Randomized Comparison of Reduced Fat and Reduced Carbohydrate Hypocaloric Diets on Intrahepatic Fat in Overweight and Obese Human Subjects
Randomized Comparison of Reduced Fat and Reduced Carbohydrate Hypocaloric Diets on Intrahepatic Fat in Overweight and Obese Human Subjects
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DOI：
10.1002/hep.24242
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发表时间：
2011-05-01
期刊：
影响因子：
13.5
通讯作者：
Jordan, Jens
中科院分区：
文献类型：
--
作者：
Haufe, Sven;Engeli, Stefan;Jordan, Jens
肥胖相关的肝脏脂肪变性是代谢和心血管疾病的主要危险因素。低脂低热量饮食能够缓解肝脏异位储存的脂质。我们假设广泛使用的低碳水化合物低热量饮食在这方面也同样有效。总共 170 名超重和肥胖的健康受试者被随机分配到减少碳水化合物 (n = 84) 或减少脂肪 (n = 86)、总能量限制饮食（饮食前能量摄入的 -30%），为期 6 个月。通过生物阻抗分析评估身体成分，并通过磁共振断层扫描评估腹部脂肪分布。受试者还接受了肝脏脂肪光谱和口服葡萄糖耐量测试。总共有 102 名受试者完成了饮食干预并测量了肝内脂质含量。两种低热量饮食均降低了体重、全身脂肪、内脏脂肪和肝内脂质含量。无论饮食结构如何，与基线值低 (< 5.56%) 的受试者相比，基线肝内脂质高 (> 5.56%) 的受试者的肝内脂质损失大约是其 7 倍。相比之下，亚组之间内脏脂肪量和胰岛素敏感性的变化相似，基线肝内脂质较低和较高。结论：长期低碳水化合物、高脂肪的低热量饮食对肝内脂质积累具有与传统低脂低热量饮食相同的有益作用。肝内脂质的降低似乎与内脏脂肪的减少无关，并且与能量限制饮食的 6 个月期间全身胰岛素敏感性的变化并不紧密相关。 （肝病学 2011；53：1504-1514）
Obesity-related hepatic steatosis is a major risk factor for metabolic and cardiovascular disease. Fat reduced hypocaloric diets are able to relieve the liver from ectopically stored lipids. We hypothesized that the widely used low carbohydrate hypocaloric diets are similarly effective in this regard. A total of 170 overweight and obese, otherwise healthy subjects were randomized to either reduced carbohydrate (n = 84) or reduced fat (n = 86), total energy restricted diet (-30% of energy intake before diet) for 6 months. Body composition was estimated by bioimpedance analyses and abdominal fat distribution by magnetic resonance tomography. Subjects were also submitted to fat spectroscopy of liver and oral glucose tolerance testing. In all, 102 subjects completed the diet intervention with measurements of intrahepatic lipid content. Both hypocaloric diets decreased body weight, total body fat, visceral fat, and intrahepatic lipid content. Subjects with high baseline intrahepatic lipids (> 5.56%) lost approximate to 7-fold more intrahepatic lipids compared with those with low baseline values (< 5.56%) irrespective of diet composition. In contrast, changes in visceral fat mass and insulin sensitivity were similar between subgroups, with low and high baseline intrahepatic lipids. Conclusion: A prolonged hypocaloric diet low in carbohydrates and high in fat has the same beneficial effects on intrahepatic lipid accumulation as the traditional low-fat hypocaloric diet. The decrease in intrahepatic lipids appears to be independent of visceral fat loss and is not tightly coupled with changes in whole body insulin sensitivity during 6 months of an energy restricted diet. (HEPATOLOGY 2011;53:1504-1514)