Department of Clinical Internal, Anaesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00161 Rome, Italy.
Division of Metabolism and Research Unit of Metabolic Biochemistry, Department of Pediatrics, IRCCS Bambino Gesù Children's Hospital, 00146 Rome, Italy.
Nutrients. 2022 Mar 12;14(6):1209. doi: 10.3390/nu14061209.
The Mediterranean diet (Med-Diet) is considered the most effective dietary patterns to obtain weight loss in NAFLD patients. Previous evidence suggested that Med-Diet adherence could reduce cardiovascular risk and have a beneficial effect on NAFLD severity. Aim of the study was to investigate the relationship between Med-Diet adherence, platelet activation (PA), and liver collagen deposition. The study was performed in 655 consecutive NAFLD outpatients from the PLINIO study, a prospective observational cohort study aimed to identify non-conventional predictors of liver fibrosis progression in NAFLD. PA was measured by the serum thromboxane B2 (TxB2), and liver collagen deposition by N-terminal propeptide of type III collagen (Pro-C3). Adherence to the Med-diet was investigated by a short nine-item validated dietary questionnaire. Patients with high Med-Diet adherence were older and had less metabolic syndrome and lower serum triglycerides, GGT, TxB2, and Pro-C3. At multivariate regression analyses, in the linear model, the Med-Diet score negatively correlated with both TxB2 (Beta = −0.106; p = 0.009) and Pro-C3 (Beta = −0.121; p = 0.002) and in the logistic model high adherence inversely correlated with higher TxB2 tertiles (II tertile: OR = 0.576, p = 0.044; III tertile: OR = 0.556, p = 0.026) and Pro-C3 tertile (III tertile: OR = 0.488, p = 0.013). Low consumption of red meat inversely correlated with higher TxB2 tertile (II tertile: OR = 0.448, p < 0.001, III tertile: OR = 0.567, p = 0.004). In conclusion, NAFLD patients with high adherence to the Med-Diet show lower PA and liver collagen deposition, suggesting a protective role of the Med-Diet against NAFLD progression and cardiovascular risk. In addition, the correlation between TxB2 and Pro-C3 suggests a link between NAFLD severity and cardiovascular risk.
地中海饮食（Med-Diet）被认为是治疗非酒精性脂肪性肝病（NAFLD）患者体重的最有效饮食模式。先前的证据表明，Med-Diet 坚持可以降低心血管风险并对 NAFLD 严重程度有有益影响。本研究旨在探讨 Med-Diet 坚持度、血小板活化（PA）和肝脏胶原沉积之间的关系。该研究在来自 PLINIO 研究的 655 例连续的 NAFLD 门诊患者中进行，该前瞻性观察性队列研究旨在确定非酒精性脂肪性肝病纤维化进展的非传统预测因子。通过血清血栓素 B2（TxB2）测量 PA，通过 III 型胶原 N 末端前肽（Pro-C3）测量肝胶原沉积。通过简短的九项验证饮食问卷研究 Med 饮食的坚持度。高 Med-Diet 坚持度的患者年龄较大，代谢综合征较少，血清甘油三酯、GGT、TxB2 和 Pro-C3 水平较低。多元回归分析中，线性模型中，Med-Diet 评分与 TxB2（Beta = -0.106；p = 0.009）和 Pro-C3（Beta = -0.121；p = 0.002）均呈负相关，而在逻辑模型中，高坚持度与更高的 TxB2 三分位数呈反比（二分位数：OR = 0.576，p = 0.044；三分位数：OR = 0.556，p = 0.026）和 Pro-C3 三分位数（三分位数：OR = 0.488，p = 0.013）。低红肉摄入与更高的 TxB2 三分位数呈反比（二分位数：OR = 0.448，p < 0.001，三分位数：OR = 0.567，p = 0.004）。总之，高 Med-Diet 坚持度的 NAFLD 患者表现出较低的 PA 和肝脏胶原沉积，表明 Med-Diet 对 NAFLD 进展和心血管风险具有保护作用。此外，TxB2 和 Pro-C3 之间的相关性表明 NAFLD 严重程度与心血管风险之间存在联系。
