25(OH)D Levels in Relation to Gender,Overweight, Insulin Resistance,and Inflammation in a Cross-Sectional Cohort of Northern Italian Workers: Evidence in Support of Preventive Health Care Programs

Objective: In recent years, the welfare of workers and the prevention of chronic disabling diseases has become a topic of great interest. This study investigates serum levels of total 25-hydroxyvitamin D (25(OH)D) in a cohort of overweight–obese and insulin-resistant northern Italian indoor workers in apparent good health followed a nutritional education program.

Methods: An observational cross-sectional study on 385 patients (females = 291, males = 94), age range 18–69 years and body mass index (BMI) > 25 kg/m², was performed at the Department of Occupational Medicine Milan, Italy, latitude 45.465454 N. We evaluated nutritional intakes, occupational and leisure physical activity, anthropometric measurements, impedance evaluation, blood pressure, the presence of metabolic syndrome (MetS) and nonalcoholic fatty liver diseases (NAFLD) by fatty liver index (FLI). Hematologic and biochemical parameters and (25(OH)D) levels were evaluated from fasting blood samples.

Results: Only 10.91% of subjects had optimal values of 25(OH)D; 17.40% of the remaining 89.09% subjects were severely deficient, with no gender difference and insufficient intake of vitamin D. Only 28% declared leisure physical activity; 39.48% had metabolic syndrome and 62.60% had an FLI > 30. An inverse relationship between 25(OH)D levels and BMI was found, with a significant reduction of total 25(OH)D serum concentrations in winter. The homeostasis model assessment–insulin resistance (HOMA-IR) is positively related to BMI and inversely related to 25(OH)D concentrations. A positive correlation between vitamin D and leisure physical activity was found. At univariate analysis adjusted for age, gender and BMI, an inverse relationship between vitamin D and FLI was observed in both genders. The correlation between 25(OH)D levels, inflammation markers, BMI, and FLI showed an increased risk of cardiovascular disease in this cohort of workers.

Conclusion: Our results suggest the rationale for a large-scale screening program for vitamin D by means of easily implementable low-cost preventive supplementation.     

Working Memory and Inadequate Micronutrient Consumption in Healthy Seniors

Abstract

Objective: To investigate whether inadequate intake of micronutrients, as defined by the Institute of Medicine’s (IOM) Recommended Dietary Allowance (RDA) according to gender, is associated with lower working memory performance in healthy seniors.

Method: 601 female and 530 male seniors (≥60 years) in the National Health and Nutrition Examination Survey (NHANES) were included. Analyses of the association between RDA micronutrient reference levels and having a memory performance score in the lowest quartile were stratified by gender. Logistic regression was used to estimate unadjusted and adjusted odds ratios for having a memory performance score in the lowest quartile for individuals with inadequate RDA levels compared to adequate RDA levels.

Results: Over half of participants had inadequate intake of vitamin C, choline, and zinc. Men who had less than the RDA of choline from their food were more likely to be in the lowest memory performance quartile, while women who with inadequate B₂ were more likely to be in the lowest quartile.

Discussion: Inadequate intake of micronutrients was significantly associated with lower working memory performance.     

Turmeric Supplementation Improves Serum Glucose Indices and Leptin Levels in Patients with Nonalcoholic Fatty Liver Diseases

Objective: Insulin and leptin resistance are important risk factors for non-alcoholic fatty liver disease (NAFLD). There is limited evidence regarding the effects of turmeric on NAFLD. The aim of this study was to investigate the effects of turmeric supplementation on glycemic status and serum leptin levels in patients with NAFLD.

Methods: This double-blind randomized controlled clinical trial was conducted on 46 patients with NAFLD (21males and 25 females) aged 20–60 years old and body mass index (BMI) between 24.9 and 40 kg/m2. The turmeric group (n = 23) was given six turmeric capsules daily for 12 weeks. Each capsule contained 500 mg turmeric powder (6×500 mg). The placebo group (n = 23) was given six placebo capsules daily for the same period. Fasting blood samples, anthropometric measurements, and physical activity levels were collected at the baseline and at the end of the study. Daily dietary intakes also were obtained throughout the study. Data were analyzed by independent t test, paired t test and analysis of covariance.

Results: Turmeric consumption decreased serum levels of glucose, insulin, HOMA-IR and leptin (by 1.22, 17.69, 19.48 and 21.33% respectively, p < 0.05 for all) over 12 weeks compared with those variables in the placebo group. Changes in weight, BMI and liver enzymes were not significant compared to the placebo group.

Conclusions: Turmeric supplementation improved glucose indexes and serum leptin levels and may be useful in the control of NAFLD complications.     

Salt and obesity: a systematic review and meta-analysis of observational studies

Background: Existing research has investigated the association between sodium intake and obesity. We aim to conduct a systematic review and meta-analysis of reported evidence regarding the association between sodium intake and obesity.

Methods: Multiple electronic databases (PubMed, Scopus, and Google Scholar) were searched for observational studies published until August 2016. A systematic literature review identified 11 cohort and 21 cross-sectional studies.

Result: Among the 32 studies identified in the systematic literature search, only 18 cross-sectional reports had sufficient data to be included in the meta-analysis. Higher sodium consumption was associated with greater BMI (weighed mean difference (WMD)?=?1.24?kg/m², 95%CI: 0.80, 1.67; I^2?=^?98.4%; p?p?<.0001) greater waist circumference (WC).

Conclusion: The present meta-analysis suggests that sodium consumption was associated with greater BMI and WC.     

Effect of Soy Milk on Metabolic Status of Patients with Nonalcoholic Fatty Liver Disease: A Randomized Clinical Trial

Objective: Studies in experimental models of nonalcoholic fatty liver disease (NAFLD) have reported positive effects of soy components in improving metabolic parameters. Whether such effects could be achieved through consumption of whole soy foods in patients with NAFLD is still unclear. Therefore, this trial was conducted to assess the effects of soy milk on metabolic parameters of patients with NAFLD.

Methods: This parallel randomized clinical trial was conducted on 70 patients with NAFLD. Patients in the soy milk group consumed 240?ml of soy milk daily as a part of low-calorie diet (i.e., 500-deficit calorie diet) for 8?weeks. Patients in the control group just followed the low-calorie diet. Grade of fatty liver, liver enzymes, lipid profile, serum high-sensitivity C-reactive protein (hs-CRP), and anthropometric indices were measured at baseline and the end of the trial.

Results: At the end of the trial, the soy milk group had significantly higher reduction in serum alanine aminotransferase (ALT) (–12.06?±?17.61?IU/L in the soy milk group versus –5?±?8.58?IU/L in the control group, p?=?0.04) and hs-CRP (–1.32?±?1.60?mg/L in the soy milk group versus –0.36?±?1.54?mg/L in the control group, p?=?0.01) compared to the control group. However, changes in fatty liver grade and other liver enzymes, including aspartate aminotransferase, alkaline phosphatase, and gamma-glutamyl transferase, as well as lipid profile and anthropometric indices were not significantly different between the treatment groups.

Conclusion: Consumption of soy milk in the context of a restricted-calorie diet for 8?weeks had favorable effects on serum ALT and hs-CRP in patients with NAFLD.     

Reduced Rank Regression-Derived Dietary Patterns Related to the Fatty Liver Index and Associations with Type 2 Diabetes Mellitus among Ghanaian Populations under Transition: The RODAM Study

The Fatty Liver Index (FLI) is a proxy for the steatotic component of non-alcoholic fatty liver disease (NAFLD). For sub-Saharan African populations, the contribution of dietary factors to the development of NAFLD in the etiology of type 2 diabetes mellitus (T2DM) remains to be clarified. We identified sex-specific dietary patterns (DPs) related to the FLI using reduced ranked regression (RRR) and evaluated the associations of these DPs with T2DM. This analysis used data from the RODAM, a multi-center cross-sectional study of Ghanaian populations living in Ghana and Europe. The daily intake frequencies of 30 food groups served as the predictor variables, while the FLI was the response variable. The odds ratios and 95% confidence intervals for T2DM were calculated per one standard deviation increase in the DP score using logistic regression. In males, the DP score explained 9.9% of the variation in their food intake and 16.0% of the variation in the FLI. This DP was characterized by high intakes of poultry, whole-grain cereals, coffee and tea, condiments, and potatoes, and the chance of T2DM was 45% higher per 1 DP score-SD (Model 2). Our results indicate that the intake of modernized foods was associated with proxies of NAFLD, possibly underlying the metabolic pathways to developing T2DM.     

Effects of a 1-year dietary intervention with n-3 polyunsaturated fatty acid-enriched olive oil on non-alcoholic fatty liver disease patients: a preliminary study

Abstract

Background and aims Non-alcoholic fatty liver disease (NAFLD) is a worldwide diffuse condition due to alimentary, environment and genetic factors. The aim of our preliminary study was to evaluate the effectiveness of long-term consumption of food enriched with n-3 polyunsaturated fatty acids (PUFA) in patients with NAFLD.

Methods Eleven patients were enrolled; six (four males, two females) were planned for oral administration of 6.5 ml olive oil enriched with n-3 PUFA for 12 months, while five (four males, one female) were used as controls.

Results Consumption of olive oil enriched with n-3 PUFA demonstrated a significant improvement of liver echo-texture and of the Doppler Perfusion Index after 12 months (after: 0.19 ± 0.02 vs. pre: 0.15 ± 0.03; P < 0.05), whereas no significant changes were seen at the end of follow-up in controls. Moreover, patients who consumed the olive oil enriched with n-3 PUFA showed a significant amelioration of liver enzymes, and of triglycerides (post: 132.8 ± 63.7 vs. pre: 164.5 ± 85.5 mg/dl; P = 0.04) in a general linear model adjusted for age and gender. Interestingly, patients reported to have a significant increase of adiponectin levels (post: 1,487.9 ± 96.7 vs. pre: 1,143 ± 24.8 μg/ml; P = 0.04).

Conclusion The results of this preliminary study showed that long-term consumption of olive oil enriched with n-3 PUFA in patients with NAFLD is able to decrease circulating liver enzymes and triglycerides, with a significant improvement of adiponectin levels.     

广州市中老年人非酒精性脂肪肝患病率及代谢相关因素分析

目的 探讨非酒精性脂肪性肝病(NAFLD)在中老年人群中的患病情况及其代谢相关因素。方法 采用横断面调查的方法,通过问卷调查和实验室检测对2 935名广州市中老年人进行资料收集、整理。探讨NAFLD在中老年人群中的患病情况,并采用协方差和logistic回归分析代谢因素与NAFLD患病情况之间的关系。NAFLD的诊断标准采用中华医学会肝脏病学分会脂肪肝和酒精性肝病学组的影像学诊断标准,并且按照其严重程度分为轻、中、重三个等级。结果 广州市中老年人群中NAFLD的患病率为50.6%。NAFLD患者组中WC、BMI、FPG、TG、SBP、DBP以及MS患病率均明显高于对照组,而体力活动水平和HDL-C明显降低(P< 0.001)。logistic回归分析显示,WC、SBP、DBP、TG、FPG和HDL-C每升高一个标准差其对应NAFLD患病的OR值(95%CI)分别为2.70(2.45～2.98)、1.47(1.35～1.59)、1.48(1.37～1.60)、1.88(1.66～2.12)、1.25(1.15～1.36)和0.51(0.47～0.56)。随着NAFLD严重程度不断增加,WC、BMI、TG、SBP、DBP和FPG水平均呈现上升趋势,而HDL-C呈现减少的趋势(P< 0.001)。结论 中老年人NAFLD患病率较高,MS及相关组分与NAFLD关系密切,其中WC增加对NAFLD患病影响最大。     

Dietary Patterns Modulate the Risk of Non-Alcoholic Fatty Liver Disease in Chinese Adults

Although previous studies reported the associations between the intakes of individual foods or nutrients and the risk of non-alcoholic fatty liver disease (NAFLD), the relationship between dietary patterns and NAFLD in the Chinese population has been rarely studied to date. This study aimed to investigate the associations between dietary patterns and the risk of NAFLD in a middle-aged Chinese population. The Study subjects were 999 Chinese adults aged 45–60 years in the Anhui province who participated in the Hefei Nutrition and Health Study. Dietary intake was collected by a semi-quantitative food frequency questionnaire. NAFLD was defined as the presence of moderate-severe hepatic steatosis (by B-ultrasonic examination); the absence of excessive alcohol use (>20 g day⁻¹ in men and 10 g day⁻¹ in women); no use of steatogenic medications within the past six months; no exposure to hepatotoxins; and no history of bariatric surgery. Log-binomial regression analysis was used to examine the association between dietary patterns and NAFLD with adjustment of potential confounding variables. Out of 999 participants, 345 (34.5%) were classified as having NAFLD. Four major dietary patterns were identified: “Traditional Chinese”, “Animal food”, “Grains-vegetables” and “High-salt” dietary patterns. After adjusting for potential confounders, subjects in the highest quartile of the “Animal food” pattern scores had greater prevalence ratio for NAFLD (prevalence ratio (PR) = 1.354; 95% confidence interval (CI): 1.063–1.724; p < 0.05) than did those in the lowest quartile. After adjustment for body mass index (BMI), compared with the lowest quartile of the “Grains-vegetables” pattern, the highest quartile had a lower prevalence ratio for NAFLD (PR = 0.777; 95% CI: 0.618–0.977, p < 0.05). However, the “traditional Chinese” and “high-salt” dietary patterns showed no association with the risk of NAFLD. Our findings indicated that the “Animal food” dietary pattern was associated with an increased risk of NAFLD.     

Comparison of Calorie-Restricted Diet and Resveratrol Supplementation on Anthropometric Indices,Metabolic Parameters,and Serum Sirtuin-1 Levels in Patients With Nonalcoholic Fatty Liver Disease: A Randomized Controlled Clinical Trial

Objective: There is a promising perspective regarding the potential effect of resveratrol in preventing and treating metabolic disturbances similar to that of calorie restriction. The aim of this study was to evaluate the effects of calorie-restricted (CR) diet on metabolic parameters and then to investigate whether resveratrol supplementation has beneficial effects similar to CR diet in patients with nonalcoholic fatty liver disease (NAFLD).

Methods: This randomized controlled clinical trial was conducted in 90 patients with NAFLD (males and females) aged 20 to 60 years with body mass index (BMI) ranging from 25 to 35 kg/m². Participants were assigned to one of three intervention groups as follows: The CR diet group (n = 30) received a prescribed low-calorie diet, the resveratrol group (n = 30) received 600 mg pure trans-resveratrol (2 × 300 mg) daily, and the placebo group (n = 30) received placebo capsules (2 × 300 mg) daily for 12 weeks. Fasting blood samples, anthropometric measurements, and dietary intake and physical activity data were collected for all participants at baseline and at the end of the trial.

Results: CR diet significantly reduced weight (by 4.5%); BMI; waist circumference; waist-to-hip ratio; and serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), and lipid profiles in participants compared to resveratrol and placebo (all p < 0.05). Significant reductions in weight (by 1.1%) and BMI were found in the resveratrol group compared to the placebo group (p < 0.05). ALT, AST, and lipid profiles did not change significantly in the resveratrol group (all p > 0.05). No significant changes were seen in hepatic steatosis grade, serum glycemic parameters, and high-density lipoprotein cholesterol and sirtuin-1 levels in any group (all p > 0.05).

Conclusions: CR diet with moderate weight loss has favorable effects on NAFLD, and resveratrol supplementation induced weight loss but failed to mimic other aspects of CR diet. Future studies are warranted to evaluate the long-term and dose-dependent effects of resveratrol on metabolic diseases.     

The Mediation Role of the Risk of Non-Alcoholic Fatty Liver Disease in Relationship between Lutein and Zeaxanthin and Cognitive Functions among Older Adults in the United States

Background: Previous studies showed lutein and zeaxanthin (L and Z) may influence cognitive function by different mechanisms. Our study aimed to be the first to examine whether the risk of non-alcoholic fatty liver disease (NAFLD) mediated the possible association between the dietary intake of L and Z and cognitive function. Methods: We conducted a cross-sectional analysis of participants aged 60 years or over in the National Health and Nutrition Examination Survey (NHANES) 2011–2014. Multivariable linear regression was used to investigate the association between the dietary intake of L and Z and cognitive function, and structural equation modeling tested the mediation effect. Results: The fatty liver index for the United States population (US FLI) acted as a mediator in the association between the higher intake of L and Z and the Animal Fluency Test, the Digit Symbol Substitution Test (DSST), and composite score and mediated 13.89%, 17.87%, and 13.79% of the total association in dietary L and Z intake (14.29%, 13.68%, and 10.34% of the total association in total L and Z intake), respectively. Conclusion: Our study indicated the potential role of the risk of NAFLD as a mediator of associations between the dietary intake of L and Z and cognitive function in the geriatric American population.     

瘦素和胰岛素抵抗与儿童非酒精性脂肪肝的关系

目的 研究儿童非酒精性脂肪肝（NAFLD）患者血清瘦素（Leptin）和胰岛素抵抗（IR）的关系。方法 试验分两组：NAFLD组,79名诊断为NAFLD的儿童;对照组：79名健康儿童;检测患儿空腹血糖（FPG）、胰岛素（FINS）、Leptin和可溶性瘦素受体（sOB-R）,及肝肾功能和血脂变化,采用游离瘦素指数（FLI,Leptin /sOB-R）和Leptin评估Leptin水平,稳态模型胰岛素抵抗指数（HOMA-IR）和胰岛素敏感指数（ISI）评估IR。用多元逐步回归分析和偏相关分析对Leptin与IR指标的相关性进行分析。结果 NAFLD组血清BMI、FPG、FINS、HOMA-IR、Leptin、sOB-R和FLI均较对照组显著增高（P〈0.05）;在NAFLD患儿中,血清Leptin和FLI水平与FINS、HOMA-IR明显正相关（r1=0.632,P〈0.01,r2=0.386,P〈0.05）,与ISI呈明显负相关（r=-0.401,P〈0.05）;HOMA-IR和ISI与BMI相关（r1=0.260,P=0.033;r2=-0.358,P=0.003）;性别（0.410）、BMI（0.436）、年龄（0.321）、FINS（0.280）、ISI（-0.262）是NAFLD儿童血清Leptin或FLI水平的独立决定因素。     

Circulating ALT Levels in Healthy Volunteers Over Life-Span: Assessing Aging Paradox and Nutritional Implications

Abstract

Background: Two facts are generally recognized: (1) development of nonalcoholic fatty liver disease (NAFLD) is consistently linked to insulin resistance which has dietary implications and (2) circulating alanine aminotransferase (ALT) levels are reasonable markers predicting NAFLD status. In a recent cross-sectional study employing nondiabetic subjects, ALT values rose steadily within a normal range early in the life cycle but begin decreasing steadily around age 65?years.

Objectives: Because of important nutritional implications, the association between ALT levels and aging in a significantly larger population of healthy volunteers was examined for corroborative purposes. A secondary goal was to gain further knowledge concerning mechanisms behind any age-related decline in ALT activity.

Methods: Baseline data from over 10,000 physician-approved, nondiabetic subjects (age 21–84?years) of both genders who had volunteered for previous clinical investigations were assessed.

Results: In this cross-sectional examination, the line of best fit (weighted) for average yearly circulating ALT levels displayed an upward surge from ages 21 to 64?years with a discernible steady downward decline around 65?years—mimicking earlier results. Examining linear lines of correlation in the younger and older age groups, the following calculations were determined: a significant positive slope for 21 to 64?years, r?=?0.42, n?=?44, p?<?0.005, and a trending negative slope for 65 and beyond, r = ?0.43, n?=?20, p?<?0.057. Using this same datum base, the correlations between age and fasting blood glucose (FBG) mimicked the ALT results by once more showing a similar upward rise in the younger and a steady decline the older group of volunteers.

Conclusions: A paradoxical downward age-related (≥ 65?years) decline of circulating ALT coinciding with a comparable steady decrease in FBG levels was replicated in a larger population of volunteers. The close association of these two chemistries along with other findings suggest that altered glucose-insulin metabolism may participate via “survivor bias” in the ubiquitously found age-related decline of serum ALT—suggesting that nutritional measures could advance optimal health over the life-span.     

Effects of Multistrain Probiotic Supplementation on Glycemic and Inflammatory Indices in Patients with Nonalcoholic Fatty Liver Disease: A Double-Blind Randomized Clinical Trial

Objective: Nonalcoholic fatty liver disease (NAFLD) is a condition defined by exceeding triglycerides accumulation in the liver. The condition can develop into fibrosis, cirrhosis, and hepatocellular carcinoma. Considering the ever-increasing prevalence of NAFLD, the aim of the present study was to investigate the effects of probiotic supplementation on glycemic and inflammatory indices in patients with NAFLD.

Methods: This randomized clinical trial was conducted on 42 patients with NAFLD who had been referred to a gastroenterology clinic. Subjects in the intervention and control groups consumed 2 capsules/day probiotic or placebo, respectively, for 8 weeks. Fasting blood sugar (FBS), insulin, insulin resistance, tumor necrosis factor alpha (TNF-α), and interleukin 6 (IL-6) were measured at baseline and at the end of the study.

Results: Means of FBS, insulin, insulin resistance, and IL-6 were significantly different between groups after intervention (p < 0.05), whereas TNF-α was not significantly modified (p > 0.05). In the probiotic group, insulin, insulin resistance, TNF-α, and IL-6 decreased significantly at the end of the study compared to the beginning of study.

Conclusion: Considering the effects of probiotic supplementation on the reduction of glycemic and inflammatory indices in patients with NAFLD, consumption of probiotics is recommended as a complementary therapy in these patients.     

Exploring the Path of Mediterranean Diet,Non-Alcoholic Fatty Liver Disease (NAFLD) and Inflammation towards 10-Year Cardiovascular Disease (CVD) Risk: The ATTICA Study 10-Year Follow-Up (2002–2012)

Background: Non-alcoholic fatty liver disease (NAFLD) is the leading cause of liver disease, affecting ~30% of the population and increasing CVD. This study aimed to explore the direct, indirect and combined effects of Mediterranean diet, NAFLD and inflammation on the 10-year CVD risk in a healthy adult population. Methods: Using baseline and 10-year follow-up data from the ATTICA study, adherence to Mediterranean diet was measured using MedDietScore, and presence of NAFLD at baseline was assessed using the fatty liver index (FLI). Participants’ 10-year CVD outcomes were recorded and C-reactive protein (CRP) was used as a surrogate marker for inflammation. The direct and indirect roles of these factors were explored using logistic regression models and the pathways between them were analysed using a structural equation model (SEM). Results: NAFLD prevalence was 22.9% and its presence was 17% less likely for every unit increase in MedDietScore. NAFLD presence at baseline was associated with increased 10-year CVD incidence (39.4% vs. 14.5%, p = 0.002), but when adjusted for MedDietScore, NAFLD was not an independent predictor of 10-year CVD risk. MedDietScore was an independent protective factor of 10-year CVD risk (OR = 0.989, 95% CI: 0.847, 0.935), when adjusted for NAFLD at baseline, age, gender, sedentary lifestyle and other confounders. Further exploration using SEM showed that MedDietScore was associated with CVD risk directly even when inflammation as CRP was introduced as a potential mediator. Conclusion: FLI as a proxy measure of NAFLD is a strong predictor of 10-year CVD risk, and this prognostic relationship seems to be moderated by the level of adherence to Mediterranean diet. Adherence to Mediterranean diet remained an independent and direct CVD risk factor irrespective of NAFLD status and CRP.     

不同类型非酒精性脂肪肝与糖脂代谢的相关分析

目的评价不同程度肝脏脂质浸润对糖脂代谢的影响，并进行非酒精性脂肪肝（NAFLD）的相关因素分析。方法根据NAFLD患者是否伴有肝脏转氨酶升高及是否同时合并糖代谢异常，将受试对象253例分为单纯脂肪肝（FL）组、脂肪性肝炎（NASH）组、单纯脂肪肝合并糖调节受损（FLI）组、脂肪性肝炎合并糖调节受损（NSI）组和对照（NC）组，分析5组间糖脂代谢、舒张压（DBP）、收缩压（SBP）、体质指数（BMI）及腰围（WC）等方面的差异，并探讨各因素与NAFLD间的相关性。结果与NC组比较，其余4组WC、SBP、空腹血糖（FPG）、30min血糖（BG）、2hBG、空腹胰岛素（FINS）、低密度脂蛋白胆固醇（LDL-C）、甘油三酯（TG）、稳态模型胰岛素抵抗指数（HOMA-IR）明显升高，而高密度脂蛋白胆固醇（HDL-C）降低，差别有统计学意义（P〈0．05）。除对照组外，其余4组间比较，WC、LDL-C差别无统计学意义（P〉0．05）；NASH组与FL组、NSI组与FLI组比较，2hBG、TG、HDL-C差别无统计学意义（P〉0．05）；NSI组和FLI组比较，FINS无统计学意义（P〉0．05），其他各项指标均有统计学意义（P〈0．05）；FLI组与FL组、NSI组与NS组间比较，SBP、FBG、30minBG、2hBG、FINS、TG、HDL-C差别有统计学意义（P〈0．05）。进一步进行相关性分析发现，NAFLD与HOMA-IR间有独立的相关性归0．31，P〈0．05）。结论随着NAFLD并发NASH和（或）合并糖代谢异常可以进一步加重机体代谢紊乱，NAFLD患者尽管具有与NC组相似的BMI，WC和胰岛素抵抗指数（IR）仍明显增加，提示WC与NAFLD和IR间有明确的相关性，其作为中心性肥胖的指标优于BMI。     

The Fatty Liver Index (FLI) Relates to Diabetes-Specific Parameters and an Adverse Lipid Profile in a Cohort of Nondiabetic,Dyslipidemic Patients

Background: Patients with hyperlipidemia are at high risk for developing a fatty liver. The fatty liver index (FLI) is a noninvasive and well-established method for the estimation of a fatty liver. However, little is known about the metabolic characterization of nondiabetic treated patients with hyperlipidemia who have different risk levels for a fatty liver.

Methods: In this study, 74 nondiabetic patients with hyperlipidemia were divided into 3 groups according to their fatty liver index. A comparison of metabolic characteristics was done. These characteristics included intima media thickness (IMT) and nutritional habits, which were further divided into FLI subgroups with low, intermediate, and high risk for a fatty liver.

Results: Patients with hyperlipidemia, with a high risk for a fatty liver (FLI ≥ 60), had subclinical elevations in parameters of carbohydrate metabolism (insulin, fasting plasma glucose, C-peptide) including a higher insulin resistance (quantitative insulin sensitivity check index, QUICKI) compared to lower FLI groups. These patients also presented a higher risk for a metabolic syndrome (p = 0.018), as well as an adverse lipid profile (e.g., high-density lipoprotein [HDL] cholesterol, triglycerides [TG]–HDL ratio). FLI group 3 was characterized by significantly lower levels of omega-3 fatty acids (p = 0.048).

Conclusion: The fatty liver index relates to diabetes-specific parameters and an adverse lipid profile and is an appropriate index for risk evaluation of metabolic syndrome.     

Effects of Egg Consumption and Choline Supplementation on Plasma Choline and Trimethylamine-N-Oxide in a Young Population

ABSTRACT

Background: Plasma trimethylamine-N-oxide (TMAO) concentrations have been associated with cardiovascular disease risk. Eggs are a rich source of choline, which is a precursor of TMAO.

Objective: The effects of egg intake versus daily choline supplementation were evaluated on plasma choline and TMAO in a young, healthy population.

Methods: Thirty participants (14 males, 16 females; 25.6 ± 2.3 years; body mass index = 24.3 ± 2.9 kg/m²) were enrolled in this 13-week crossover intervention. After a 2-week washout, participants were randomized to consume either 3 eggs/d or a choline bitartrate supplement (～ 400 mg choline total in eggs or supplement) for 4 weeks. Following a 3-week washout, participants were switched to the alternate treatment. Dietary records were measured at the end of each period. Plasma TMAO and choline were measured at baseline and at the end of each dietary intervention. Gene expression of scavenger receptors associated with plasma TMAO were quantified at the end of each intervention.

Results: Compared to the choline supplement, intake of total fat, cholesterol, selenium, and vitamin E were higher (p < 0.05), whereas carbohydrate intake was lower (p < 0.001) with consumption of 3 eggs/d. Fasting plasma choline increased 20% (p = 0.023) with egg intake, while no changes were observed with choline supplementation. Plasma TMAO levels were not different between dietary treatments or compared to baseline.

Conclusions: Dietary choline appears to be more bioavailable via egg consumption when compared to a choline supplement. Plasma TMAO concentrations were not affected in healthy participants after 4 weeks of taking ～400 mg/d choline either via eggs or choline supplementation.     

Functions of Coenzyme Q10 Supplementation on Liver Enzymes,Markers of Systemic Inflammation,and Adipokines in Patients Affected by Nonalcoholic Fatty Liver Disease: A Double-Blind,Placebo-Controlled,Randomized Clinical Trial

Background: Nonalcoholic fatty liver disease (NAFLD) is a chronic liver disorder related to inflammation. Coenzyme Q10 (CoQ10) is a natural compound that has recently been considered as an anti-inflammatory factor. In the current study we aimed to evaluate the effects of CoQ10 supplementation on liver enzymes, inflammation status, and adipokines in patients with NAFLD.

Methods: Forty-one subjects with NAFLD participated in the current randomized, double-blind, placebo-controlled trial. The participants were randomly divided into 2 groups: one group received CoQ10 capsules (100 mg once a day) and the other received placebo for 12 weeks. Blood samples of each patient were taken before and after the 12-week intervention period for measurement of liver aminotransferases, inflammatory biomarkers, and adipokines (adiponectin and leptin).

Results: Taking 100 mg CoQ10 supplement daily resulted in a significant decrease in liver aminotransferases (aspartate aminotransferase [AST] and gamma-glutamyl transpeptidase [GGT]), high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor α, and the grades of NAFLD in the CoQ10 group in comparison to the control group (p < 0.05). In addition, patients who received CoQ10 supplement had higher serum levels of adiponectin (p = 0.016) and considerable changes in serum leptin (p = 0.053). However, no significant changes occurred in serum levels of interleukin-6 in both groups.

Conclusion: The present study suggested that CoQ10 supplement at a dosage of 100 mg could be effective for improving the systemic inflammation and biochemical variables in NAFLD.     

Effects of eicosapentaenoic acid on hepatic dyslipidemia and oxidative stress in high fat diet-induced steatosis

Abstract

We investigated the ability of eicosapentaenoic acid (EPA) to prevent high-fat diet (HFD)-induced obesity and non-alcoholic fatty liver disease (NAFLD). Male C57BL/6J mice were fed standard chow (5.3% fat content), an HFD (32.0% fat content) or an HFD?+?EPA (1?g/kg/day EPA for the last 6 weeks) for 12 weeks. Serum total cholesterol, hepatic triglyceride and total cholesterol levels were significantly increased in the HFD group, in comparison with those of normal mice (p?<?0.01). In contrast, hepatic triglyceride and total cholesterol levels were significantly decreased in the HFD?+?EPA group, in comparison with those of the HFD group (p?<?0.05). In addition, EPA decreased the body weight of obese mice and improved hepatic function. Hepatic superoxide dismutase activity and glutathione levels were significantly decreased in obese mice, but increased with EPA administration. Our data suggest that EPA supplementation has a beneficial effect on NAFLD progression.