Aller R, de Luis D A, Izaola O, de la Fuente B, Bachiller R
Institute of Endocrinology and Nutrition, Medicine School and Deparment of Endocrinology and Nutrition, Hospital Clinico Universitario, University of Valladolid, Valladolid, Spain.
Eur Rev Med Pharmacol Sci. 2014;18(7):1041-7.
Hyperaminotransferasemia is an important problem in obese patients. We decide to examine the changes in hyperaminotransferasemia after weight reduction in obese patients with and without NAFLD secondary to a high monounsaturated fat vs. a high polyunsaturated fat hypocaloric diets.
A population of 306 obese patients was randomly allocated to two groups: Diet M (high monounsaturated fat hypocaloric diet) and Diet P (high polyunsaturated fat hypocaloric diet). Patients were classified as group I (obese subjects; n=262) when serum ALT activity was normal or group II (NAFLD patients; n=44) when serum ALT activity was (≥ 43 UI/L).
In NAFLD group with diet M, BMI, weight, fat mass, waist circumference, systolic blood pressure, total cholesterol, LDL cholesterol), insulin and HOMA-R decreased. In NAFLD group with diet P, BMI, weight, fat mass, waist circumference, systolic blood pressure, total cholesterol, LDL cholesterol), insulin and HOMA-R decreased, too. In NAFLD group, alanine aminotransferase [(diet M) -20.3±19.2 UI/L vs. (diet P) -14.2±20.1 UI/L], aspartate aminotransferase [(diet M) -11.3±12.2 UI/L vs. (diet P) -11.1±10.1 UI/L], and gammaglutamyl transferase [(diet M) -18.1±12.2 UI/L vs. (diet P) -10.9±20.1 UI/L] improved with both diets.
We showed that weight reduction secondary to two hypocaloric diets was associated with improvement in hypertransaminasemia and insulin resistance in NAFLD patients.
高转氨酶血症是肥胖患者的一个重要问题。我们决定研究在患有和未患有非酒精性脂肪性肝病（NAFLD）的肥胖患者中，采用高单不饱和脂肪与高多不饱和脂肪低热量饮食减肥后高转氨酶血症的变化情况。
306名肥胖患者被随机分为两组：饮食M组（高单不饱和脂肪低热量饮食）和饮食P组（高多不饱和脂肪低热量饮食）。血清谷丙转氨酶（ALT）活性正常的患者被归类为I组（肥胖受试者；n = 262），血清ALT活性≥43 UI/L的患者被归类为II组（NAFLD患者；n = 44）。
在采用饮食M的NAFLD组中，体重指数（BMI）、体重、脂肪量、腰围、收缩压、总胆固醇、低密度脂蛋白胆固醇、胰岛素和胰岛素抵抗稳态模型评估（HOMA-R）均下降。在采用饮食P的NAFLD组中，BMI、体重、脂肪量、腰围、收缩压、总胆固醇、低密度脂蛋白胆固醇、胰岛素和HOMA-R也下降。在NAFLD组中，两种饮食均使丙氨酸转氨酶[（饮食M）-20.3±19.2 UI/L vs.（饮食P）-14.2±20.1 UI/L]、天冬氨酸转氨酶[（饮食M）-11.3±12.2 UI/L vs.（饮食P）-11.1±10.1 UI/L]和γ-谷氨酰转移酶[（饮食M）-18.1±12.2 UI/L vs.（饮食P）-10.9±20.1 UI/L]有所改善。
我们发现，两种低热量饮食导致的体重减轻与NAFLD患者高转氨酶血症和胰岛素抵抗的改善相关。
