Chen Shi-Ming, Liu Chieh-Yu, Li Shian-Rei, Huang Hui-Ting, Tsai Ching-Yen, Jou Hei-Jen
Department of Obstetrics and Gynecology, Taiwan Adventist Hospital Taipei, Taiwan, Republic of China.
J Chin Med Assoc. 2008 Nov;71(11):551-8. doi: 10.1016/S1726-4901(08)70168-0.
To investigate the effects of varied therapeutic lifestyle programs on patients with ultrasound-diagnosed nonalcoholic fatty liver disease (NAFLD).
A prospective, case-controlled study was conducted. A total of 54 subjects with NAFLD were subdivided into 3 groups: (1) diet plus exercise group (DPE group, n = 16); (2) exercise group (E group, n = 23); and (3) control group (C group, n = 15). The DPE group received a low-calorie balanced diet and regular high-intensity stationary bicycle exercise program for 10 weeks, while the E group received the same exercise protocol as the DPE group but without any changes in diet. Anthropometric indices, biochemical data, physical fitness data and liver ultrasound findings were recorded. A generalized estimating equation method was used to determine the differences among groups.
Compared with the C group, the DPE group demonstrated significant improvements in anthropometric indices, total cholesterol, insulin sensitivity, liver biochemistry, ultrasound finding and physical fitness, while the E group showed significant improvements in anthropometric indices, insulin sensitivity status, ultrasound finding and physical fitness but not liver biochemistry. Compared with the E group, the DPE group showed greater reduction in anthropometric indices (body mass index, body weight, abdominal circumference, hip circumference), total cholesterol, alanine aminotransferase, and gamma-glutamyltransferase.
Our data suggest that both 10-week diet-plus-exercise and exercise-only therapeutic lifestyle programs are effective for improving anthropometric indices, insulin sensitivity, ultrasound findings and physical fitness in ultrasound-diagnosed NAFLD patients. However, the range of improvement in patients on the diet-plus-exercise program is more obvious than that in patients on the exercise-only program. Moreover, the diet-plus-exercise program resulted in significant improvement in liver biochemistry, but the exercise-only program did not. In summary, diet plus exercise is more efficacious than exercise alone in the lifestyle modification treatment of NAFLD.
探讨不同治疗性生活方式方案对超声诊断为非酒精性脂肪性肝病（NAFLD）患者的影响。
进行了一项前瞻性病例对照研究。共有54例NAFLD患者被分为3组：（1）饮食加运动组（DPE组，n = 16）；（2）运动组（E组，n = 23）；（3）对照组（C组，n = 15）。DPE组接受低热量均衡饮食和为期10周的常规高强度固定自行车运动方案，而E组接受与DPE组相同的运动方案，但饮食无任何改变。记录人体测量指标、生化数据、体能数据和肝脏超声检查结果。采用广义估计方程法确定组间差异。
与C组相比，DPE组在人体测量指标、总胆固醇、胰岛素敏感性、肝脏生化指标、超声检查结果和体能方面有显著改善，而E组在人体测量指标、胰岛素敏感性状态、超声检查结果和体能方面有显著改善，但肝脏生化指标无改善。与E组相比，DPE组在人体测量指标（体重指数、体重、腹围、臀围）、总胆固醇、丙氨酸氨基转移酶和γ-谷氨酰转移酶方面下降幅度更大。
我们的数据表明，为期10周的饮食加运动和单纯运动的治疗性生活方式方案对改善超声诊断的NAFLD患者的人体测量指标、胰岛素敏感性、超声检查结果和体能均有效。然而，饮食加运动方案患者的改善范围比单纯运动方案患者更明显。此外，饮食加运动方案使肝脏生化指标有显著改善，但单纯运动方案没有。总之，在NAFLD的生活方式改变治疗中，饮食加运动比单纯运动更有效。
