Pôle Hépatogastroentérologie, Endocrinologie et Nutrition, CHU de Bordeaux, Avenue de Magellan, 33600 Pessac, France.
Int J Endocrinol. 2013;2013:428542. doi: 10.1155/2013/428542. Epub 2013 May 2.
Is steatosis related to the spontaneous carbohydrate intake in patients with NAFLD? We performed dietary records for 24 patients with NAFLD, 3 months after their liver biopsy was performed and before the deliverance of a dietary advice. The food quotient, indicator of the proportion of calories from carbohydrates, was calculated as (1.00×% calories from carbohydrates/100) + (0.70×% calories from lipids/100) + (0.81×% calories from proteins/100). The associations between diet variables and steatosis% on the hepatic biopsies were tested by regression analysis, and diet variables were compared according to the presence of fibrosis. The subjects displayed a large range of steatosis, 50.5% ± 25.5 [10-90], correlated with their energy intake (1993 ± 597 kcal/d, r = 0.41, P < 0.05) and food quotient (0.85 ± 0.02, r = 0.42, P < 0.05), which remained significant with both variables by a multivariate regression analysis (r = 0.51, P < 0.05). For the 17/24 patients with a hepatic fibrosis, the energy intake was lower (fibrosis: 1863 ± 503 versus others: 2382 ± 733 kcal/d, P < 0.05), and their food quotients did not differ from patients without fibrosis. Hepatic steatosis was related to the energy and carbohydrate intakes in our patients; the role of dietary carbohydrates was detectable in the range of usual carbohydrate intake: 32% to 58% calories.
脂肪变性与非酒精性脂肪性肝病患者的自发性碳水化合物摄入有关吗?我们对 24 例非酒精性脂肪性肝病患者进行了饮食记录,这些患者在肝活检后 3 个月且在提供饮食建议之前进行了饮食记录。食物系数,即碳水化合物热量比例的指标,计算方法为(1.00×碳水化合物热量百分比/100)+(0.70×脂肪热量百分比/100)+(0.81×蛋白质热量百分比/100)。通过回归分析测试了饮食变量与肝活检脂肪变性百分比之间的关系,并根据纤维化的存在比较了饮食变量。患者的脂肪变性程度差异很大,范围为 50.5%±25.5[10-90],与他们的能量摄入(1993±597千卡/天,r=0.41,P<0.05)和食物系数(0.85±0.02,r=0.42,P<0.05)相关,多元回归分析显示这两个变量仍然具有显著相关性(r=0.51,P<0.05)。对于 24 例中有 17 例肝纤维化的患者,能量摄入较低(纤维化:1863±503 与其他:2382±733 千卡/天,P<0.05),且其食物系数与无纤维化患者无差异。我们的患者肝脂肪变性与能量和碳水化合物摄入有关;在通常的碳水化合物摄入范围内(32%至 58%卡路里),可以检测到饮食碳水化合物的作用。