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Accepted for/Published in: JMIR Cardio

Date Submitted: Feb 17, 2025
Date Accepted: Aug 5, 2025

The final, peer-reviewed published version of this preprint can be found here:

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

Björnsdottir S, Ulfsdottir H, Gudmundsson EF, Dobies B, Sveinsdottir K, Isberg AP, Magnusdottir GEA, Gunnarsdottir T, Karlsdottir T, Bjornsdottir G, Sigurdsson S, Oddsson S, Gudnason V

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

JMIR Cardio 2025;9:e72074

DOI: 10.2196/72074

PMID: 40939135

PMCID: 12431163

Long-Term Feasibility and Outcomes of a Digital Health Program to Improve Liver Fat and Cardiometabolic Markers in Individuals with Non-Alcoholic Fatty Liver Disease: A 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; 
  • Sigurdur Sigurdsson; 
  • Saemundur Oddsson; 
  • Vilmundur Gudnason

ABSTRACT

Background:

A 3-month digital health program for NAFLD previously showed feasibility in engagement, program retention and clinical outcomes. This study investigates whether improvements in cardiometabolic risk factors achieved during a 3-month active program were sustained over a subsequent 6-month follow-up period.

Objective:

To evaluate whether the clinical improvements achieved after 3 months program were maintained over the subsequent 6-month period.

Methods:

In a 9-month, single-arm study using the Sidekick app, individuals with NAFLD and BMI>30 or metabolic syndrome, or type 2 diabetes (T2D) were included. The initial 3 months focused on providing education about diet, physical activity, stress management, and sleep followed by 6 months without coaching. The measured outcomes encompassed demographics, body composition, liver fat and blood markers.

Results:

Of 38 participants enrolled, 28 (82%) completed the nine-month study measurements 63.0 years (IQR 53.5-71.0) , 57.1% female). At nine months, the mean weight loss was 4.0 kg (SD 5.0, P<.001) compared to baseline. Liver fat decreased by 2.5% (SD 4.5, P<.001), with an 18.4% relative reduction. Systolic blood pressure decreased by 8.3 mmHg (SD 13.4, P<.001) and diastolic by 1.0 mmHg (SD 2.4, P=.02). Waist circumference decreased by 4.7 cm (SD 7.1, P<.001) and median HbA1c decreased by 18.5 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. Clinical Trial: Clinicaltrials.gov NCT05426382; https://clinicaltrials.gov/study/NCT05426382


 Citation

Please cite as:

Björnsdottir S, Ulfsdottir H, Gudmundsson EF, Dobies B, Sveinsdottir K, Isberg AP, Magnusdottir GEA, Gunnarsdottir T, Karlsdottir T, Bjornsdottir G, Sigurdsson S, Oddsson S, Gudnason V

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

JMIR Cardio 2025;9:e72074

DOI: 10.2196/72074

PMID: 40939135

PMCID: 12431163

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