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营养在一组肥胖成年人非酒精性脂肪性肝病(NAFLD)的病因发病机制和预防中的作用。

Role of Nutrition in the Etiopathogenesis and Prevention of Nonalcoholic Fatty Liver Disease (NAFLD) in a Group of Obese Adults.

机构信息

Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98122 Messina, Italy.

Department Oncological D.A.I., UOC of General Surgery-Oncology, 98125 Messina, Italy.

出版信息

Medicina (Kaunas). 2023 Mar 22;59(3):638. doi: 10.3390/medicina59030638.

Abstract

Nonalcoholic fatty liver disease (NAFLD) is liver damage characterized by an accumulation of triglycerides in hepatocytes of >5% (due to an alteration of the balance of the lipid metabolism in favour of lipogenesis compared to lipolysis) that is not induced by the consumption of alcohol. The pathology includes simple steatosis and nonalcoholic steatohepatitis, or NASH (steatosis associated with microinflammatory activities), which can evolve in 15% of subjects with hepatic fibrosis to cirrhosis and the development of hepatocellular carcinoma. The aim of this study is to report the role of macro- and micronutrients in the pathogenesis and prevention of NAFLD in obese subjects. A total of 22 obese or overweight patients with hepatic steatosis were monitored periodically, evaluating their eating habits, fasting glycaemia, lipid picture, liver enzymes, anthropometric parameters, nutrition status, liver ultrasound, oxidative stress, and adherence to the Mediterranean diet. A statistical analysis shows a significant positive relationship between total cholesterol and the Mediterranean adequacy index (MAI) (r = -0.57; = 0.005) and a significant negative relationship between ALT transaminases and the MAI (r = -0.56; = 0.007). Nutrition and diet are important factors in the pathogenesis and prevention of NAFLD. The dietary model, based on the canons of the Mediterranean diet, prevents and reduces the accumulation of fat in hepatocytes. Therefore, in agreement with other studies in the literature, we can state that a dietary model characterized by foods rich in fibre, carotenoids, polyphenols, ω3 fatty acids, folic acid, and numerous other molecules is inversely correlated with the serum levels of ALT transaminases, an enzyme whose level increases when the liver is damaged and before the most obvious symptoms of organ damage appear.

摘要

非酒精性脂肪性肝病(NAFLD)是一种以肝细胞中甘油三酯积聚超过 5%为特征的肝损伤(由于脂质代谢平衡向生脂作用转变,而不是向脂解作用转变),这种损伤不是由饮酒引起的。病理学包括单纯性脂肪变性和非酒精性脂肪性肝炎,或 NASH(伴有微炎症活动的脂肪变性),在 15%的有肝纤维化的患者中,这种疾病可进展为肝硬化和肝细胞癌。本研究旨在报告宏量和微量营养素在肥胖患者中 NAFLD 的发病机制和预防中的作用。共监测了 22 例有肝脂肪变性的肥胖或超重患者,定期评估他们的饮食习惯、空腹血糖、血脂谱、肝酶、人体测量参数、营养状况、肝脏超声、氧化应激和对地中海饮食的依从性。统计分析显示,总胆固醇与地中海适宜指数(MAI)呈显著正相关(r = -0.57; = 0.005),丙氨酸转氨酶与 MAI 呈显著负相关(r = -0.56; = 0.007)。营养和饮食是 NAFLD 发病机制和预防的重要因素。基于地中海饮食规范的饮食模式可以预防和减少肝细胞内脂肪的堆积。因此,与文献中的其他研究一致,我们可以说,以富含纤维、类胡萝卜素、多酚、ω3 脂肪酸、叶酸和许多其他分子的食物为特征的饮食模式与血清丙氨酸转氨酶水平呈负相关,这种酶在肝脏受损时会升高,而且在器官损伤的最明显症状出现之前就会升高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b326/10055888/a082902d4dc5/medicina-59-00638-g001.jpg

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