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00925njm 22002777a 4500 dc Martínez-Urbistondo, Diego author San Cristóbal, RodrigoSan author Villares, Paula author Martínez-González, Miguel Ángel author Babio, Nancy author Corella, Dolores author Del Val, José Luis author Ordovás, José M author Alonso-Gómez, Ángel M author Wärnberg, Julia author Vioque, Jesús author Romaguera, Dora author López-Miranda, José author Estruch, Ramon author Tinahones, Francisco J author Lapetra, José author Serra-Majem, J Luís author Bueno-Cavanillas, Aurora author Tur, Josep A author Marcos, Alba author Pintó, Xavier author Delgado-Rodríguez, Miguel author Matía-Martín, Pilar author Vidal, Josep author Vázquez, Clotilde author Ros, Emilio author Bullón Vela, María Vanessa author Palau, Antoni author Masagué, Marta author Abete, Itziar author Moreno-Rodríguez, Anai author Candela-García, Inma author Konieczna, Jadwiga author García-Ríos, Antonio author Juárez, Oscar Lecea author Martín, Paco author Goday, Albert author Zulet, M Ángeles author Vaquero-Luna, Jessica author Orea, María Del Carmen Sayón author Megías, Isabel author Baltasar, Enric author Martínez, J Alfredo author Daimiel, Lidia author 2022-06-29 Objective: 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). Martínez-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. 1664-2392 http://hdl.handle.net/10668/20564 http://hdl.handle.net/20.500.13003/18128 http://hdl.handle.net/20.500.12105/18690 35846291 10.3389/fendo.2022.868795 Frontiers in endocrinology 2-s2.0-85134176497 835976900001 L2018233028 HRQoL NAFLD Mediterranean diet Metabolic syndrome Physical activity Role of NAFLD on the Health Related QoL Response to Lifestyle in Patients With Metabolic Syndrome: The PREDIMED Plus Cohort