Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of California San Diego.
Department of Gastroenterology, Rady Children's Hospital San Diego, San Diego.
J Pediatr Gastroenterol Nutr. 2021 Apr 1;72(4):e90-e96. doi: 10.1097/MPG.0000000000003040.
We sought to evaluate the relevance of pediatric dairy fat recommendations for children at risk for nonalcoholic fatty liver disease (NAFLD) by studying the association between dairy fat intake and the amount of liver fat. The effects of dairy fat may be mediated by odd chain fatty acids (OCFA), such as pentadecanoic acid (C15:0), and monomethyl branched chain fatty acids (BCFA), such as iso-heptadecanoic acid (iso-C17:0). Therefore, we also evaluated the association between plasma levels of OCFA and BCFA with the amount of liver fat.
Observational, cross-sectional, community-based sample of 237 children ages 8 to 17. Dairy fat intake was assessed by 3 24-hour dietary recalls. Plasma fatty acids were measured by gas chromatography-mass spectrometry. Main outcome was hepatic steatosis measured by whole liver magnetic resonance imaging proton density fat fraction (MRI-PDFF).
Median dairy fat intake was 10.6 grams/day (range 0.0--44.5 g/day). Median liver MRI-PDFF was 4.5% (range 0.9%-45.1%). Dairy fat intake was inversely correlated with liver MRI-PDFF (r = -0.162; P = .012). In multivariable log linear regression, plasma C15:0 and iso-C17:0 were inverse predictors of liver MRI-PDFF (B = -0.247, P = 0.048; and B = -0.234, P = 0.009).
Dairy fat intake, plasma C15:0, and plasma iso-C17:0 were inversely correlated with hepatic steatosis in children. These hypothesis-generating findings should be tested through clinical trials to better inform dietary guidelines.
通过研究乳脂摄入量与肝脏脂肪量之间的关系，评估小儿乳脂推荐量对非酒精性脂肪肝（NAFLD）高危儿童的相关性。乳脂的作用可能通过奇数链脂肪酸（OCFA），如十五烷酸（C15:0）和单甲基支链脂肪酸（BCFA），如异十七烷酸（iso-C17:0）来介导。因此，我们还评估了血浆 OCFA 和 BCFA 水平与肝脏脂肪量之间的关系。
这是一项观察性、横断面、基于社区的 237 名 8 至 17 岁儿童的样本研究。通过 3 次 24 小时膳食回忆来评估乳脂摄入量。通过气相色谱-质谱法测量血浆脂肪酸。主要结果是通过全肝磁共振成像质子密度脂肪分数（MRI-PDFF）测量的肝脂肪变性。
中位数乳脂摄入量为 10.6 克/天（范围 0.0-44.5 克/天）。中位数肝脏 MRI-PDFF 为 4.5%（范围 0.9%-45.1%）。乳脂摄入量与肝脏 MRI-PDFF 呈负相关（r=-0.162；P=0.012）。在多变量对数线性回归中，血浆 C15:0 和 iso-C17:0 是肝脏 MRI-PDFF 的逆预测因子（B=-0.247，P=0.048；B=-0.234，P=0.009）。
儿童乳脂摄入量、血浆 C15:0 和 iso-C17:0 与肝脂肪变性呈负相关。这些产生假说的发现应通过临床试验进行检验，以更好地为饮食指南提供信息。
