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果糖摄入量与非酒精性脂肪性肝病(NAFLD)患者的肝纤维化风险无关。

Fructose intake is not associated to the risk of hepatic fibrosis in patients with Non-Alcoholic Fatty Liver Disease (NAFLD).

作者信息

Azevedo Vittoria Zambon, Dall'Alba Valesca

机构信息

Post-Graduation Program in Food, Nutrition and Health, School of Medicine, Universidade Federal Do Rio Grande Do Sul (UFRGS), Porto Alegre, Rio Grande do Sul (RS), Brazil.

Post-Graduation Program in Food, Nutrition and Health, School of Medicine, Universidade Federal Do Rio Grande Do Sul (UFRGS), Porto Alegre, Rio Grande do Sul (RS), Brazil; Post-Graduation Program in Sciences of Gastroenterology and Hepatology, School of Medicine, UFRGS, Porto Alegre, RS, Brazil; Nutrition and Dietetics Division, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil; Department of Nutrition, School of Medicine, UFRGS, Porto Alegre, RS, Brazil.

出版信息

Clin Nutr. 2021 Jun;40(6):4275-4283. doi: 10.1016/j.clnu.2021.01.022. Epub 2021 Jan 27.

Abstract

BACKGROUND & AIMS: Non-Alcoholic Fatty Liver Disease (NAFLD) has been linked to fructose intake (FI). The aim of this study was to evaluate whether the dietary FI from different food sources (added/industrial processing and natural/intrinsic to food) is associated with NAFLD and risk of hepatic fibrosis (HF).

METHODS

Cross-sectional study with 128 patients with NAFLD underwent clinical, functional, laboratory, nutritional and dietary intake by 3-day-diet-record evaluation. The proportions (in grams/milliliters) of foods and beverages in the diet for each subject was computed from the database NUTTAB and classified by their processing level according to the NOVA classification to identify the source of fructose.

RESULTS

The mean age was 54.0 ± 11.9 years; 72.7% were women, and BMI 32.6 ± 5.4 kg/m. Total fructose (TF) intake was 21.6 g, natural fructose (NF) 14.8 g and added fructose (AF) 6.8 g. TF, NF, and AF intakes not differ in patients with steatosis, steatohepatitis and cirrhosis (p-values 0.140; 0.101; 0.739, respectively), and not justify HF according NAFLD score, in view of the low correlation power found (r 0.009; 0.040; 0.051) respectively for TF, NF and AF. Patients presented elevated cardiometabolic risk due to the prevalence of 78.0% intermediate/high risk of HF; 96.8% over waist-to-height ratio (WHtR), 79.7% of metabolic syndrome (MetS), 65.6% low hand grip strength (HGS), and 70.3% had sarcopenic obesity.

CONCLUSIONS

Patients had low FI compared to the amounts presented in other occidental countries and studies. No association was found between FI and NAFLD or risk of HF.

摘要

背景与目的

非酒精性脂肪性肝病(NAFLD)与果糖摄入量(FI)有关。本研究的目的是评估不同食物来源(添加/工业加工的以及食物天然/内在含有的)的膳食FI是否与NAFLD及肝纤维化(HF)风险相关。

方法

对128例NAFLD患者进行横断面研究,通过3天饮食记录评估其临床、功能、实验室、营养和膳食摄入情况。根据数据库NUTTAB计算每个受试者饮食中食物和饮料的比例(以克/毫升计),并根据NOVA分类按其加工水平进行分类,以确定果糖来源。

结果

平均年龄为54.0±11.9岁;72.7%为女性,体重指数为32.6±5.4kg/m。总果糖(TF)摄入量为21.6克,天然果糖(NF)为14.8克,添加果糖(AF)为6.8克。脂肪变性、脂肪性肝炎和肝硬化患者的TF、NF和AF摄入量无差异(p值分别为0.140、0.101、0.739),且根据NAFLD评分,鉴于分别发现TF、NF和AF的低相关强度(r分别为0.009、0.040、0.051),HF无依据。由于78.0%的患者存在HF中/高风险、96.8%的患者超过腰高比(WHtR)、79.7%的患者患有代谢综合征(MetS)、65.6%的患者握力低(HGS)以及70.3%的患者患有肌少症肥胖,患者呈现出升高的心脏代谢风险。

结论

与其他西方国家和研究中的摄入量相比,患者的FI较低。未发现FI与NAFLD或HF风险之间存在关联。

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