Center of Investigation of Endocrinology and Nutrition, Department of Endocrinology and Investigation, Medicine School, Hospital Clinico Universitario, University of Valladolid, 47003 Valladolid, Spain.
Nutrients. 2022 Dec 16;14(24):5353. doi: 10.3390/nu14245353.
Dietary changes play a role in metabolic response of patients with metabolic-associated fatty liver disease, and there is little evidence on the use of partial meal replacement (pMR) diets in this pathology.
We decided to evaluate the modifications in transaminases levels after a pMR hypocaloric diet in subjects with obesity and elevated fatty liver index (FLI).
A sample of 606 patients with obesity and FLI ≥ 60 were enrolled and treated during 3 months with a pMR diet. Patients were divided as group I (Alanine amino transferase (ALT) normal) or group II (ALT ≥ 43 UI/L).
Body mass index, body weight, total fat mass, waist circumference, blood pressure, fasting glucose, total cholesterol, Low-density lipoprotein (LDL) cholesterol, triglycerides, insulin, Homeostasis Model assessment (HOMA-IR), and FLI index improved significantly in the total group with pMR diet, without differences between group I and II. ALT, aspartate aminotransferase activity (AST), Gama glutamine transferase (GGT), and ratios of AST/ALT improved in both groups, too. This improvement was higher in group II (deltas group I vs. deltas group II); ALT (-4.2 ± 0.9 UI/L vs. -32.1 ± 5.7 UI/L: = 0.01), AST (-4.8 ± 1.8 UI/L vs. -14.1 ± 1.9 UI/L: = 0.02), GGT (-4.8 ± 1.4 UI/L vs. -37.1 ± 4.2 UI/L: = 0.01), and AST/ALT ratio (-0.04 ± 0.002 units vs. -0.19 ± 0.04 units: = 0.01).
We reported that a pMR diet is an effective method to lose weight and to improve metabolic parameters in patients with obesity and high FLI. The decrease in liver parameters was greater in patients with ALT ≥ 43 UI/L.
饮食变化在代谢相关脂肪性肝病患者的代谢反应中起作用,而在该病理学中,部分代餐(pMR)饮食的应用证据很少。
我们决定评估肥胖和升高的脂肪肝指数(FLI)患者接受 pMR 低热量饮食后转氨酶水平的变化。
共纳入 606 例肥胖且 FLI≥60 的患者,并用 pMR 饮食治疗 3 个月。将患者分为 I 组(丙氨酸氨基转移酶(ALT)正常)或 II 组(ALT≥43UI/L)。
pMR 饮食可显著降低体重指数、体重、总脂肪量、腰围、血压、空腹血糖、总胆固醇、低密度脂蛋白(LDL)胆固醇、甘油三酯、胰岛素、稳态模型评估(HOMA-IR)和 FLI 指数,且 I 组和 II 组间无差异。两组患者的 ALT、天门冬氨酸氨基转移酶(AST)、γ-谷氨酰转移酶(GGT)和 AST/ALT 比值均有所改善。II 组改善更为显著(I 组差值与 II 组差值比较):ALT(-4.2±0.9 UI/L 与-32.1±5.7 UI/L:=0.01)、AST(-4.8±1.8 UI/L 与-14.1±1.9 UI/L:=0.02)、GGT(-4.8±1.4 UI/L 与-37.1±4.2 UI/L:=0.01)和 AST/ALT 比值(-0.04±0.002 单位与-0.19±0.04 单位:=0.01)。
我们报告称,pMR 饮食是一种有效降低肥胖和高 FLI 患者体重和改善代谢参数的方法。ALT≥43UI/L 的患者肝参数下降更为明显。