Jazayeri-Tehrani Seyed Ali, Rezayat Seyed Mahdi, Mansouri Siavash, Qorbani Mostafa, Alavian Seyed Moayed, Daneshi-Maskooni Milad, Hosseinzadeh-Attar Mohammad-Javad
1Nutritional Sciences, Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
2Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Nutr Metab (Lond). 2019 Jan 28;16:8. doi: 10.1186/s12986-019-0331-1. eCollection 2019.
Since lifestyle changes are main therapies for non-alcoholic fatty liver disease (NAFLD), changing dietary components (nutritional or bioactive) may play a parallel important role. Few studies have assessed the effects of curcumin on NAFLD (mainly antioxidant and anti-inflammatory effects). We aimed to determine the effects of nano-curcumin (NC) on overweight/obese NAFLD patients by assessing glucose, lipids, inflammation, insulin resistance, and liver function indices, especially through nesfatin.
This double-blind, randomized, placebo-controlled clinical trial was conducted in the Oil Company Central Hospital, Tehran. 84 overweight/obese patients with NAFLD diagnosed using ultrasonography were recruited according to the eligibility criteria (age 25-50 yrs., body mass index [BMI] 25-35 kg/m). The patients were randomly divided into two equal NC ( = 42) and placebo (n = 42) groups. Interventions were two 40 mg capsules/day after meals for 3 months. Lifestyle changes were advised. A general questionnaire, a 24-h food recall (at the beginning, middle and end), and the short-form international physical activity questionnaire (at the beginning and end) were completed. Also, blood pressure, fatty liver degree, anthropometrics, fasting blood sugar (FBS) and insulin (FBI), glycated hemoglobin (HbA1c), homeostasis model assessment-insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), tumor necrosis factor-alpha (TNF-α), high sensitive c-reactive protein (hs-CRP), interleukin-6 (IL-6), liver transaminases, and nesfatin were determined at the beginning and end.
NC compared with placebo significantly increased HDL, QUICKI, and nesfatin and decreased fatty liver degree, liver transaminases, waist circumference (WC), FBS, FBI, HbA1c, TG, TC, LDL, HOMA-IR, TNF-α, hs-CRP, and IL-6 ( < 0.05). The mean changes in weight, BMI, body composition (BC), and blood pressure were not significant ( > 0.05). After adjustment for confounders, the changes were similar to the unadjusted model.
NC supplementation in overweight/obese NAFLD patients improved glucose indices, lipids, inflammation, WC, nesfatin, liver transaminases, and fatty liver degree. Accordingly, the proposed mechanism for ameliorating NAFLD with NC was approved by the increased serum nesfatin and likely consequent improvements in inflammation, lipids, and glucose profile. Further trials of nano-curcumin's effects are suggested.
Iranian Registry of Clinical Trials, IRCT2016071915536N3. Registered 2016-08-02.
由于生活方式改变是非酒精性脂肪性肝病(NAFLD)的主要治疗方法,改变饮食成分(营养成分或生物活性成分)可能也起着同样重要的作用。很少有研究评估姜黄素对NAFLD的影响(主要是抗氧化和抗炎作用)。我们旨在通过评估血糖、血脂、炎症、胰岛素抵抗和肝功能指标,特别是通过内脂素,来确定纳米姜黄素(NC)对超重/肥胖NAFLD患者的影响。
这项双盲、随机、安慰剂对照临床试验在德黑兰石油公司中心医院进行。根据纳入标准(年龄25 - 50岁,体重指数[BMI] 25 - 35kg/m²)招募了84例经超声诊断为超重/肥胖的NAFLD患者。患者被随机分为两组,每组42例,分别给予NC组和安慰剂组。干预措施为每日餐后服用两粒40mg胶囊,持续3个月。建议患者改变生活方式。完成一份一般问卷、一份24小时食物回忆(在开始、中间和结束时)以及简版国际体力活动问卷(在开始和结束时)。此外,在开始和结束时测定血压、脂肪肝程度、人体测量学指标、空腹血糖(FBS)和胰岛素(FBI)、糖化血红蛋白(HbA1c)、稳态模型评估胰岛素抵抗(HOMA - IR)、定量胰岛素敏感性检查指数(QUICKI)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL - c)、高密度脂蛋白胆固醇(HDL - c)、肿瘤坏死因子 - α(TNF - α)、高敏C反应蛋白(hs - CRP)、白细胞介素 - 6(IL - 6)、肝转氨酶和内脂素。
与安慰剂相比,NC显著提高了HDL、QUICKI和内脂素水平,降低了脂肪肝程度、肝转氨酶、腰围(WC)、FBS、FBI、HbA1c、TG、TC、LDL、HOMA - IR、TNF - α、hs - CRP和IL - 6(P < 0.05)。体重、BMI、身体成分(BC)和血压的平均变化不显著(P > 0.05)。在对混杂因素进行调整后,变化与未调整模型相似。
超重/肥胖NAFLD患者补充NC可改善血糖指标、血脂、炎症、WC、内脂素、肝转氨酶和脂肪肝程度。因此,通过增加血清内脂素以及可能随之改善的炎症、血脂和血糖谱,证实了NC改善NAFLD的机制。建议进一步开展纳米姜黄素作用的试验。
伊朗临床试验注册中心,IRCT2016071915536N3。2016年8月2日注册。