富含水果的饮食对非酒精性脂肪性肝病患者肝脏生物标志物、胰岛素抵抗和血脂谱的影响：一项随机临床试验。

The effect of a fruit-rich diet on liver biomarkers, insulin resistance, and lipid profile in patients with non-alcoholic fatty liver disease: a randomized clinical trial.

作者信息

Alami Farkhondeh, Alizadeh Mohammad, Shateri Kamran

机构信息

Student Research Committee, Department of Nutrition, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran.

Food and Beverages Safety Research Center, Department of Nutrition, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran.

出版信息

Scand J Gastroenterol. 2022 Oct;57(10):1238-1249. doi: 10.1080/00365521.2022.2071109. Epub 2022 Jun 16.

DOI:10.1080/00365521.2022.2071109

PMID:35710164

Abstract

BACKGROUND

Despite confirmed dietary approaches to improve the Non-Alcoholic Fatty Liver Disease (NAFLD), the effect of fruits on NAFLD is not clear. The present study aimed to investigate the effect of a fruit rich diet (FRD) on liver steatosis, liver enzymes, Insulin resistance, and lipid profile in patients with NAFLD.

METHODS

Eighty adults with NAFLD participated in this randomized controlled trial. The participants were randomly assigned to the FRD group with consumption of at least 4 servings of fruits daily or the control group with fruits consumption of less than 2 servings/day. The grade of steatosis, serum levels of liver enzymes including alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and gamma-glutamyl transferase (GGT), total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), glucose, and homeostatic model assessment for insulin resistance (HOMA-IR) were measured at the baseline and at the end of the study.

RESULTS

After 6 months of intervention, the FRD group had significantly higher BMI (31.40 ± 2.61 vs. 25.68 ± 2.54, < .001), WC (113.5 ± 10.7 vs. 100.5 ± 7.5, < .001), the grade of steatosis, ALT (89.1 ± 92.9 vs. 32.0 ± 19.2, < .001), AST (74.5 ± 107.8 vs. 24.0 ± 8.5, < .001), ALP (273.4 ± 128.5 vs. 155.0 ± 43.9, < .001), GGT (92.7 ± 16.2 vs. 21.2 ± 7.7, < .001), TC (206.1 ± 40.5 vs. 172.7 ± 42.4, < .01), LDL (126.9 ± 32.3 vs. 99.8 ± 29.8, < .001), glucose (115.5 ± 30.0 vs. 97.7 ± 19.0, < .01), and insulin resistance (7.36 ± 4.37 vs. 2.66 ± 1.27, < .001), and lower HDL (41.4 ± 8.9 vs. 53.8 ± 15.1, < .001) compared to the control group. Adjusting for BMI and calorie intake did not change the results.

CONCLUSION

The results of the present study indicated that consumption of fruits more than 4 servings/day exacerbates steatosis, dyslipidemia, and glycemic control in NAFLD patients. Further studies are needed to identify the underlying mechanisms of the effects of fruits on NAFLD.

CLINICAL TRIAL REGISTRATION

This trial was registered at Iranian randomized clinical trial website with IRCT registration no. IRCT20201010048982N1on October 15, 2020.

摘要

背景

尽管已有经证实的饮食方法可改善非酒精性脂肪性肝病（NAFLD），但水果对NAFLD的影响尚不清楚。本研究旨在调查富含水果的饮食（FRD）对NAFLD患者肝脏脂肪变性、肝酶、胰岛素抵抗和血脂谱的影响。

方法

80名患有NAFLD的成年人参与了这项随机对照试验。参与者被随机分配到FRD组，每天食用至少4份水果，或对照组，每天水果摄入量少于2份。在基线和研究结束时测量脂肪变性程度、肝酶血清水平，包括丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、碱性磷酸酶（ALP）和γ-谷氨酰转移酶（GGT）、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白（LDL）、高密度脂蛋白（HDL）、葡萄糖以及胰岛素抵抗的稳态模型评估（HOMA-IR）。

结果

经过6个月的干预，与对照组相比，FRD组的体重指数（BMI）显著更高（31.40±2.61 vs. 25.68±2.54，P<0.001）、腰围（WC）更大（113.5±10.7 vs. 100.5±7.5，P<0.001）、脂肪变性程度、ALT（89.1±92.9 vs. 32.0±19.2，P<0.001）、AST（74.5±107.8 vs. 24.0±8.5，P<0.001）、ALP（273.4±128.5 vs. 155.0±43.9，P<0.001）、GGT（92.7±16.2 vs. 21.2±7.7，P<0.001）、TC（206.1±40.5 vs. 172.7±42.4，P<0.01）、LDL（126.9±32.3 vs. 99.8±29.8，P<0.001）、葡萄糖（115.5±30.0 vs. 97.7±19.0，P<0.01）和胰岛素抵抗（7.36±4.37 vs. 2.66±1.27，P<0.001）更高，而HDL更低（41.4±8.9 vs. 53.8±15.1，P<0.001）。对BMI和卡路里摄入量进行校正后，结果未改变。