Screening for fibrosis promotes life-style changes. A prospective cohort study in 4,796 individuals.

BACKGROUND AND AIMS:Early detection of liver fibrosis is believed to promote lifestyle changes. We evaluated self-reported changes in alcohol intake, diet, exercise, and weight after participating in a screening study for liver fibrosis. METHODS:We conducted a prospective screening study of individuals at risk of alcohol related (ALD) or metabolic dysfunction-associated steatotic liver disease (MASLD). We provided lifestyle advice to all participants and evaluated lifestyle changes by questionnaires after one week and six months, with re-examination of a subgroup after two years. RESULTS:A total of 1,850 at risk of ALD and 2,946 at risk of MASLD were included, of whom 383 (8%) were screening positive (transient elastography ≥8 kPa). Eighty-four percent replied to the 6-month questionnaire. In ALD participants, excessive drinking decreased from 46% to 32% after 6 months. Only 15% reported increased drinking, without differences between screening positive and negative individuals (p=0.698). In high-risk drinkers, a positive screening test predicted abstinence or decreased alcohol use after six months (odds ratio 2.45, 1.32-4.57, p=0.005). After two years, excessive drinking decreased from 52% to 41% in a subgroup of 752 individuals and a positive screening test predicted abstinence or decreased alcohol use after two years (odds ratio 1.84, 1.09-3.11, p=0.023). MASLD participants showed similar improvements: 35% improved their diet, 22% exercised more, and 13% reported a weight loss ≥5% after six months. CONCLUSION:Screening for liver fibrosis is associated with sustained improvements in alcohol consumption, diet, weight, and exercise in at-risk ALD and MASLD. The changes are most pronounced in screening positive participants, but not limited to this group.