Evidence map›Paper›PMID 40939135›Full record

ArticleJMIR cardio2025

Long-Term Feasibility and Outcomes of a Digital Health Program to Improve Liver Fat and Cardiometabolic Markers in Individuals With Nonalcoholic Fatty Liver Disease: Prospective Single-Arm Feasibility Study.

Sigridur Björnsdottir, Hildigunnur Ulfsdottir, Elias Freyr Gudmundsson, Bartosz Dobies, Kolbrun Sveinsdottir, Ari Pall Isberg, Gudlaug E A Magnusdottir, Thrudur Gunnarsdottir, Tekla Karlsdottir, Gudlaug Bjornsdottir and 3 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JMIR cardio, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Sigridur BjörnsdottirDepartment of Molecular Medicine and Surgery, Karolinska University Hospital, Eugeniavägen 3, Solna, Stockholm, 171 77, Sweden, 354 8217107.ORCID http://orcid.org/0000-0002-3320-5972
Hildigunnur UlfsdottirClinical Office, Sidekick Health, Vallakor 4, Kopavogur, 200, Iceland.ORCID http://orcid.org/0009-0004-0301-7710
Elias Freyr GudmundssonClinical Office, Sidekick Health, Vallakor 4, Kopavogur, 200, Iceland.ORCID http://orcid.org/0000-0002-7661-4872
Bartosz DobiesClinical Office, Sidekick Health, Vallakor 4, Kopavogur, 200, Iceland.ORCID http://orcid.org/0009-0000-8851-3692
Kolbrun SveinsdottirClinical Office, Sidekick Health, Vallakor 4, Kopavogur, 200, Iceland.ORCID http://orcid.org/0009-0001-3148-5210
Ari Pall IsbergClinical Office, Sidekick Health, Vallakor 4, Kopavogur, 200, Iceland.ORCID http://orcid.org/0000-0002-7957-6285
Gudlaug E A MagnusdottirClinical Office, Sidekick Health, Vallakor 4, Kopavogur, 200, Iceland.ORCID http://orcid.org/0009-0002-8441-0017
Thrudur GunnarsdottirClinical Office, Sidekick Health, Vallakor 4, Kopavogur, 200, Iceland.ORCID http://orcid.org/0000-0002-2419-8846
Tekla KarlsdottirClinical Office, Sidekick Health, Vallakor 4, Kopavogur, 200, Iceland.ORCID http://orcid.org/0009-0001-5505-3607
Gudlaug BjornsdottirIcelandic Heart Association, Kopavogur, Iceland.ORCID http://orcid.org/0000-0003-1377-768X
Sigurdur SigurdssonIcelandic Heart Association, Kopavogur, Iceland.ORCID http://orcid.org/0000-0001-5439-3389
Saemundur OddssonClinical Office, Sidekick Health, Vallakor 4, Kopavogur, 200, Iceland.ORCID http://orcid.org/0000-0001-9427-443X
Vilmundur GudnasonIcelandic Heart Association, Kopavogur, Iceland.ORCID http://orcid.org/0000-0001-5696-0084

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: A 12-week digital health program for nonalcoholic fatty liver disease (NAFLD) previously showed feasibility in engagement, program retention, and clinical outcomes. This study investigates whether improvements in cardiometabolic risk factors achieved during a 12-week active program were sustained over a subsequent 6-month follow-up period. Objective: The primary objective of this analysis was to evaluate whether the clinical improvements achieved after a 12-week program were maintained over the subsequent 6-month period, which did not include coaching or new intervention materials. In addition, the study aimed to assess participants' retention and engagement with the maintenance program. Methods: In a 9-month, single-arm study using the Sidekick app (Sidekick Health), individuals with NAFLD and BMI >30 or metabolic syndrome or type 2 diabetes were included. The initial 12 weeks focused on providing education about diet, physical activity, stress management, and sleep, followed by 6 months without coaching or new intervention materials. The measured outcomes encompassed demographics, body composition, liver fat assessed using magnetic resonance imaging-proton density fat fraction (MRI-PDFF), and blood markers. Results: Of the 34 participants who completed the first 12 weeks, 28 (82%) completed the 9-month study measurements. The median age was 63.0 years (IQR 53.5-71.0) and 57.1% (16/28) were women. At 9 months, compared to baseline, the mean weight loss was 4.0 kg (SD 5.0; P<.001). Liver fat decreased by 2.5% (SD 4.5; P<.001), with an 18.4% relative reduction. Systolic blood pressure decreased by 8.3 mm Hg (SD 13.4, P<.001) and diastolic by 2.5 mm Hg (SD 6.0; P=.02). Waist circumference decreased by 4.7 cm (SD 7.1; P<.001) and median glycated hemoglobin A1c (HbA1c) decreased by 19.5 mmol/mol (P<.001). Conclusions: Sustained improvements in liver fat and metabolic markers suggest that Sidekick Health's digital program is a promising strategy for managing NAFLD without requiring continuous coaching.

Indexed as

LiverNon-alcoholic Fatty Liver DiseaseBiomarkersDiabetes Mellitus, Type 2Digital HealthFeasibility StudiesFemaleFollow-Up StudiesHumansMagnetic Resonance ImagingMaleMetabolic SyndromeMiddle AgedProspective StudiesBiomarkersacceptabilityBMIbody compositioncardiologycardiometaboliccardiometabolic healthcardiovascularchroniccoachcoachingdiabetesdiabeticdietdietarydigital healthdigital health programdigital therapeuticsexercisefatfeasibilityhepaticlifestyleliverMAFLDMASLDmetabolic syndromeNAFLDnonalcoholic fatty liver diseasenutritionnutritionalpatient educationphysical activitytype 2 diabetesweight

Identifiers

PMID40939135
PMCPMC12431163

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.