Department of Clinical Nutrition, German Institute of Human Nutrition Potsdam-Rehbrücke, Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany.
German Center for Diabetes Research (Deutsches Zentrum Für Diabetesforschung e.V.), Ingolstädter Landstraße 1, 85764, Neuherberg, Germany.
Sci Rep. 2021 Apr 23;11(1):8843. doi: 10.1038/s41598-021-87360-2.
Non-alcoholic fatty liver disease (NAFLD) is common in Metabolic Syndrome and type 2 diabetes (T2DM), driven by energy imbalance, saturated fats and simple carbohydrates. NAFLD requires screening and monitoring for late complications. Liver fat indices may predict NAFLD avoiding expensive or invasive gold-standard methods, but they are poorly validated for use in interventional settings. Recent data indicate a particular insensitivity to weight-independent liver fat reduction. We evaluated 31 T2DM patients, completing a randomized intervention study on isocaloric high-protein diets. We assessed anthropometric measures, intrahepatic lipid (IHL) content and serum liver enzymes, allowing AUROC calculations as well as cross-sectional and longitudinal Spearman correlations between the fatty liver index, the NAFLD-liver fat score, the Hepatosteatosis Index, and IHL. At baseline, all indices predicted NAFLD with moderate accuracy (AUROC 0.731-0.770), supported by correlation analyses. Diet-induced IHL changes weakly correlated with changes of waist circumference, but no other index component or the indices themselves. Liver fat indices may help to easily detect NAFLD, allowing cost-effective allocation of further diagnostics to patients at high risk. IHL reduction by weight-independent diets is not reflected by a proportional change in liver fat scores. Further research on the development of treatment-sensitive indices is required.Trial registration: The trial was registered at clinicaltrials.gov: NCT02402985.
非酒精性脂肪性肝病（NAFLD）在代谢综合征和 2 型糖尿病（T2DM）中很常见，其发病机制与能量失衡、饱和脂肪和简单碳水化合物有关。NAFLD 需要进行筛查和监测以预防晚期并发症。肝脏脂肪指数可预测 NAFLD，从而避免使用昂贵或有创的金标准方法，但这些方法在干预性环境中的验证效果较差。最近的数据表明，这些方法对与体重无关的肝脂肪减少的敏感性较差。我们评估了 31 例 T2DM 患者，他们完成了一项关于等热量高蛋白饮食的随机干预研究。我们评估了人体测量指标、肝内脂质（IHL）含量和血清肝酶，允许计算 AUROC 以及脂肪肝指数、NAFLD-肝脂肪评分、肝脂肪指数和 IHL 之间的横断面和纵向 Spearman 相关性。在基线时，所有指数均以中等准确性预测 NAFLD（AUROC 0.731-0.770），这得到了相关分析的支持。饮食诱导的 IHL 变化与腰围变化弱相关，但与其他指数成分或指数本身均不相关。通过与体重无关的饮食降低肝脂肪指数并不能反映肝脂肪评分的比例变化。需要进一步研究开发对治疗敏感的指数。试验注册：该试验在 clinicaltrials.gov 上注册：NCT02402985。
