Programme no. 255-P
Patient Empowerment
Differences in total and high density lipoprotein cholesterol reduction between healthy overweight people with and without signs of fatty liver
Vija Silina*1, Peteris Tretjakovs2, Gita Krievina3, Mesfin Kassaye Tessma4, Ilze Jakobsone5, Guntis Bahs6
1Department of Family Medicine,Riga Stradins University,Riga,Latvia;Private primary care practice,Riga,Latvia, 2Department of Human Physiology and Biochemistry,Riga Stradins University,Riga,Latvia;Institute of Experimental and Clinical Medicine,Latvia University,Riga,Latvia, 3Department of Human Physiology and Biochemistry,Riga Stradins University,Riga,Latvia;Institute of Experimental and Clinical Medicine,Latvia University,Riga,Latvia, 4Department of Learning, Informatics, Management and Ethics,Karolinska Institutet,Stockholm,Sweden, 5Private primary care practice,Riga,Latvia, 6Department of Internal Diseases,Riga Stradins University,Riga,Latvia
* = Presenting author
Objectives: To find out, if there are any total cholesterol (TC), high density lipoprotein cholesterol (HDLC) and TC/HDLC ratio changes within a year after consulting healthy overweight people with and without signs of fatty liver.
Background: Motivating clinically healthy overweight and obese individuals to bring lifestyle behavioural changes prior to an apparent disease is still a challenge in primary care. Finding out and discussing any cardiovascular diseases risk associated changes, e.g., fatty liver can be used as an argument to start lifestyle changes to improve serum lipid level spectrum.
Results: A statistically significant paired mean difference was observed regarding TC/HDLC ratio reduction in the whole group (0.19, 95% CI 0.07, 0.31; p=0.003), as well as, in the group where fatty liver was found (0.27, 95% CI 0.37, 0.50; p=0.024).

We found that in the whole group TC levels decreased (ME=0.92; SE=0.064) and HDLC levels increased (ME=0.09; SE=0.51), however the difference was not statistically significant, and the same we found by dividing individuals into subgroups regarding presence of fatty liver.

Material/Methods: A prospective observational study in Riga, Latvia included 118 clinically healthy individuals having body mass index ≥25 m2/kg and below 40 m2/kg and in age group 30-45 that visited primary care physician. Individuals were tested and consulted for fatty liver and were advised to start lifestyle changes to improve lipid levels and to decrease weight and waist circumference by at least 5 % within one year. Using a paired t test, we estimated TC, HDLC and TC/HDLC ratio differences in all individuals and between two groups: those with fatty liver (n=44) and without fatty liver (n=74).
Conclusion: Our study showed there are positive changes in TC, HDLC and statistically significant changes in TC/HDLC ratio levels after one year in clinically healthy overweight and obese individuals residing in Riga, Latvia, especially in those who are aware of having fatty liver.
Points for discussion: Further research is required to set indicators, when behavioural changes should be definitely started, and to understand what could be the best motivation for behavioural changes in clinically healthy overweight and obese individuals.