”Prof. N. Paulescu” National Institute of Diabetes, Nutrition and Metabolic Diseases - Bucharest, Romania. We selected 67 patients (34 men/33 women). We performed anthropometric measurements (weight, height, BMI (body mass index), bioimpedance analysis (BIA) as well as fasting serum lipids (cholesterol, triglycerides, HDL-cholesterol), glucose profile (glucose, HbA1c), liver profile (ALT, AST, GGT, alkaline phosphatase, bilirubin, albumin, total protein), blood count for all patients at baseline. Results: The average age was 53.91±10.19 years. Obesity was present in 32.8% (n=22) of patients at baseline. Total fat mass decreased with weight loss 2.21 kg (p = 0.0001) respectively 3.17 kg (p = 0.0001). Weight loss was accompanied by decreased resting energy expenditure. Triglycerides decreased from 158.11±7.63 mg/dl to 134.88±6.1 mg/dl, cholesterol decreased from 187.3±6.8 mg/dl to 168.65±4.42 mg/dl and HDL-cholesterol increased from 45.13±1.9 mg/dl to 47.2±1.39 mg/dl after 12 months. Aspartaminotransferase, alaninaminotransferese, gamma-glutamil transpeptidase decreased with significant differences. Conclusions: Patients with hepatitis C undergoing an 1-year lifestyle intervention had significant improvements in fasting glucose, fasting insulin, HOMA-IR, lipidic profile, hepatic profile and adipose tissue distribution. The present study establishes the positive impact of an educational program in the management of patients with hepatitis C.