Relationship between Dietary Macronutrient Composition and Nonalcoholic Fatty Liver Disease in Lean and Non-Lean Populations: A Cross-Sectional Study

2021 ◽  
pp. 1-31
Author(s):  
Bahareh Amirkalali ◽  
Mahmood Reza Khansari ◽  
Masoud Reza Sohrabi ◽  
Hossein Ajdarkosh ◽  
Nima Motamed ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Fatty Liver Disease ◽  
Saturated Fatty Acids ◽  
Animal Protein ◽  
Cross Sectional ◽  
Nonalcoholic Fatty Liver ◽  
Lean Nafld

Abstract Objective: This study aimed to customize dietary changes for lean patients with nonalcoholic fatty liver disease (NAFLD). Design: This study was done with a population-based cross-sectional design. The Food Frequency Questionnaire (FFQ) was used to analyze dietary macronutrient intake and ultrasonography results for NAFLD diagnosis. The study subjects were divided into the lean and non-lean groups based on their body mass index (< 25 and ≥ 25). Multivariable logistic regression was used to evaluate the relationship between dietary macronutrients and NAFLD. Substitution analyses were also performed. Setting: Amol and its suburban areas in Iran. Participants: Adults in the age range of 18 to <65 with full relevant data. Results: Among the total study subjects (2308), 46.7% had fatty liver. The substitution of polysaccharides for animal protein and saturated fatty acids (SFA) in the lean group resulted in a significant NAFLD reduction; whereas, the substitution of SFA for all types of macronutrients, except for w-6 and mono-disaccharides, led to a significant increase in NAFLD (p<0.05). In non-lean participants, the substitution of monounsaturated fatty acids (MUFA) for mono-disaccharides resulted in a significant reduction of NAFLD (p<0.05). In this group, the substitution of SFA and mono-disaccharides for MUFA, and w-6 for all macronutrients, except vegetable protein and SFA, were significantly related to an increase in NAFLD (p<0.05). Conclusions: Lower lean NAFLD is correlated with increasing polysaccharides in exchange for SFA and animal protein intake; whereas, lower non-lean NAFLD is correlated with increasing MUFA in exchange for mono-disaccharides and reducing w-6 and SFA.

scholarly journals Diet-Dependent Acid Load—The Missing Link Between an Animal Protein–Rich Diet and Nonalcoholic Fatty Liver Disease?

2019 ◽  
Vol 104 (12) ◽  
pp. 6325-6337 ◽  
Author(s):  
Louise J M Alferink ◽  
Jessica C Kiefte-de Jong ◽  
Nicole S Erler ◽  
Robert J de Knegt ◽  
Ewout J Hoorn ◽  
...  
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Fatty Liver Disease ◽  
Animal Protein ◽  
P Value ◽  
Cross Sectional ◽  
Nonalcoholic Fatty Liver ◽  
Acid Load ◽  
Protein Rich

Abstract Objective Our group recently showed that animal protein was independently associated with nonalcoholic fatty liver disease (NAFLD). We hypothesize that this may be explained by a high diet-dependent acid load [dietary acid load (DAL)]. Methods This cross-sectional study is embedded in a prospective population-based cohort. We estimated DAL proxies via food-frequency questionnaires using potential renal acid load (PRAL; using dietary protein, phosphorus, potassium, calcium, and magnesium intake), net endogenous acid production (NEAP; using protein and potassium intake), and the animal protein–to–potassium ratio (A:P). We defined NAFLD using ultrasound after excluding secondary steatogenic causes. We used logistic regression models—adjusted for sociodemographic, lifestyle, and metabolic traits—on categorized [quartile (Q)1 to 4] and continuous DAL proxies (allowing for nonlinearity) and NAFLD. Results We included 3882 participants, of which 1337 had NAFLD. All DAL proxies were higher, meaning more acidic, in individuals with NAFLD (PRAL, −2.9 vs −5.5 mEq/d; NEAP, 37.0 vs 35.1 mEq/d; and A:P, 13.3 vs 12.4; all P < 0.001). The highest Q of DAL proxies was associated with NAFLD independent of sociodemographic and lifestyle confounders, but significance dissipated after correction for metabolic confounders and multiple testing. However, the P value for nonlinearity was significant in all DAL proxies (P < 0.001). Natural cubic splines performed better with than without DAL proxies in the fully adjusted model (all P ≤ 0.038). The highest probability of NAFLD was found for an acidic diet. Conclusions This study showed an independent nonlinear association between an acidic diet and NAFLD. Further studies with acid-base biomarkers are needed, but our findings might provide a mechanistic explanation for the harmful association between an animal protein–rich diet and NAFLD.

Outcomes of Nonalcoholic Fatty Liver Disease In Covid Positive Diabetic Patients: Cross Sectional Study

2021 ◽  
Vol 15 (12) ◽  
pp. 3241-3243
Author(s):  
Azhar Hussain ◽  
Mehwish Iftikhar ◽  
Amna Rizvi ◽  
Muhammad Latif ◽  
Muhammad Javed Ahmed ◽  
...  
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Fatty Liver Disease ◽  
Statistical Significance ◽  
Cross Sectional Study ◽  
Diabetic Patients ◽  
Sectional Study ◽  
Cross Sectional ◽  
Nonalcoholic Fatty Liver

Background: SARS-CoV-2 principally invades the respiratory system. ACE receptor are also abundant throughout the hepatobiliary system and their increased expression on hepatocyte make patients with NAFLD more vulnerable. Aim: To see outcomes of COVID positive diabetic patients suffering from Nonalcoholic fatty liver disease (NAFLD). Study design: Cross Sectional Study. Methodology: 150 diabetic and COVID PCR positive were recruited from COVID ward of Services Hospital in Lahore. Clinical parameters like BMI, SpO2, Hepatomegaly and lab parameters like HbA1C, AST ALT were noted in spreadsheet. Statistical analysis was done using SPSS v.25. Statistical significance for difference in proportions is calculated using Pearson’s Chi-Squared test. P less than 0.05 was considered statistically significant. Results: Around 84(56%) were males and 66(44%) females, smoked were 27(18%), mean age (years) was 59.7333 ±11.35023, mean BMI (kg/m²) was 30.1425±7.30673, 87(58%) patients had NAFLD, who experienced sever disease (53.2%; x^2=0.010) and more mortalities (60.2%;x^2=0.453) as compared to those who do not had condition. Conclusion: We concluded that NAFLD makes COVID-19 infected patients more fragile. Such patients experienced sever disease and more mortalities however need of mechanical ventilation remains almost equal between those who has NAFLD and those who didn’t had. Keywords: Nonalcoholic fatty liver disease, COVID-19, Diabetes, Mortality and Severity.

Lifestyle predictors of obese and non-obese patients with nonalcoholic fatty liver disease: A cross-sectional study

2018 ◽  
Vol 37 (5) ◽  
pp. 1550-1557 ◽  
Author(s):  
Joo Hee Kwak ◽  
Dae Won Jun ◽  
Seung Min Lee ◽  
Yong Kyun Cho ◽  
Kang Nyeong Lee ◽  
...  
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Fatty Liver Disease ◽  
Cross Sectional Study ◽  
Obese Patients ◽  
Sectional Study ◽  
Cross Sectional ◽  
Nonalcoholic Fatty Liver

scholarly journals Lean Nonalcoholic Fatty Liver Disease and Risk of Incident Diabetes in a Euglycemic Population Receiving Health Checkups: A Cohort Study

2020 ◽  
Author(s):  
Limin Wei ◽  
Xin Cheng ◽  
Yulong Luo ◽  
Rongxuan Yang ◽  
Zitong Lei ◽  
...  
Keyword(s):  
Cohort Study ◽  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Fatty Liver Disease ◽  
Incident Diabetes ◽  
Benign Condition ◽  
Nonalcoholic Fatty Liver ◽  
Increased Risk ◽  
Lean Nafld

Abstract Background: Although recent evidence suggests that nonalcoholic fatty liver disease (NAFLD) is associated with insulin resistance and an increased risk of diabetes, the association between lean NAFLD and incident diabetes is unclear. This study aimed to investigate whether lean NAFLD and overweight/obese NAFLD have similar or dissimilar effects on the risk of new-onset diabetes.Methods: A longitudinal study was performed in 14,482 euglycemic adults who participated in a health check-up program. Fatty liver was diagnosed by abdominal ultrasonography. The outcome of interest was incident diabetes.Cox proportional hazards regression models were applied to calculate HRs with 95% CIs for future diabetes risk.Results: During the median 6.0 years of follow-up, 356 cases of diabetes occurred. Despite a low probability of hepatic fibrosis indicated by the BAAT score, lean NAFLD was positively associated with an increased risk of diabetes. Moreover, after adjusting for sociodemographic and potential confounders, the fullyadjusted HRs (95% CIs) for incident diabetes between lean NAFLD and overweight/obese NAFLD to the reference (lean without NAFLD) were 2.58 (95% CI 1.68 to 3.97) and 2.52 (95% CI 1.79 to 3.55), respectively. In post hoc analysis, the HR (95% CI) for diabetes comparing lean NAFLD to obese/overweight NAFLD was 1.02 (95% CI 0.68 to 1.54, p = 0.909). The results were robust to challenges in multiple subgroup analyses and appeared to be more pronounced for female participants (p for interaction = 0.005).Conclusions: In this cohort study, lean patients with NAFLD had a risk of incident type 2 diabetes similar to that of overweight/obese ones with NAFLD. These findings suggest that lean NAFLD is not a benign condition. Further investigations are needed to gain a better understanding of the pathogenesis and natural history of NAFLD in lean subjects.

scholarly journals Gender differences in the prevalence of nonalcoholic fatty liver disease in the Northeast of Thailand: A population-based cross-sectional study

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 1630 ◽  
Author(s):  
Ueamporn Summart ◽  
Bandit Thinkhamrop ◽  
Nittaya Chamadol ◽  
Narong Khuntikeo ◽  
Metha Songthamwat ◽  
...  
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Fatty Liver Disease ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Nonalcoholic Fatty Liver ◽  
Prevalence Difference ◽  
Post Menopausal

Background. Nonalcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease. A large number of studies have strongly described larger proportions of men being afflicted with NAFLD than women; however, recent studies investigating the role of gender and NAFLD have exposed the contrary. Methods. This cross-sectional study utilized data from the baseline survey of an ongoing cohort study called the Cholangiocarcinoma Screening and Care Program (CASCAP), conducted in the northeastern region of Thailand between March 2013 and September 2015. Information regarding socio-demographic, including gender, was collected using a standardized self-administered questionnaire. NAFLD was diagnosed with ultrasonography by board-certified radiologists. A binomial regression was used for estimating the prevalence differences, odds ratios (OR) and the 95% confidence intervals (CI) of NAFLD between men and women. Results. A total of 34,709 participants (27,073 females and 7,636 males) were recruited. The prevalence of NAFLD in women was 22.9% (95% CI: 22.5 to 23.5), whereas it was only 18.3% (95% CI: 17.4 to 19.2) in men. After adjusting for age and presence of diabetes mellitus and other underlying diseases, the prevalence was significantly higher in women, with adjusted prevalence difference of 4.2% (95% CI: 3.2 to 5.2) and adjusted OR of 1.3 (95% CI: 1.2 to 1.4). Women had a higher prevalence of NAFLD than men in all age groups and the largest difference was found in those aged 56-60 years (prevalence = 27.4% versus 21.2%; adjusted prevalence difference = 9.4%; 95% CI: 7.9 to 10.9; adjusted OR = 1.8; 95% CI: 1.8 to 2.0). Conclusion. NAFLD is more likely to affect women more than men, in particular, among the population 56-60 years of age, which is the post-menopausal transitional period. Therefore, post-menopausal women should be the target for interventions or further investigation for NAFLD.

Abstract 14339: Nonalcoholic Fatty Liver Disease and the Risk of Clinical Cardiovascular Events: A Meta-Analysis

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Toufik Mahfood Haddad ◽  
Shadi Hamdeh ◽  
Mahesh Anantha Narayanan ◽  
Arun Kanmanthareddy ◽  
Venkata M Alla
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Publication Bias ◽  
Fatty Liver Disease ◽  
Cardiovascular Events ◽  
Meta Analysis ◽  
Significant Heterogeneity ◽  
Cross Sectional ◽  
Nonalcoholic Fatty Liver

Background: Numerous studies have assessed the association of Nonalcoholic fatty liver disease (NAFLD) withcardiovascular disease (CVD). However, results have been conflicting due to variability in definitionsof NAFLD and ascertainment of CVD, often combining clinical and surrogate endpoints. We therefore systematically reviewed published literature to assess the association between NAFLD and clinical cardiovascular events. Methods: We searched Medline, Cochrane, google scholar, CINAHL, and Web of Sciencedatabasesusing terms “nonalcoholic fatty liver disease”, “cardiovascular disease”, and their combinations to identify studies published through March 2015. Data from selected studies was extracted and meta-analysis was then performed using Random effects model following the PRISMA guidelines. Publication bias and heterogeneity wereassessed. The main outcome measure was Odds ratio (OR) with 95% CI. Clinical CVD was defined as symptomatic coronary artery disease, myocardial infarction, coronary or peripheral intervention, ischemic stroke, and symptomatic peripheral vascular disease. Results: A total of 7 studies with 14634 patients (NAFLD: 4204; controls: 10430) were included in the final analysis. 3 studies were cross- sectional reporting prevalence, while 4 studies were prospective cohort studies reporting incidence. Patients with NAFLD had a significantly higher risk of clinical CVD compared to controls [OR: 3.17; 95% CI: 1.89-5.30, P<0.01) (figure 1A). There was significant heterogeneity (I2=93%). Funnel plot and Begg’s test did not reveal significant publication bias. Separate analyses of the cohort and cross sectional studies and exclusion sensitivity analysis did not alter the findings (figure 1B). Conclusion: NAFLD is associated with a three fold increase in the risk of clinical CVD compared to controls without NAFLD. These results need to be conformed in large prospective studies.

scholarly journals Independent Association of Physical Activity with Nonalcoholic Fatty Liver Disease and Alanine Aminotransferase Levels

2019 ◽  
Vol 8 (7) ◽  
pp. 1013 ◽  
Author(s):  
Jang ◽  
Lee ◽  
Lee ◽  
Kim
Keyword(s):  
Physical Activity ◽  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Alanine Aminotransferase ◽  
Fatty Liver Disease ◽  
Hepatocellular Injury ◽  
Nonalcoholic Fatty Liver ◽  
Independent Association ◽  
Lean Nafld

The aim of the current study was to examine the independent association of physical activity with nonalcoholic fatty liver disease (NAFLD) and aminotransferases while adjusting for obesity and diet. Cross-sectional data from 32,391 participants aged ≥ 20 years in the Korea National Health and Nutrition Examination Surveys (KNHANES) was analyzed by logistic regression models and general linear models. Physical activity was assessed from the questionnaire by health-enhancing physical activity (HEPA). The physical activity was negatively associated with NAFLD and lean NAFLD after adjustment for multiple factors with an odds ratio of 0.7 (95% CI, 0.6–0.8) and 0.5 (95% CI, 0.4–0.7) comparing the most active (HEPA active) and the least active (inactive) participants. Among the participants with NAFLD, physical activity also showed an independent negative association with alanine aminotransferase (ALT) levels but not with aspartate aminotransferase levels. These independent associations were not observed when comparing the minimally active and inactive participants except for the risk of lean NAFLD. Physical activity is independently associated with the degree of hepatocellular injury in patients with NAFLD as well as the risk of NAFLD and lean NAFLD in the general population. Sufficiently active physical activity greater than a minimally active level may be needed to lower the risk of NAFLD and ALT levels.

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