Internal Medicine Department, Faculty of Medicine, Cairo University, Egypt.
Biochemistry Department, Faculty of Medicine, Cairo University, Egypt.
J Diabetes Res. 2019 Apr 8;2019:5267025. doi: 10.1155/2019/5267025. eCollection 2019.
Type 2 DM and obesity are the coming epidemics and their association with NAFLD is well established; essential fatty acids are vital for body health yet the body cannot make them; 2 essential fatty acids are especially important: linoleic (omega-6) and alpha-linoleic (omega-3) acids; they can be considered as "bioactive lipids" and serve as functional foods.
50 type 2 Egyptian diabetic patients controlled on oral hypoglycemic drugs together with 20 age- and sex-matched healthy participants were enrolled in the study; all were subjected to complete history taking, BMI, fasting plasma glucose, HOMA-IR, ALT, AST, GGT, urea and creatinine, total lipid profile, hepatitis markers including hepatitis B surface antigen and hepatitis C virus antibodies, conjugated linoleic fatty acid "CLA," and abdominal ultrasound for grading of NAFLD.
Our study in Egyptian diabetics with NAFLD revealed a low level of serum CLA compared to healthy control; such deficiency was more marked with advanced grades of NAFLD; lowest levels were observed in those with severe steatosis (NASH) with definite association between CLA and obesity.
Insulin resistance is the main link between NAFLD, diabetes, and obesity. Conjugated linoleic acid (CLA) has a role in fat deposition in the liver and in development and improvement of insulin resistance. Fatty food had a documented role in the pathogenesis of obesity and diabetes but it can also be the cure.
2 型糖尿病和肥胖症是即将到来的流行病,它们与非酒精性脂肪性肝病(NAFLD)的关系已得到充分证实;必需脂肪酸对身体健康至关重要,但人体无法自行合成;两种必需脂肪酸尤为重要:亚油酸(ω-6)和α-亚麻酸(ω-3);它们可以被视为“生物活性脂质”,并作为功能性食品。
本研究纳入了 50 例接受口服降糖药物治疗的埃及 2 型糖尿病患者和 20 名年龄和性别匹配的健康对照者;所有参与者均接受了详细的病史采集、体重指数(BMI)、空腹血糖、稳态模型评估的胰岛素抵抗指数(HOMA-IR)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、γ-谷氨酰转移酶(GGT)、尿素和肌酐、总脂质谱、乙型肝炎表面抗原和丙型肝炎病毒抗体等肝炎标志物检测、共轭亚油酸(CLA)以及腹部超声检查以对 NAFLD 进行分级。
我们的研究发现,埃及 NAFLD 糖尿病患者的血清 CLA 水平较健康对照组低;这种缺乏在 NAFLD 分级较高时更为明显;在伴有明显脂肪变性(NASH)的患者中观察到最低水平,CLA 与肥胖之间存在明确的相关性。
胰岛素抵抗是非酒精性脂肪性肝病、糖尿病和肥胖症之间的主要联系。共轭亚油酸(CLA)在肝脏脂肪沉积以及胰岛素抵抗的发展和改善中发挥作用。高脂肪食物在肥胖和糖尿病的发病机制中具有明确的作用,但也可能是治疗方法。