Yogurt improves insulin resistance and liver fat in obese women with nonalcoholic fatty liver disease and metabolic syndrome: a randomized controlled trial
Yogurt improves insulin resistance and liver fat in obese women with nonalcoholic fatty liver disease and metabolic syndrome: a randomized controlled trial
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酸奶可改善患有非酒精性脂肪肝和代谢综合征的肥胖女性的胰岛素抵抗和肝脏脂肪：一项随机对照试验
DOI：
10.1093/ajcn/nqy358
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发表时间：
2019-06-01
影响因子：
7.1
通讯作者：
Sun, Changhao
中科院分区：
文献类型：
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作者：
Chen, Yang;Feng, Rennan;Sun, Changhao
背景资料：由于食用传统酸奶对健康人群有益，而胰岛素抵抗（IR）是非酒精性脂肪肝（NAFLD）和代谢综合征（MetS）的共同发病机制，我们假设酸奶可以改善NAFLD和MetS患者的IR。目的：这项研究的目的是研究酸奶对IR和次要终点的影响，包括肝脏脂肪，肠道微生物群，方法：将100名年龄在36-66岁的肥胖妇女随机分为两组，分别饮用220 g/d的普通酸奶和牛奶，共24 wk。在基线和第24周，我们测量人体测量指标，血糖，胰岛素，血脂，和细胞因子在所有参与者中，肝脏脂肪和肠道菌群在20名参与者随机选择从每个group.Results：48参与者从酸奶组和44从牛奶组完成了干预。与牛奶相比，酸奶显著降低了稳态模型评估的胰岛素抵抗（-0.53; 95% CI：-1.03，-0.02），空腹胰岛素（-2.77 mU/L; 95% CI：-4.91，-0.63 mU/L）、2小时胰岛素（-25.5 mU/L; 95% CI：-33.0，-17.9 mU/L）、2小时胰岛素曲线下面积（-29.4 mU/L）。h; 95% CI：-44.0，-14.8 mU/L。h）、丙氨酸氨基转移酶（-4.65 U/L; 95% CI：-8.67，-0.64 U/L）、肝内脂质（-3.44%; 95% CI：-6.19%，-0.68%）和肝脂肪分数（-3.48%; 95% CI：-6.34%，-0.63%）。酸奶还降低了血清LPS（-0.31 EU/mL; 95%CI：-0.48，-0.14 EU/mL）、成纤维细胞生长因子21（-57.76 pg/mL; 95%CI：-86.32，-29.19 pg/mL）、脂质以及炎症和氧化应激的生物标志物，并改变了肠道微生物群组成。调解分析表明，酸奶可以改善IR通过降低血脂，炎症，氧化应激，和LPS.Conclusions：酸奶是更好地改善IR和肝脏脂肪在肥胖的中国女性NAFLD和MetS，可能通过改善脂质代谢，减少炎症，氧化应激，和LPS，并改变肠道菌群组成。该试验在www.chictr.org.cn上注册为ChiCTR-IPR-15006801。
Background: Because consumption of conventional yogurt has beneficial effects in a healthy population, and insulin resistance (IR) is the mutual pathogenesis in nonalcoholic fatty liver disease (NAFLD) and metabolic syndrome (MetS), we hypothesized that yogurt would ameliorate IR in patients with NAFLD and MetS.Objectives: The aim of this study was to investigate the effects of yogurt on IR and secondary endpoints including liver fat, gut microbiota, and serum biomarkers of inflammation and oxidative stress in obese women with NAFLD and MetS.Methods: One hundred obese women aged 36-66 y with both NAFLD and MetS were randomly assigned to consume 220 g/d of either conventional yogurt or milk for 24 wk. At baseline and week 24, we measured anthropometric indices, serum glucose, insulin, lipids, and cytokines in all participants, and liver fat and gut microbiota in 20 participants randomly selected from each group.Results: Forty-eight participants from the yogurt group and 44 from the milk group completed the intervention. Compared with milk, yogurt significantly decreased the homeostasis model assessment of insulin resistance (-0.53; 95% CI: -1.03, -0.02), fasting insulin (-2.77 mU/L; 95% CI: -4.91, -0.63 mU/L), 2-h insulin (-25.5 mU/L; 95% CI: -33.0, -17.9 mU/L), 2-h area under the curve for insulin (-29.4 mU/L . h; 95% CI: -44.0, -14.8 mU/L . h), alanine aminotransferase (-4.65 U/L; 95% CI: -8.67, -0.64 U/L), intrahepatic lipid (-3.44%; 95% CI: -6.19%, -0.68%), and hepatic fat fraction (-3.48%; 95% CI: -6.34%, -0.63%). Yogurt also decreased serum LPS (-0.31 EU/mL; 95% CI: -0.48, -0.14 EU/mL), fibroblast growth factor 21 (-57.76 pg/mL; 95% CI: -86.32, -29.19 pg/mL), lipids, and biomarkers of inflammation and oxidative stress, and altered gut microbiota composition. Mediation analysis showed that yogurt may improve IR by reducing serum lipids, inflammation, oxidative stress, and LPS.Conclusions: Yogurt was better than milk at ameliorating IR and liver fat in obese Chinese women with NAFLD and MetS, possibly by improving lipid metabolism, reducing inflammation, oxidative stress, and LPS, and changing the gut microbiota composition. This trial was registered at www.chictr.org.cn as ChiCTR-IPR-15006801.