Dietary approach in the treatment of nonalcoholic fatty liver disease

Nonalcoholic fatty liver disease(NAFLD) has been identified as one of the most prevalent chronic liver disease in adults and children populations. NAFLD is usually associated with the metabolic syndrome(MS), which is chiefly related to insulin resistance and its consequences. Insulin resistance has a crucial role in the pathogenesis of hepatic steatosis and potentially nonalcoholic steatohepatitis(NASH). Because of the contemporary epidemics of MS and obesity, the burden of NAFLD is also expected to rise. Unhealthy diets, such as the so-called western diet, are enriched in fructose, trans-fatty acids and saturated fat and seem to be associated with the development of NAFLD. In human studies, certain dietary sugars, particularly fructose, are used as a substrate for lipogenesis leading to hepatic fatty infiltration, inflammation, and possibly fibrosis. Other investigations have shown that fat consumption especially cholesterol and trans/saturated fatty acids are also steatogenic and seem to increase visceral adiposity. The identification of specific dietary components that favor the development of NASH could be important for the management of this disorder. This review focuses on the effects of different dietary approaches to prevent and treat NAFLD emphasizing the macronutrients and energy composition.     

冠心病患者胆红素、尿酸、血脂水平及其临床意义

目的 探讨冠心病患者血清胆红素、血脂及尿酸水平及其临床意义.方法 抽取冠心病组与健康对照组清晨空腹静脉血,应用全自动生化分析仪对血清胆红素、尿酸、血脂进行检测.结果 冠心病组血清胆红素、直接胆红素、间接胆红素、高密度脂蛋白胆固醇、载脂蛋白含量显著低于健康对照组;尿酸、三酰甘油、低密度脂蛋白胆固醇、载脂蛋白显著高于健康对照组;而胆固醇变化不明显.结论 检测冠心病患者血清胆红素尿酸血脂水平,对于测评估冠心病有一定临床价值.     

秦皇岛市大学生体脂分布与丙氨酸氨基转移酶相关性研究

[目的]探讨大学生体脂分布与丙氨酸氨基转移酶（ALT）相关性.[方法]采用分层整群随机抽样的方法,选取秦皇岛市两所大学789名在校大学生（男性 369例,女性 420例）作为研究对象,测量身高、体重、腰围（WC）,计算体重指数（BMI）,检测血清丙氨酸氨基转移酶（ALT）.[结果]大学生ALT升高检出率为9.8%,男性检出率高于女性（16.3% vs 4.0%,P=0.000）.ALT升高组BMI和WC升高检出率均高于ALT正常组（P〈0.001）.Logistic回归分析显示,单纯BMI升高者ALT升高检出率是BMI和WC均正常者的 4.252倍,而单纯WC升高者达到 10.570倍,在BMI和WC均升高者达到最高14.141倍.[结论]秦皇岛市大学生ALT升高检出率较高.ALT升高与体脂分布密切相关.     

Potential mechanisms underpinning the nutritional modulation of periodontal inflammation

BackgroundPeriodontitis results from an inappropriate host response to pathogenic biofilms. Because traditional management approaches have failed to reduce disease prevalence, the research focus has shifted toward managing host-mediated inflammation. In this article, the author reviews the role of nutrition in the development and resolution of inflammation.MethodsThe author reviewed the biomedical literature to elucidate mechanisms by which dietary factors affect inflammatory processes and to establish what evidence exists for macronutritional and micronutritional modulation of inflammation at a cellular and molecular level.ConclusionsHyperinflammation characterizes the periodontitis phenotype, and oxidative stress is a key orchestration point for the diverse signaling pathways, which control inflammation. Oxidative stress is modulated by diet, as well as by infection. Recent research has demonstrated that subtle shifts in nutritional status are associated independently with the prevalence of periodontitis. Moreover, the results of contemporary animal and human studies have demonstrated the role of specific micronutrients in the modulation of the host's inflammatory response by reducing inflammatory biomarkers and bone loss.Clinical ImplicationsThe scientific community is starting to realize the health benefits of diets containing foods naturally rich in antioxidants and omega-3 polyunsaturated fatty acids, as well as the dangers of diets that are high in refined carbohydrates. Nutritional intervention studies in patients with inflammatory periodontitis are needed to evaluate the effect of nutritional approaches to periodontal management.     

Dietary Saturated Fats and Health: Are the U.S. Guidelines Evidence-Based?

The last decade has seen nearly 20 papers reviewing the totality of the data on saturated fats and cardiovascular outcomes, which, altogether, have demonstrated a lack of rigorous evidence to support continued recommendations either to limit the consumption of saturated fatty acids or to replace them with polyunsaturated fatty acids. These papers were unfortunately not considered by the process leading to the most recent U.S. Dietary Guidelines for Americans, the country’s national nutrition policy, which recently reconfirmed its recommendation to limit saturated fats to 10% or less of total energy intake, based on insufficient and inconsistent evidence. Continuation of a cap on saturated fat intake also fails to consider the important effects of the food matrix and the overall dietary pattern in which saturated fatty acids are consumed.     

中老年健康体检血脂检验分析

目的：了解本地区中老年血脂现况,寻找预防血脂异常的最佳方法。方法：选取自2008年11月～2009年11月间我院进行健康体检的1864名中老年人血脂的测定结果进行分析。结果：随着年龄增长血脂水平呈升高趋势,50-59最高,随着年龄略有下降。结论：中老年人要适当调整饮食习惯,多运动,更加健康科学的生活。     

Polymorphic Behavior of Sprayed Lipid Micropellets and Its Evaluation by Differential Scanning Calorimetry and Scanning Electron Microscopy

Considering the importance of polymorphism occurring in solid dosage forms causing instability, the polymorphic behavior of spray-dried and -congealed lipid micropellets was examined by differential scanning calorimetry and scanning electron microscopy. The results showed that both of the spraying processes exert an important effect on their polymorphic and crystallization properties. In spray-drying, due to the rapid solvent evaporation, the obtained lipid micropellets possess an unstable polymorphic form. This unstable form transforms gradually toward a stable form by storage at elevated temperatures. The same modifications were observed with spray-congealed lipid micropellets. The type of glyceride (composition, chain length), solvent and drugs (estradiol cypionate, medroxyprogesterone acetate) and, further, the presence of a stabilizing agent such as lecithin affect the polymorphic transition and its rate.     

Efficacy of the Ketogenic Diet for Intractable Seizure Disorders: Review of 58 Cases

The ketogenic diet was developed in the 1920s as a treatment for intractable childhood seizures when few antiepileptic drugs (AEDs) were available. There are still children whose seizures are refractory even to modern therapy, but use of the ketogenic diet appears to be waning. At Johns Hopkins, we continue to believe that the diet is very effective and well accepted by patients and families. To reevaluate our opinion of the efficacy and acceptability of this form of therapy in patients cared for in the 1980s with the newer AEDs, we analyzed the records of 58 consecutive patients who had been started on the diet. Before using the diet, 80% of the patients had multiple seizure types and 88% were treated with multiple AEDs; these children were among our most intractable patients. Despite this, seizure control improved in 67% of patients with the ketogenic diet, and actuarial analysis indicated that 75% of these improved patients continued the diet for at least 18 months. Sixty-four percent had AEDs reduced, 36% became more alert, and 23% had improved behavior. The improvement in these patients with intractable seizures and the length of time that families maintained the regimen indicate that the ketogenic diet continues to have a very useful therapeutic role in selected patients and their families.     

冷冻脂肪与新鲜脂肪注射移植的疗效观察

目的　探索冷冻脂肪注射移植的可行性及实用性。方法　 63例接受脂肪颗粒注射的患者中 ,3 0例随后注射冷冻脂肪 ,其中 2 7例注射 1次 ,3例注射 2次 ,9例重复注射新鲜脂肪。脂肪贮存在 - 2 0℃的冰箱中 ,重复注射间隔 1个月。结果　冷冻脂肪和新鲜脂肪移植后 ,局部反应正常 ,再吸收率无明显差别。结论　冷冻脂肪完全可以用于再注射移植     

Trans fatty acids and cholesterol levels: An evidence map of the available science

High intakes of industrial trans fatty acids (iTFA) increase circulating low density lipoprotein cholesterol (LDL-C) levels, which has implicated iTFA in coronary heart disease (CHD) risk. Published data on iTFA and LDL-C, however, represent higher intake levels than the U.S. population currently consume. This study used state-of-the-art evidence mapping approaches to characterize the full body of literature on LDL-C and iTFA at low intake levels. A total of 32 independent clinical trials that included at least one intervention or control group with iTFA at ≤3%en were found. Findings indicated that a wide range of oils and interventions were used, limiting the ability to determine an isolated effect of iTFA intake. Few data points were found for iTFA at <3%en, with the majority of low-level exposures actually representing control group interventions containing non-partially hydrogenated (PHO) oils. Further, it appears that few dose-response data points are available to assess the relationship of low levels of iTFA, particularly from PHO exposure, and LDL-C. Therefore, limited evidence is available to determine the effect of iTFA at current consumption levels on CHD risk.