Adenovirus-36 Seropositivity Enhances Effects of Nutritional Intervention on Obesity, Bright Liver, and Insulin Resistance
Adenovirus-36 Seropositivity Enhances Effects of Nutritional Intervention on Obesity, Bright Liver, and Insulin Resistance
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DOI：
10.1007/s10620-011-1903-8
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发表时间：
2012-02-01
影响因子：
3.1
通讯作者：
Catalano, Daniela
中科院分区：
文献类型：
--
作者：
Trovato, Guglielmo M.;Martines, Giuseppe Fabio;Catalano, Daniela
肥胖和肝脏脂肪变性目前都归因于不适当的生活方式和营养。人类腺病毒Ad36血清阳性（Ad36+）的较高流行率仅在肥胖人群中报道。探讨生活方式-营养干预在NAFLD患者中是否能达到不同的结果，即根据Ad36血清阳性状态，生活方式-营养干预是否会减弱或增强。对62例非酒精性脂肪性肝病超重肥胖患者进行为期一年的营养干预，并通过肝脏超声、Bright liver Score （BLS）评估、胰岛素抵抗稳态模型评估（HOMA）、体成分和Ad36+测定进行研究。他们接受了由健康心理学家提供的低盐/低热量地中海饮食、增加体育活动、戒烟和生活方式咨询。在相同BLS水平下，Ad36血清阳性患者的基线BMI更高。观察到不同的介入后反应发生率，Ad36+患者的发生率明显更高：BMI评估的肥胖发生率降低更大，HOMA评估的胰岛素抵抗发生率降低更大，亮肝消失发生率更高。经bmi调整的多元线性回归模型解释了23.8% （p < 0.04）的方差；显著预测变量为Ad36血清阳性（p < 0.012）和脂肪质量损失（p < 0.011），说明亮肝消失发生的方差。通过选择量身定制的营养介入治疗，Ad36既往感染与体重减轻、亮肝消失和胰岛素敏感性恢复显著相关。尽管如此，Ad36血清阴性NAFLD患者的脂肪肝模式改善程度较低，也没有明显的体重减轻：饮食改变的影响，地中海饮食，不仅仅是降低食物热量摄入，可以想象是有效的。
Obesity and liver steatosis are both currently attributed to inappropriate lifestyle and nutrition. Higher prevalence of human adenovirus Ad36 seropositivity (Ad36+) is reported only in obesity.To investigate whether a lifestyle-nutritional intervention achieves different outcomes in NAFLD patients, i.e., if is blunted or enhanced according to Ad36 seropositivity status.One-year nutritional intervention was planned and accomplished for 62 non-alcoholic fatty liver disease overweight-obese patients, studied by liver ultrasound, evaluating Bright Liver Score (BLS), by Homeostatic Model assessment of Insulin Resistance (HOMA), by body composition and Ad36+ assay. Lower salt/lower calories Mediterranean diet, physical activity increase, smoking withdrawal and lifestyle counseling, provided by a health psychologist, were given.Ad36 seropositive patients have baseline greater BMI with the same level of BLS. Different prevalence of post-interventional response, significantly greater among Ad36+ patients, is observed: greater decrease of obesity, assessed by BMI, greater reduction of insulin resistance, assessed by HOMA and higher prevalence of bright liver disappearance.A BMI-adjusted multiple linear regression model explains significantly 23.8% (p < 0.04) of the variance; significant predictive variables are Ad36 seropositivity (p < 0.012) and fat mass loss (p < 0.011) accounting for the variance of the occurrence of bright liver disappearance.Ad36 previous infection is significantly associated with enhanced weight loss, bright liver disappearance, and recovery of insulin sensitivity through the chosen tailored nutritional interventional treatment. Nonetheless, Ad36 seronegative NAFLD patients' fatty liver pattern improves, at a lower extent, also without significant weight loss: an effect of dietary changes profile, Mediterranean diet, not only of lowered food caloric intake, is conceivably operating.