1 Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.
2 First Department of Propaedeutic and Internal Medicine, Laiko General Hospital, Athens University Medical School, Athens, Greece.
J Med Food. 2019 Jul;22(7):729-740. doi: 10.1089/jmf.2018.0020.
Diet is a modifiable key factor targeted in prevention and management of nonalcoholic fatty liver disease (NAFLD). The aim was to study the effect of Mediterranean Diet (MedDiet) on clinical, biochemical, and inflammatory profile in NAFLD patients with simple steatosis. Potential associations of signal transducer and activator of transcription 3 (STAT3) rs2293152 genotype to diet composition and patients' profile were investigated. In this nonrandomized, open-label, 24-week prospective intervention study, 44 untreated NAFLD patients with nonsignificant fibrosis received nutritional counsel to increase adherence to MedDiet. Adherence to MedDiet was estimated with MedDietScore. Furthermore, we genotyped STAT3 rs2293152 single nucleotide polymorphism and performed clinical and inflammatory measurements. In all patients, MedDietScore increased and anthropometric indices improved, whereas liver imaging, liver fibrosis score, blood pressure, fasting glucose, glycated hemoglobin (HbA1c), C-reactive protein (CRP), visfatin, and oxidized low-density lipoprotein levels were also significantly ameliorated compared with baseline ( < .05). No association of STAT3 polymorphism with diet composition was found. Comparisons of mean differences between G- and C-carriers at the end point of the trial showed that only visfatin was significantly associated with the STAT3 genotype (-0.0 ± 4.6 vs. -4.2 ± 3.9, = .04, respectively). Carrying the G-allele was associated with an increase of the visfatin levels (3.4 ± 1.5 ng/mL, = .028). Our results show amelioration of clinical, biochemical, and inflammatory biomarkers in NAFLD patients in response to MedDiet. STAT3 rs2293152 G-carriers experienced more beneficial changes at the end of the intervention compared with baseline. An association between visfatin levels and STAT3 genotype has been shown for the first time.
饮食是针对非酒精性脂肪性肝病（NAFLD）预防和管理的可改变的关键因素。本研究旨在研究地中海饮食（MedDiet）对单纯性脂肪性肝病患者的临床、生化和炎症特征的影响。研究了信号转导和转录激活因子 3（STAT3）rs2293152 基因型与饮食成分和患者特征的潜在关联。在这项非随机、开放标签、24 周前瞻性干预研究中，44 名未经治疗的非纤维化非酒精性脂肪性肝病患者接受营养咨询以增加对 MedDiet 的依从性。采用 MedDietScore 评估 MedDiet 的依从性。此外，我们还对 STAT3 rs2293152 单核苷酸多态性进行了基因分型，并进行了临床和炎症测量。在所有患者中，MedDietScore 增加，体重指数改善，而肝脏成像、肝纤维化评分、血压、空腹血糖、糖化血红蛋白（HbA1c）、C 反应蛋白（CRP）、内脏脂肪素和氧化型低密度脂蛋白水平与基线相比也显著改善（ < .05）。未发现 STAT3 多态性与饮食成分之间存在关联。在试验终点时，G-和 C-携带者的均值差异比较显示，只有内脏脂肪素与 STAT3 基因型显著相关（-0.0 ± 4.6 对-4.2 ± 3.9， = .04）。携带 G-等位基因与内脏脂肪素水平升高相关（3.4 ± 1.5 ng/mL， = .028）。我们的研究结果表明，地中海饮食可改善非酒精性脂肪性肝病患者的临床、生化和炎症生物标志物。与基线相比，干预结束时，STAT3 rs2293152 G-携带者的变化更有益。首次显示内脏脂肪素水平与 STAT3 基因型之间存在关联。
