- مبلغ: ۸۶,۰۰۰ تومان
- مبلغ: ۹۱,۰۰۰ تومان
AIM To determine the clinical effectiveness of nutritional counseling on reduction of non-alcoholic fatty liver disease (NAFLD) severity, weight loss, metabolic and anthropometric indexes and liver enzymes.
METHODS forty-six adults with NAFLD received a 6-mo clinical and a dietary intervention (based on Mediterranean diet) carried out respectively by a gastroenterologist and a nutritionist with counseling license. The counseling process consisted of monthly meeting (about 45 min each). The effect of the treatment was evaluated monitoring liver enzymes, metabolic parameters, cardiovascular risk indexes, NAFLD severity [assessed by ultrasound (US)] and related indexes. All parameters were assessed at baseline. Biochemistry was also assessed at mid- and end-interventions and US was repeated at end-intervention.
RESULTS The percentage of patients with steatosis grade equal or higher than 2 was reduced from 93% to 48% and steatosis regressed in 9 patients (20%). At the end of the treatment the end-point concerning the weight (i.e., a 7% weight reduction or achievement/maintenance of normal weight) was accomplished by 25 out of 46 patients (i.e., 54.3%). As far as the liver enzymes is concerned, all three liver enzymes significantly decrease during the treatment the normalization was particularly evident for the ALT enzyme (altered values reduced from 67% down to 11%). Several parameters, i.e. , BMI, waist circumference, waist-to-hip ratio, AST, ALT, GGT, HDL, serum glucose, Tot-Chol/HDL, LDL/HDL, TG/ HDL, AIP, HOMA, FLI, Kotronen index, VAI, NAFLD liver fat score and LAP, showed a significant improvement (P < 0.01) between baseline and end-treatment.
CONCLUSION Outcomes of this study further strengthen the hypothesis that MedDiet and more active lifestyle can be considered a safe therapeutic approach for reducing risk and severity of NAFLD and related disease states. The proposed approach may be proposed as a valid and recommended approach for improving the clinical profile of NAFLD patients.
Non-alcoholic fatty liver disease (NAFLD) is a relevant issue in public health because represents a major cause of chronic liver diseases worldwide. Approximately 20% to 30% of adult population has NAFLD, making it the most common liver disease in developed countries[1,2]. NAFLD is the result of fat accumulation in the liver (with fat representing more than 5% of whole liver weight) in absence of excessive alcohol consumption (usually evaluated using thresholds of 20 and 30 g/d for women and men respectively.
Limitations of the study
In this study we did not distinguish between simple fatty liver and NASH. In addition, despite MR-S is considered gold standards for assessing the severity of NAFLD using non-invasive techniques, in this study was used US which is considered the preferred firstline diagnostic procedure for imaging (EASL-EASDEASO, 2016). According to previous studies (inter alia Ghaemi et al, 2013) we also supported the diagnosis with US with serum biomarkers and scores.