Department of Gastroenterology, The First Affiliated Hospital, Jinan University, Guangzhou, China.
Department of Gastroenterology, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China.
Am J Gastroenterol. 2022 Oct 1;117(10):1621-1631. doi: 10.14309/ajg.0000000000001885. Epub 2022 Jun 17.
We aimed to assess the effects of 2 isoenergetic intervention diets (a freshwater fish-based diet [F group] or freshwater fish-based and red meat-based diets alternately [F/M group]) on liver steatosis and their relationship with intestinal flora in patients with nonalcoholic fatty liver disease (NAFLD).
In this open-label, 84-day randomized controlled trial, 34 NAFLD patients with hepatic steatosis ≥10% were randomly assigned to the F group or F/M group in a 1:1 ratio using a computer-generated random number allocation by a researcher not involved in the study. Liver fat content and gut microbiota and its metabolites were measured.
At the end of intervention, the absolute reduction of hepatic steatosis was significantly greater in the F group than in the F/M group (-4.89% vs -1.83%, P = 0.032). Of the 16 secondary clinical outcomes, the improvement in 7 in the F group was greater compared with the F/M group, including alanine aminotransferase and gamma-glutamyl transferase. Furthermore, dietary freshwater fish and red meat consumption alternately did not exacerbate NAFLD. Moreover, changes in the enrichment of Faecalibacterium, short-chain fatty acids, and unconjugated bile acids and the depletion of Prevotella 9 and conjugated bile acids in the F group were significantly greater compared with the F/M group.
Higher intake of freshwater fish may be beneficial to NAFLD by regulating gut microbiota and its metabolites, whereas intake of a similar total of animal protein and fat from the alternating freshwater fish and red meat may not be harmful for NAFLD in the dietary management of patients with NAFLD.
本研究旨在评估两种等能量干预饮食（以淡水鱼为主的饮食[F 组]或淡水鱼和红肉交替的饮食[F/M 组]）对非酒精性脂肪性肝病（NAFLD）患者肝脂肪变性的影响及其与肠道菌群的关系。
这是一项开放标签、84 天随机对照试验，34 名肝脂肪变性≥10%的 NAFLD 患者按 1:1 的比例随机分配到 F 组或 F/M 组，采用计算机生成的随机数分配，由不参与研究的研究人员进行。测量肝脏脂肪含量和肠道菌群及其代谢物。
干预结束时，F 组肝脂肪变性的绝对减少量明显大于 F/M 组（-4.89%比-1.83%，P=0.032）。在 16 项次要临床终点中，F 组有 7 项改善情况优于 F/M 组，包括丙氨酸氨基转移酶和γ-谷氨酰转移酶。此外，交替食用淡水鱼和红肉并不会加重 NAFLD。此外，F 组中 Faecalibacterium、短链脂肪酸和非结合胆汁酸的富集变化以及 Prevotella 9 和结合胆汁酸的消耗变化明显大于 F/M 组。
更高的淡水鱼摄入量可能通过调节肠道菌群及其代谢物对 NAFLD 有益，而交替摄入等量的动物蛋白质和脂肪对 NAFLD 患者的饮食管理中的 NAFLD 可能没有危害。
