Unit of Geriatrics and Internal Medicine, National Institute of Gastroenterology "Saverio de Bellis", IRCCS Hospital, Castellana Grotte, 70013 Bari, Italy.
Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", IRCCS Hospital, Castellana Grotte, 70013 Bari, Italy.
Nutrients. 2023 Feb 6;15(4):825. doi: 10.3390/nu15040825.
Very low-calorie ketogenic diets (VLCKD) are widely employed in successful weight-loss strategies. Herein, we evaluated the efficacy and safety of a VLCKD on non-alcoholic fatty liver disease (NAFLD) and parameters commonly associated with this condition in overweight and obese subjects who did not take any drugs. This prospective, real-life study included thirty-three participants who followed a VLCKD for 8 weeks. NAFLD was diagnosed using transient elastography (FibroScan). Data on anthropometric measurements, bioimpedance analysis, and biochemical assays were gathered both before and after the dietary intervention. BMI (kg/m) (from 33.84 ± 6.55 to 30.89 ± 6.38, < 0.01), waist circumference (cm) (from 106.67 ± 15.51 to 98.64 ± 16.21, < 0.01), and fat mass (Kg) (from 38.47 ± 12.59 to 30.98 ± 12.39, < 0.01) were significantly lower after VLCKD. CAP (db/m), the FibroScan parameter quantifying fatty liver accumulation, showed a significant reduction after VLCKD (from 266.61 ± 67.96 to 223 ± 64.19, < 0.01). After VLCKD, the fatty liver index (FLI), a benchmark of steatosis, also revealed a significant decline (from 62.82 ± 27.46 to 44.09 ± 31.24, < 0.01). Moreover, fasting blood glucose, insulin, triglycerides, total cholesterol, LDL-cholesterol, ALT, γGT, and FT3 blood concentrations, as well as insulin resistance (quantified by HOMAIR) and systolic and diastolic blood pressure levels, were significantly lower after VLCKD ( < 0.01 for all the parameters). By contrast, HDL-cholesterol, 25 (OH) vitamin D, and FT4 blood concentrations were higher after VLCKD ( < 0.01 for all parameters). The variation (δ) of CAP after VLCKD did not show a correlation with the δ of any other parameter investigated in this study. We conclude that VLCKD is a helpful approach for NAFLD independent of changes in factors commonly associated with NAFLD (obesity, fat mass, insulin resistance, lipids, and blood pressure) as well as vitamin D and thyroid hormone levels.
极低卡路里生酮饮食（VLCKD）被广泛应用于成功的减肥策略中。在此，我们评估了 VLCKD 在不服用任何药物的超重和肥胖受试者中对非酒精性脂肪肝（NAFLD）和与该病症相关的常见参数的疗效和安全性。这项前瞻性、真实世界的研究纳入了 33 名参与者，他们接受了为期 8 周的 VLCKD 治疗。使用瞬时弹性成像（FibroScan）诊断 NAFLD。在饮食干预前后均收集了人体测量学、生物阻抗分析和生化检测的数据。BMI（kg/m²）（从 33.84 ± 6.55 降至 30.89 ± 6.38， < 0.01）、腰围（cm）（从 106.67 ± 15.51 降至 98.64 ± 16.21， < 0.01）和脂肪量（kg）（从 38.47 ± 12.59 降至 30.98 ± 12.39， < 0.01）在 VLCKD 后明显降低。CAP（db/m），即定量评估脂肪肝堆积的 FibroScan 参数，在 VLCKD 后显著降低（从 266.61 ± 67.96 降至 223 ± 64.19， < 0.01）。在 VLCKD 后，脂肪性肝病指数（FLI），即评估脂肪变性的基准，也显著下降（从 62.82 ± 27.46 降至 44.09 ± 31.24， < 0.01）。此外，空腹血糖、胰岛素、甘油三酯、总胆固醇、LDL-胆固醇、ALT、γGT 和 FT3 血浓度，以及胰岛素抵抗（通过 HOMAIR 量化）和收缩压及舒张压水平在 VLCKD 后均显著降低（所有参数均为 < 0.01）。相反，HDL-胆固醇、25（OH）维生素 D 和 FT4 血浓度在 VLCKD 后升高（所有参数均为 < 0.01）。VLCKD 后 CAP 的变化（δ）与本研究中调查的任何其他参数的变化均无相关性。我们得出结论，VLCKD 是一种有助于治疗非酒精性脂肪肝的方法，与非酒精性脂肪肝常见相关因素（肥胖、脂肪量、胰岛素抵抗、血脂和血压）以及维生素 D 和甲状腺激素水平的变化无关。
