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[新开发的特殊医学用途食品在非酒精性脂肪性肝炎患者饮食中的疗效]

[Efficacy of newly developed food for special dietary use in the diet of patients with non-alcoholic steatohepatitis].

作者信息

Sasunova A N, Morozov S V, Sobolev R V, Isakov V A, Kochetkova A A, Vorobyeva I S

机构信息

Federal Research Centre of Nutrition, Biotechnology and Foоd Safety, 109240, Moscow, Russian Federation.

出版信息

Vopr Pitan. 2022;91(2):31-42. doi: 10.33029/0042-8833-2022-91-2-31-42. Epub 2022 Mar 14.

Abstract

Although diet plays a leading role in treatment of non-alcoholic fatty disease (and, in particular, non-alcoholic steatohepatitis), specialized foods for the treatment of these patients have not yet been developed. of the study was to assess efficacy of the food for special dietary use (FSDU) in patients with non-alcoholic steatohepatitis. . New FSDU contained (% of the RDAs): protein - 8%; fat - 7% (including ω-3 PUFA - 40%); soluble dietary fiber - 180%; phospholipids - 25%; alpha-lipoic acid - 33%; betaine - 10%; 12 mineral substances - 13-44%; 13 vitamins - 24-140%. The study (NCT04308980) was approved by local ethics committee and enrolled patients with diagnosis of NASH. Subjects were randomized to the following groups: those received iso-calorie diet (according to resting energy expenditures, by indirect calorimetry) alone (ICD) and iso-calorie diet + FSDU (2 portions per day, 14 days) (ICD + FSDU group). Safety was assessed based on clinical and laboratory data. Repeated measurements (baseline vs those on the 15th day of the study) of body composition assessed by bioelectrical impedance analysis, and blood chemistry were compared. . The results of complex examination of 20 subjects (12 in ICD + FSDU and 8 in ICD group) served as a source for the study. Initially, groups did not differ by age, sex, and body mass index (BMI). The product was well tolerated. In contrast to ICD group, those in ICD + FSDU group demonstrated greater decrease of weight: BMI initially (BMI0) (M±σ): 38.7±5.4 kg/m vs BMI at the end-point (BMI) 36.7±5.1 kg/m, p=0.003 in ICD + FSDU group, whereas in the ICD group BMI0=38.9±7.2 vs BMI=38.9±7.3 kg/m, p=0.08. These results were reached predominantly by a decrease of fat mass: body fat weight (BFW) 50.2±10.7 vs BFW=48.5±10.8 kg, p=0.002 in ICD + FSDU group, whereas BFW=48.9±11.4 vs BFW=47.8±11.6 kg, p=0.07 in ICD group. The activity of alanine and aspartate aminotransferase, gamma-glutamil transpeptidase and alkaline phosphatase decreased in ICD + FSDU group (р=<0.05), whereas in ICD group the difference between initial and control assessment was not significant (р=<0.10). . The new FSDU is well tolerated by patients with NASH. In combination with iso-calorie diet, it may increase efficacy of weight loss, predominantly by fat.

摘要

尽管饮食在非酒精性脂肪性疾病(尤其是非酒精性脂肪性肝炎)的治疗中起着主导作用,但尚未开发出用于治疗这些患者的特殊食品。本研究的目的是评估特殊膳食用途食品(FSDU)对非酒精性脂肪性肝炎患者的疗效。新型FSDU包含(占每日推荐摄入量的百分比):蛋白质-8%;脂肪-7%(包括ω-3多不饱和脂肪酸-40%);可溶性膳食纤维-180%;磷脂-25%;α-硫辛酸-33%;甜菜碱-10%;12种矿物质-13%-44%;13种维生素-24%-140%。该研究(NCT04308980)获得当地伦理委员会批准,纳入了诊断为非酒精性脂肪性肝炎的患者。受试者被随机分为以下几组:仅接受等热量饮食(根据静息能量消耗,通过间接测热法)的组(ICD)和等热量饮食+FSDU(每天2份,共14天)的组(ICD+FSDU组)。根据临床和实验室数据评估安全性。比较通过生物电阻抗分析评估的身体成分以及血液生化指标在研究基线与第15天的重复测量结果。20名受试者(ICD+FSDU组12名,ICD组8名)的综合检查结果作为本研究的数据源。最初,两组在年龄、性别和体重指数(BMI)方面无差异。该产品耐受性良好。与ICD组相比,ICD+FSDU组的体重下降幅度更大:ICD+FSDU组初始BMI(BMI0)(均值±标准差):38.7±5.4kg/m²,终点时BMI为36.7±5.1kg/m²,p=0.003,而ICD组BMI0=38.9±7.2 vs BMI=38.9±7.3kg/m²,p=0.08。这些结果主要是由于脂肪量的减少:ICD+FSDU组体脂肪重量(BFW)50.2±10.7 vs BFW=48.5±10.8kg,p=0.002,而ICD组BFW=48.9±11.4 vs BFW=47.8±11.6kg,p=0.07。ICD+FSDU组丙氨酸和天冬氨酸转氨酶、γ-谷氨酰转肽酶和碱性磷酸酶的活性降低(p<0.05),而ICD组初始评估与对照评估之间的差异不显著(p<0.10)。新型FSDU在非酒精性脂肪性肝炎患者中耐受性良好。与等热量饮食相结合,它可能提高减肥效果,主要是减少脂肪。

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