Dietary determinants of hepatic steatosis and visceral adiposity in overweight and obese youth at risk of type 2 diabetes
Dietary determinants of hepatic steatosis and visceral adiposity in overweight and obese youth at risk of type 2 diabetes
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DOI：
10.3945/ajcn.113.079277
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发表时间：
2014-04-01
影响因子：
7.1
通讯作者：
McGavock, Jonathan M.
中科院分区：
文献类型：
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作者：
Mollard, Rebecca C.;Senechal, Martin;McGavock, Jonathan M.
背景：肝脂肪变性是非酒精性脂肪性肝病的重要前兆，其饮食决定因素尚不明确。目的：我们探讨了糖和脂肪摄入作为有 2 型糖尿病风险的超重青少年中肝脂肪变性和内脏肥胖决定因素的作用。设计：这是一项针对 74 名超重青少年（年龄：15.4 +/- 1.8 岁；体重指数）饮食模式和脂肪组织分布的横断面研究。 z 分数：2.2 +/- 0.4)。主要结果指标是通过磁共振波谱测量的肝脏脂肪变性（>= 5.5%脂肪：水）和通过磁共振成像测量的内脏肥胖（内脏与皮下脂肪组织比率>= 0.25）。主要暴露变量是通过哈佛青少年食物频率问卷评估的饮食摄入量和习惯。结果：样本中分别有 43% 和 44% 的人有明显的肝脏脂肪变性和内脏肥胖。患有脂肪肝的青少年比没有脂肪肝的青少年更常见油炸食品消费（41% vs 18%；P = 0.04）。总脂肪摄入量（β = 0.51，P = 0.03）和每日能量摄入量的 35% 来自脂肪的消耗（OR：11.8；95% CI：1.6，86.6；P = 0.02）均与肝脂肪变性呈正相关。可用碳水化合物（β = 0.54，P = 0.02）和经常饮用苏打水与内脏肥胖呈正相关（OR：6.4；95% CI：1.2，34.0；P = 0.03）。每日纤维摄入量与内脏肥胖几率降低相关（OR：0.82；95% CI：0.68，0.98；P = 0.02），但与肝脏脂肪变性无关。结论：对于有 2 型糖尿病风险的超重和肥胖青少年，肝脏脂肪变性与脂肪和油炸食品摄入量增加有关，而内脏肥胖与糖摄入量增加和纤维摄入量减少相关。该研究已在临床试验中注册。政府编号为 NCT00755547。
Background: Dietary determinants of hepatic steatosis, an important precursor for nonalcoholic fatty liver disease, are undefined.Objective: We explored the roles of sugar and fat intake as determinants of hepatic steatosis and visceral obesity in overweight adolescents at risk of type 2 diabetes.Design: This was a cross-sectional study of dietary patterns and adipose tissue distribution in 74 overweight adolescents (aged: 15.4 +/- 1.8 y; body mass index z score: 2.2 +/- 0.4). Main outcome measures were hepatic steatosis (>= 5.5% fat: water) measured by magnetic resonance spectroscopy and visceral obesity (visceral-tosubcutaneous adipose tissue ratio >= 0.25) measured by magnetic resonance imaging. Main exposure variables were dietary intake and habits assessed by the Harvard Youth Adolescent Food Frequency Questionnaire.Results: Hepatic steatosis and visceral obesity were evident in 43% and 44% of the sample, respectively. Fried food consumption was more common in adolescents with hepatic steatosis than in adolescents without hepatic steatosis (41% compared with 18%; P = 0.04). Total fat intake (beta = 0.51, P = 0.03) and the consumption of.35% of daily energy intake from fat (OR: 11.8; 95% CI: 1.6, 86.6; P = 0.02) were both positively associated with hepatic steatosis. Available carbohydrate (beta = 0.54, P = 0.02) and the frequent consumption of soda were positively associated with visceral obesity (OR: 6.4; 95% CI: 1.2, 34.0; P = 0.03). Daily fiber intake was associated with reduced odds of visceral obesity (OR: 0.82; 95% CI: 0.68, 0.98; P = 0.02) but not hepatic steatosis.Conclusion: Hepatic steatosis is associated with a greater intake of fat and fried foods, whereas visceral obesity is associated with increased consumption of sugar and reduced consumption of fiber in overweight and obese adolescents at risk of type 2 diabetes. This study was registered at clinicaltrials. gov as NCT00755547.