Nutritional investigation of non-obese patients with non-alcoholic fatty liver disease: The significance of dietary cholesterol
Nutritional investigation of non-obese patients with non-alcoholic fatty liver disease: The significance of dietary cholesterol
复制标题
DOI：
10.1080/00365520802588133
复制
发表时间：
2009-01-01
影响因子：
1.9
通讯作者：
Enjoji, Munechika
中科院分区：
文献类型：
--
作者：
Yasutake, Kenichiro;Nakamuta, Makoto;Enjoji, Munechika
目标。非酒精性脂肪性肝病（NAFLD）的发病和进展似乎受营养摄入的影响；然而，在非肥胖NAFLD患者中没有进行详细的检查。本研究的目的是确定影响NAFLD及其相关营养问题的潜在营养因素。材料和方法。我们调查了NAFLD患者的腹部脂肪分布、饮食摄入和生化数据，并比较了非肥胖患者和肥胖患者。结果。在肥胖组和非肥胖组之间，糖尿病或血脂异常患者的百分比没有显著差异。肥胖组的腰围、腹部总脂肪水平和皮下脂肪水平明显高于肥胖组，而两组之间的内脏脂肪水平无显著差异。免疫反应性胰岛素（IRI）和稳态模型评估-胰岛素抵抗（HOMA-IR）在非肥胖组显著降低，表明非肥胖患者没有明显的胰岛素抵抗。虽然两组的血清脂联素和TNF-水平相似，但肥胖组的瘦素水平明显较高。肥胖组的总能量和碳水化合物摄入量往往更高。一个显著特征是，非肥胖组的膳食胆固醇摄入量明显较高，而多不饱和脂肪酸（PUFAs）的摄入量明显较低。结论。非肥胖NAFLD患者：1)虽然内脏脂肪增加，但不一定表现出胰岛素抵抗和/或脂肪细胞因子分泌失调；2)与肥胖患者相比，总能量和碳水化合物摄入量不过量，但膳食胆固醇含量过高，膳食PUFAs含量显著降低；3)特征性脂肪摄入可能与NAFLD的形成有关。
Objective. The onset and progression of non-alcoholic fatty liver disease (NAFLD) seem to be affected by nutritive intake; however, detailed examinations have not been performed in non-obese NAFLD patients. The purpose of this study was to identify potential nutritive factors that affect NAFLD and its related nutritional problems. Material and methods. We investigated the distribution of abdominal fat, dietary intake, and biochemical data in patients with NAFLD and compared non-obese with obese patients. Results. There was no significant difference in the percentage of patients with diabetes or dyslipidemia between the obese and non-obese groups. Waist circumference, total abdominal fat levels, and subcutaneous fat levels were significantly higher in the obese group, while visceral fat levels were not significantly different between the two groups. Immunoreactive insulin (IRI) and homeostasis model assessment-insulin resistance (HOMA-IR) were significantly lower in the non-obese group, suggesting that the non-obese patients were not overtly insulin resistant. Although serum adiponectin and TNF- levels were similar in both groups, leptin levels were significantly higher in the obese group. Total energy and carbohydrate intake tended to be higher in the obese group. A characteristic feature was that dietary cholesterol intake was significantly higher, while the intake of polyunsaturated fatty acids (PUFAs) was significantly lower in the non-obese group. Conclusions. In non-obese NAFLD patients: 1) although visceral fat was increased, insulin resistance and/or dysregulated secretion of adipocytokines was not necessarily shown; 2) intakes of total energy and carbohydrates were not excessive, although dietary cholesterol was superabundant and dietary PUFAs were significantly lower compared with those in obese patients; and 3) characteristic fat intake may be associated with the formation of NAFLD.