Post Graduate Program of Nutrition, Federal University of São Paulo-Unifesp, Brazil.
Eur J Gastroenterol Hepatol. 2010 May;22(5):557-63. doi: 10.1097/MEG.0b013e3283346df2.
Little progress has been made to identify the central neuroendocrine pathway involved in the energy intake control in nonalcoholic fatty liver disease (NAFLD) patients.
To assess the influence of orexigenic neuropeptides in the nutritional aspects of NAFLD obese adolescents submitted to a long-term interdisciplinary approach.
Fifty adolescents aged 15-19 years, with body mass index at least 95th percentile, consisting of 25 patients without NAFLD and 25 with NAFLD. The NAFLD diagnosis was determined by ultrasonography. Blood samples were collected to analyze glycemia, hepatic transaminases, and lipid profile. Insulin resistance was estimated by Homeostasis Model Assessment Insulin Resistance Index. Neuropeptide Y (NPY) and agouti related protein concentrations were measured by enzyme-linked immunosorbent assay. Analyses of food intake were made by 3 days recordatory inquiry.
At baseline conditions, the patients with NAFLD had significantly higher values of body mass, body mass index, visceral fat, triglycerides, VLDL-C, and hepatic transaminases. After the long-term intervention, they presented a significant reduction in these parameters. In both the groups, it was observed a significant decrease in energy intake, macronutrients and dietetic cholesterol. Only the patients with NAFLD presented a positive correlation between the saturated fatty acids intake and the orexigenic neuropeptides NPY and agouti related protein, and carbohydrate with NPY. Indeed, it was observed a positive correlation between energy intake, lipid (%) and saturated fatty acids with visceral fat accumulation.
Our findings showed an important influence of diet composition in the orexigenic system, being essential consider that the excessive saturated fatty acids intake could be a determinant factor to increase nonalcoholic fatty liver disease.
在非酒精性脂肪肝（NAFLD）患者中，能量摄入控制所涉及的中枢神经内分泌途径的识别进展甚微。
评估食欲肽神经肽在接受长期多学科治疗的肥胖青少年 NAFLD 营养方面的影响。
50 名年龄在 15-19 岁之间、体重指数至少为第 95 百分位数的青少年，包括 25 名无 NAFLD 的患者和 25 名有 NAFLD 的患者。NAFLD 的诊断通过超声确定。采集血样以分析血糖、肝转氨酶和血脂谱。通过稳态模型评估胰岛素抵抗指数估计胰岛素抵抗。通过酶联免疫吸附试验测量神经肽 Y（NPY）和刺鼠相关蛋白的浓度。通过 3 天记录查询进行食物摄入量分析。
在基线条件下，患有 NAFLD 的患者的体重、体重指数、内脏脂肪、甘油三酯、VLDL-C 和肝转氨酶显著升高。经过长期干预，这些参数均显著降低。在两组中，均观察到能量摄入、宏量营养素和饮食胆固醇显著减少。只有患有 NAFLD 的患者观察到饱和脂肪酸摄入量与食欲肽神经肽 NPY 和刺鼠相关蛋白呈正相关，碳水化合物与 NPY 呈正相关。实际上，观察到能量摄入、脂质（%）和饱和脂肪酸与内脏脂肪积累呈正相关。
我们的研究结果表明饮食成分对食欲肽系统有重要影响，必须考虑到过量的饱和脂肪酸摄入可能是增加非酒精性脂肪肝的决定因素。
