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.     

小檗碱治疗代谢性疾病抗炎作用的研究进展

慢性非可控性炎症在代谢性疾病如糖尿病、非酒精性脂肪性肝病（NAFLD）和动脉粥样硬化的发生和发展过程中发挥关键作用。天然产物小檗碱对代谢性疾病有良好的改善作用并对其伴随的慢性炎症有明显的抑制作用。研究显示小檗碱主要通过调控AMP依赖的蛋白激酶（AMPK）、核转录因子-κB（NF-κB）和肠道菌群来发挥抗炎活性。对小檗碱抗炎作用的深入研究将为其应用于临床治疗代谢性疾病提供进一步科学依据。     

非酒精性脂肪肝病与血脂的相关性研究

目的:探讨非酒精性脂肪肝病(NAFLD)与血脂的相关性。方法:研究对象均为2010~2011年在本院进行体检的武汉大学教职员工,内容包括询问病史、体格检查、生化检查、肝脏彩超检查。将研究对象分为NAFLD组和非脂肪肝组,分析两组的人口学特征及血脂水平,采用Logistic回归模型分析,评价血脂水平在非酒精性脂肪肝的意义。结果:NAFLD组较非脂肪肝组TG,、TC、LDL-C水平高;而观察HDL-C水平,NAFLD组较非脂肪肝组为低,差异有统计学意义;NAFLD组合并高甘油三酯血症、高胆固醇血症、低高密度脂蛋白血症均较非脂肪肝组高,差异有显著性(0.001),其中高甘油三酯血症最为显著;Logistic回归分析显示,非酒精性脂肪肝病与TG、TC、LDL-C显著相关。结论:武汉大学教工体检人群NAFLD与TC、TG及LDL-C密切相关。     

Myeloperoxidase gene polymorphism predicts fibrosis severity in women with hepatitis C

Oxidative stress plays an important role on liver fibrosis progression in the course of hepatitis C virus (HCV) infection. Myeloperoxidase (MPO) is an enzyme released by neutrophils and macrophages, responsible for generating hypochlorous acid and reactive oxygen species (ROS) that may lead to liver injury in HCV infection. On the other hand, antioxidant enzymes such as manganese superoxide dismutase (SOD) controls ROS-mediated damage. The aim of the present study was to investigate the influence of MPO G-463A and SOD2 Ala16Val polymorphisms in the severity of liver fibrosis in individuals with chronic HCV infection. The present study included 270 patients with chronic HCV recruited from the Gastrohepatology Service of the Oswaldo Cruz University Hospital/Liver Institute of Pernambuco (Recife, Northeastern Brazil). All patients underwent liver biopsy, which was classified according METAVIR score. The SNPs were determined by real-time PCR. After multivariate analysis adjustment, the GG genotype of MPO and the presence of metabolic syndrome were independently associated with fibrosis severity in women (P = 0.025 OR 2.25 CI 1.10–4.59 and P = 0.032 OR 2.32 CI 1.07–5.01, respectively). The presence of the GG genotype seems to be a risk factor for fibrosis severity in women with HCV.     

Utility and Limitations of Transient Elastography to Monitor Hepatic Steatosis,Hepatic Fibrosis,and Methotrexate-Associated Hepatic Disease in Psoriasis: A Systematic Review

ObjectivePsoriasis is associated with hepatic steatosis, fibrosis, and methotrexate-associated liver injury. There is a need for reliable methods to monitor liver disease in psoriasis. Transient elastography (TE) is a validated non-invasive method for assessing hepatic steatosis and fibrosis. Psoriasis-specific TE studies have been limited until recently. Here, we review the utility and limitations of TE to detect and monitor liver disease in the context of psoriasis.MethodsA comprehensive search using OVID, PubMed, and gray literature was conducted (2005–November 2019) to identify studies of TE use in psoriasis for assessment of hepatic steatosis and fibrosis.ResultsFifteen studies met inclusion criteria. A total of 1,536 patients with psoriasis or psoriatic arthritis were represented. TE-detected liver fibrosis is associated with age, diabetes, obesity, and severity of psoriasis. TE successfully evaluates hepatic steatosis and fibrosis. Elastography has a high negative predictive value and specificity in the context of methotrexate-associated liver fibrosis in psoriasis; however, reported associations between abnormal elastography results and cumulative methotrexate dose varied significantly despite methotrexate’s association with hepatotoxicity and fibrosis. The presence of central adiposity is associated with increased TE failure rate.LimitationThe TE studies included in this review date from 2007 to 2019, which could contribute to publication bias, as the technique of TE has improved over this time period.ConclusionTE is a useful and non-invasive modality to detect hepatic steatosis and fibrosis in psoriasis. Dermatologists might consider TE in psoriatic patients and concomitant risk factors for fibrosis with the understanding that failure rates may be higher in patients with central adiposity.     

门冬氨酸-鸟氨酸颗粒剂治疗非酒精性脂肪性肝炎的多剂量平行对照临床研究

目的 研究门冬氨酸-鸟氨酸颗粒剂治疗非酒精性脂肪性肝炎的临床疗效和安全性.方法 用多中心开放性多剂量平行对照的临床试验设计选择非酒精性脂肪性肝炎患者,分别用门冬氨酸-鸟氨酸颗粒剂高剂量(6g,2次/d,口服)和低剂量(3 g,2次/d,口服)治疗12周,观察其疗效和安全性.对不同资料采用pearson x 2检验或Fisher确切概率法、t检验或非参数检验进行统计学分析.结果 本试验共有87例患者入选,高剂量组42例,低剂量组45例;共脱落15例,高剂量组4例,低剂量组11例;实际完成病例数72例,高剂量组38例,低剂量组34例.治疗后两组患者的肝脾CT比值分别为0.89±0.19及0.80±0.15,与治疗前相比,S值分别为329及246;P值均＜ 0.0001,差异均有统计学意义;并且高剂量组疗效优于低剂量组(Z=-2.1042,P＜ 0.05);高剂量组总有效率为52.63％,低剂量组总有效率为38.23％.与治疗前相比,ALT水平均显著降低,高、低剂量组治疗6周S值分别为324.5、223.0,P值均＜0.0001;治疗12周S值分别为370.5、297.5,P值均＜0.0001,差异均有统计学意义;且治疗12周后高剂量组ALT水平的降低较低剂量组更明显.高剂量组降ALT的总有效率为78.95％,高于低剂量组的52.94％.高、低剂量组6周和12周治疗后AST、y-谷氨酰转移酶显著低于治疗前,差异均有统计学意义.治疗12周后,两组的甘油三酯水平也较治疗前降低.共报道4例(4.6％)不良反应,其中低剂量组2例(4.4％),高剂量组2例(4.8％),均为胃肠道反应.结论 门冬氨酸-鸟氨酸颗粒剂治疗非酒精性脂肪性肝炎具有一定的临床疗效,且安全性好.