Department of Medicine, Division of Gastroenterology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
Department of Medicine, Division of Clinical Nutrition, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
Nutrients. 2021 Dec 11;13(12):4438. doi: 10.3390/nu13124438.
Dietary modification is essential for treating nonalcoholic fatty liver disease (NAFLD); however, the dietary components are less well defined. We enrolled 252 adults with no history of liver disease and excessive alcohol use to evaluate the relationship between macronutrients and NAFLD and insulin resistance. Participants took photographs of their meals and documented their food intake in a food diary for seven consecutive days. A dietitian estimated the type and portion size of food items and analyzed nutrients with INMUCAL-Nutrients software. Later, participants underwent transient elastography to diagnose NAFLD and blood tests to measure insulin resistance using the homeostasis model. Total energy intake and the proportion of carbohydrate, fat, and protein consumption did not differ between participants with NAFLD ( = 41) and those without NAFLD ( = 211). Using multiple logistic regression analysis, daily intake of protein < 1.0 g/kg (OR: 3.66, 95% CI: 1.41-9.52) and full-fat dairy product ≥ 50 g (OR: 0.42, 95% CI: 0.18-0.99) were associated with NAFLD. Insulin resistance was associated with a daily intake of protein < 1.0 g/kg (OR: 3.09, 95% CI: 1.59-6.05), full-fat dairy product ≥ 50 g (OR: 0.46, 95% CI: 0.25-0.82), and dietary fiber ≥ 8 g (OR: 0.41, 95% CI: 0.22-0.74). Our data show that a low protein intake increases the odds for NAFLD and insulin resistance. Contrarily, a high intake of full-fat dairy products and dietary fiber has been associated with a potential protective effect against NAFLD and insulin resistance.
饮食调整对于治疗非酒精性脂肪性肝病（NAFLD）至关重要；然而，饮食成分的定义还不太明确。我们招募了 252 名没有肝脏疾病和过量饮酒史的成年人，以评估宏量营养素与 NAFLD 和胰岛素抵抗之间的关系。参与者拍摄了他们的膳食照片，并在连续 7 天的饮食日记中记录了他们的食物摄入量。营养师根据食物照片估计食物的种类和份量，并使用 INMUCAL-Nutrients 软件分析营养素。随后，参与者接受了瞬态弹性成像检查以诊断 NAFLD，并进行了血液检查以使用稳态模型评估胰岛素抵抗。患有 NAFLD 的参与者（n=41）和没有 NAFLD 的参与者（n=211）之间的总能量摄入以及碳水化合物、脂肪和蛋白质的摄入量比例没有差异。使用多因素逻辑回归分析，发现每日蛋白质摄入量<1.0 g/kg（OR：3.66，95%CI：1.41-9.52）和全脂乳制品摄入量≥50 g（OR：0.42，95%CI：0.18-0.99）与 NAFLD 相关。胰岛素抵抗与每日蛋白质摄入量<1.0 g/kg（OR：3.09，95%CI：1.59-6.05）、全脂乳制品摄入量≥50 g（OR：0.46，95%CI：0.25-0.82）和膳食纤维摄入量≥8 g（OR：0.41，95%CI：0.22-0.74）有关。我们的数据表明，低蛋白摄入会增加 NAFLD 和胰岛素抵抗的几率。相反，高摄入全脂乳制品和膳食纤维与 NAFLD 和胰岛素抵抗的潜在保护作用有关。
