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饮食诱导的体重减轻对非酒精性脂肪肝患者红细胞膜 ω-3 脂肪酸和肝脏状态的影响:肥胖相关性脂肪肝研究。

Effects of a 6-month dietary-induced weight loss on erythrocyte membrane omega-3 fatty acids and hepatic status of subjects with nonalcoholic fatty liver disease: The Fatty Liver in Obesity study.

机构信息

Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, Pamplona, Spain.

Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, Pamplona, Spain; Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain.

出版信息

J Clin Lipidol. 2020 Nov-Dec;14(6):837-849.e2. doi: 10.1016/j.jacl.2020.08.007. Epub 2020 Aug 27.

Abstract

BACKGROUND

Omega-3 polyunsaturated fatty acids (PUFAs) have been suggested as important biomolecules in the management of nonalcoholic fatty liver disease (NAFLD).

OBJECTIVE

This study aimed to evaluate the effect of 6-month weight loss diets on erythrocyte membrane omega-3 PUFA composition of NAFLD adults, and to evaluate the potential relationship between erythrocyte membrane omega-3 PUFAs and hepatic health markers.

METHODS

In this secondary analysis of the Fatty Liver in Obesity study, erythrocyte membranes were analyzed by gas chromatography in 54 subjects with liver steatosis detected by ultrasonography who achieved a weight loss >5% after the follow-up. Baseline and 6-month evaluation included hepatic acoustic radiation force impulse elastography and magnetic resonance imaging, anthropometry, body composition, and biochemical determinations.

RESULTS

After the follow-up, α-linolenic acid (ALA) proportion significantly increased in erythrocyte membranes, whereas eicosapentaenoic acid (EPA) showed no statistical difference and docosapentaenoic acid decreased. Both the changes in erythrocyte membrane ALA and EPA were positively associated with dietary ALA. Regression analyses evidenced that the changes in erythrocyte membrane ALA and EPA were inversely associated with the changes in liver stiffness and liver iron content, respectively.

CONCLUSION

The adherence to weight loss strategies for 6 months led to changes in erythrocyte membrane omega-3 PUFA composition, which in turn were associated with changes in hepatic markers, suggesting that these fatty acids accompany the improvements in the liver during a dietary treatment. These findings show that beyond weight loss, the composition of the diet has an important role in the management of NAFLD.

摘要

背景

ω-3 多不饱和脂肪酸(PUFAs)已被认为是治疗非酒精性脂肪性肝病(NAFLD)的重要生物分子。

目的

本研究旨在评估 6 个月减肥饮食对 NAFLD 成人红细胞膜 ω-3 PUFA 组成的影响,并评估红细胞膜 ω-3 PUFAs 与肝健康标志物之间的潜在关系。

方法

在肥胖相关性脂肪肝研究的二次分析中,通过气相色谱法分析了 54 例超声检查显示肝脂肪变性的患者的红细胞膜,这些患者在随访后体重减轻了>5%。基线和 6 个月的评估包括肝脏声辐射力脉冲弹性成像和磁共振成像、人体测量学、身体成分和生化测定。

结果

随访后,红细胞膜中 α-亚麻酸(ALA)的比例显著增加,而二十碳五烯酸(EPA)则没有统计学差异,二十二碳五烯酸(DPA)减少。红细胞膜 ALA 和 EPA 的变化均与饮食 ALA 呈正相关。回归分析表明,红细胞膜 ALA 和 EPA 的变化与肝硬度和肝铁含量的变化呈负相关。

结论

坚持 6 个月的减肥策略会导致红细胞膜 ω-3 PUFA 组成发生变化,而这反过来又与肝标志物的变化相关,提示这些脂肪酸伴随着饮食治疗中肝脏的改善。这些发现表明,除了减肥,饮食的组成在 NAFLD 的治疗中起着重要的作用。

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