Department of Gastroenterology and Hepatology, The Third Central Hospital of Tianjin, Tianjin, China;Tianjin Institute of Hepatobiliary Disease, Tianjin, China;Artificial Cell Engineering Technology Research Center, Tianjin, China;The Third Central Clinical College of Tianjin Medical University, Tianjin, China.
The Third Central Clinical College of Tianjin Medical University, Tianjin, China;Nutritional Department, The Third Central Hospital of Tianjin, Tianjin, China.
Turk J Gastroenterol. 2021 Feb;32(2):116-122. doi: 10.5152/tjg.2021.20908.
The high prevalence and incidence of non-alcoholic fatty liver disease (NAFLD) have become a global medical concern. Compared with obesity, metabolic abnormalities may be more critical. Currently, there is lack of relevant data for nutritional status and energy metabolic characteristics in patients with obese and lean NAFLD.
All the enrolled NAFLD patients were divided into 2 groups: the obese group (205 patients with body mass index (BMI) ≥ 25 kg/m2) and the lean group (73 patients with BMI < 25 kg/m2). Using a body composition analyzer, we analyzed their nutritional status including skeletal muscle, body fat, protein content, and visceral fat area (VFA). Energy metabolic characteristics including resting energy expenditure (REE), respiratory quotient, and oxidation rate of 3 major nutrients (carbohydrate, CHO%, fat, FAT%, and protein, PRO%) were analyzed by metabolic cart.
The lean NAFLD patients' LDL-c and UA even increased significantly than the obese patients (P = .001 and .006, respectively). Compared with the control group, VFA and REE were significantly higher in the lean NAFLD group (P = .008, P < .001 respectively). CHO%, FAT%, and PRO% in the lean NAFLD group were 29.31 ± 7.07%, 55.59 ± 12.09%, and 15.10 ± 4.07%, respectively, and there was no significant difference compared to the control. However, compared to the obese NAFLD group, their CHO% increased, whereas FAT% decreased (both P < .001).
NAFLD patients suffer from nutritional imbalances and energy metabolic abnormalities, regardless of whether they are associated with obesity. LDL, UA, VFA, and REE can be used as good evaluation indicators.
非酒精性脂肪性肝病（NAFLD）的高患病率和发病率已成为全球关注的医学问题。与肥胖相比，代谢异常可能更为关键。目前，尚缺乏肥胖和非肥胖 NAFLD 患者营养状况和能量代谢特征的相关数据。
所有入组的 NAFLD 患者分为两组：肥胖组（205 例 BMI≥25kg/m2）和非肥胖组（73 例 BMI<25kg/m2）。采用人体成分分析仪分析其骨骼肌、体脂、蛋白质含量和内脏脂肪面积（VFA）等营养状况。采用代谢车分析静息能量消耗（REE）、呼吸商和三大营养素（碳水化合物，CHO%；脂肪，FAT%；蛋白质，PRO%）氧化率的能量代谢特征。
与肥胖组相比，非肥胖 NAFLD 患者的 LDL-c 和 UA 甚至更高（P=0.001 和 P=0.006）。与对照组相比，非肥胖 NAFLD 组的 VFA 和 REE 明显更高（P=0.008，P<0.001）。非肥胖 NAFLD 组的 CHO%、FAT%和 PRO%分别为 29.31±7.07%、55.59±12.09%和 15.10±4.07%，与对照组无显著差异。然而，与肥胖 NAFLD 组相比，CHO%升高，FAT%降低（均 P<0.001）。
NAFLD 患者存在营养失衡和能量代谢异常，无论是否伴有肥胖。LDL、UA、VFA 和 REE 可作为较好的评价指标。
