不健康的生活方式是促进非酒精性脂肪肝（NAFLD）发病和恶化的关键因素。我们的目的是评估强制急性生活方式改变对 NAFLD 演变的影响。在三个意大利医疗中心对 187 名 NAFLD 患者进行了随访前两年和封锁期间两年的随访。针对每位患者，收集了生化、临床、非侵入性肝纤维化、营养和身体成分数据。事实证明，与封锁期间每周体力活动受损相关的脂肪和碳水化合物摄入量增加以及体重指数增加和腰臀比（p< 0.0001）。总胆固醇、低密度脂蛋白、高密度脂蛋白、甘油三酯、葡萄糖、胰岛素、胰岛素抵抗稳态模型评估和转氨酶在封锁期间恶化（葡萄糖：p = 0.0007；其他情况下p < 0.0001）。此外，NAFLD 纤维化评分、肝脏硬度和受控衰减参数在同一时期也受到损害（全部 p<0.0001）。生物电阻抗分析 (BIA) 证明脂肪量 (FM) 增加，游离脂肪量 (FFM) 和体细胞量 (BCM) 减少（全部 p<0.0001）。封锁总体肝细胞癌 (HCC) 和米兰外 HCC 发生率显示风险比 (HR)：2.398，95% 置信区间 (CI)：1.16-5，p = 0.02，HR：5.931，CI：2-17.6， p = 0.008 分别。就平均值和变异 (T1-T2 Δ) 而言，评估结果和身体成分分析之间存在肝脏疾病阶段和合并症独立关联。急性生活方式的改变通过身体成分改变对 HCC 的发生产生负面影响，从而影响 NAFLD 的演变。 © 2024。作者。

Unhealthy lifestyles represent a key element fueling Non-alcoholic fatty liver disease (NAFLD) onset and worsening. We aimed to evaluate the effects of forced acute lifestyle changes on NAFLD evolution.187 NAFLD patients were followed two years pre- and two years during the lockdown social restrictions in three Italian medical centers. For each patient, biochemical, clinical, non-invasive liver fibrosis, nutritional, and body composition data were collected.An increase in fats and carbohydrate intake associated with impaired weekly physical activity during the lockdown was demonstrated as well as an increase in body mass index and waist-hip-ratio (p < 0.0001 for all). Total cholesterol, low-density lipoprotein, high-density lipoprotein, triglycerides, glucose, insulin, homeostatic model assessment for insulin resistance, and transaminases worsened during the lockdown (glucose: p = 0.0007; p < 0.0001 for the others). Moreover, NAFLD fibrosis score, liver stiffness, and controlled attenuation parameter were also impaired during the same period (p < 0.0001 for all). The bioelectrical impedance analysis (BIA) evidenced an increase of fat mass (FM), and a reduction of free fat mass (FFM) and body cell mass (BCM) (p < 0.0001 for all). The lockdown overall hepatocellular carcinoma (HCC) and Milan-out HCC occurrence revealed Hazard Ratio (HR): 2.398, 95% Confidence Interval (CI):1.16-5, p = 0.02, and HR:5.931, CI:2-17.6, p = 0.008 respectively. A liver disease stage and comorbidities independent association between both the assessed outcomes and body composition analysis in terms of mean values and variation (T1-T2 Δ) was demonstrated.The acute lifestyle changes impacted NAFLD evolution via body composition modifications negatively influencing the HCC occurrence.© 2024. The Author(s).