scholarly journals Energy Expenditure Improved Risk Factors Associated with Renal Function Loss in NAFLD and MetS Patients

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 629
Author(s):  
Manuela Abbate ◽  
Catalina M. Mascaró ◽  
Sofía Montemayor ◽  
María Barbería-Latasa ◽  
Miguel Casares ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Energy Expenditure ◽  
Controlled Trial ◽  
Caloric Intake ◽  
Liver Fat ◽  
Alcoholic Fatty Liver ◽  
Treatment Groups ◽  
Conventional Diet ◽  
Hepatic Fat ◽  
Activity Groups

To assess the efficacy of three lifestyle interventions on the reduction of liver fat content and metabolic syndrome (MetS), and whether such reductions would influence renal outcomes, we conducted a randomized controlled trial on 128 participants with MetS and non-alcoholic fatty liver disease (NAFLD), as well as available data on estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatine ratio (UACR). Patients were randomized in 1:1:1 ratio to either Conventional Diet, Mediterranean diet (MD)–high meal frequency, and MD–physical activity groups. Each intervention aimed at reducing caloric intake by 25%–30% of baseline intake and increase energy expenditure by 400 kcal/70 kg. Patients attended regular visits and were followed-up for 6 months. Increased albuminuria was present in 13.3% of patients, while 32.8% showed hyperfiltration. UACR reduction was associated with higher levels of UACR at baseline but not with changes in liver fat. eGFR decreased in patients presenting hyperfiltration at baseline and was associated with reduction in liver fat and insulin resistance, as well as with increase in energy expenditure (R2 = 0.248, p = 0.006). No significant differences were observed between the three treatment groups. In patients with NAFLD and MetS, energy expenditure significantly reduced hepatic fat accumulation and insulin resistance, which reduced glomerular hyperfiltration. Increased albuminuria was reduced, but it was not associated with reduced liver fat.

Proposed trial: safety and efficacy of resveratrol for the treatment of non-alcoholic fatty liver disease (NAFLD) and associated insulin resistance in adolescents who are overweight or obese adolescents — rationale and protocol

2015 ◽  
Vol 93 (5) ◽  
pp. 522-530 ◽  
Author(s):  
Brandy Wicklow ◽  
Kristy Wittmeier ◽  
Geert W. t’ Jong ◽  
Jonathon McGavock ◽  
Marni Robert ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Fatty Liver ◽  
Outcome Measures ◽  
Side Effect ◽  
Controlled Trial ◽  
Whole Body ◽  
Secondary Outcome ◽  
Side Effect Profile ◽  
Obese Adolescent ◽  
Alcoholic Fatty Liver

Non-alcoholic fatty liver (NAFL) disease (NAFLD) affects 30% of overweight adolescents and increases the risk of type 2 diabetes mellitus (T2D). Resveratrol is a naturally occurring compound with potential to reverse NAFL and its associated insulin resistance in adults. The use of resveratrol to reduce risk for T2D through its effect on NAFL has not been examined to date in youth. This paper provides a literature review and protocol for a 30 day proof of principle trial of resveratrol in a population of adolescents at risk for T2D. This randomized double-blind controlled trial is designed with the primary objective of evaluating a twice daily supplementation of 75 mg of resveratrol for safety and tolerability in overweight and obese adolescent subjects (13 to <18 years of age) with NAFL. Secondary objectives are to determine the effect size of the intervention on hepatic steatosis and whole body insulin sensitivity. Adolescents in the intervention arm (n = 10) will receive oral supplementation of resveratrol 75 mg twice daily (with breakfast and dinner) for a total daily dose of 150 mg for the duration of 30 days. The comparison group (n = 10) will receive a placebo twice daily for 30 days. Both cases and controls will receive a standardized lifestyle intervention program. Subjects in both groups will be followed for an additional 30 days post intervention for total study duration of approximately 60 days. Primary outcome measures include a primary side effect profile determined by participant interview, a side effect profile determined by serum biochemistry and vital signs. Secondary outcome measures include an oral glucose tolerance test, liver and cardiac fat content measured by magnetic resonance spectroscopy, anthropometric measures of overweight/obesity, inflammatory markers, and cardiac function and morphology measured with ultrasonography. Additional outcome measures include serum concentrations of resveratrol, compliance to protocol, physical activity, and nutritional assessment. This study will determine the safety and tolerability of resveratrol in an overweight adolescent population and inform the design of a larger randomized controlled trial.

scholarly journals Dietary determinants of hepatic fat content and insulin resistance in overweight/obese children: a cross-sectional analysis of the Prevention of Diabetes in Kids (PREDIKID) study

2019 ◽  
Vol 121 (10) ◽  
pp. 1158-1165 ◽  
Author(s):  
Lide Arenaza ◽  
María Medrano ◽  
Maddi Oses ◽  
Inge Huybrechts ◽  
Ignacio Díez ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Dietary Intake ◽  
Dietary Habits ◽  
Sugar Content ◽  
Model Assessment ◽  
Obese Children ◽  
Cross Sectional ◽  
Alcoholic Fatty Liver ◽  
Sugar Intake ◽  
Hepatic Fat

AbstractPaediatric non-alcoholic fatty liver disease has increased in parallel with childhood obesity. Dietary habits, particularly products rich in sugars, may influence both hepatic fat and insulin resistance (homeostatic model assessment for insulin resistance (HOMA-IR)). The aim of the study was to examine the association of the consumption of foods and food components, dairy desserts and substitutes (DDS), sugar-sweetened beverages (SSB), as well as total and added sugars, with hepatic fat and HOMA-IR. Dietary intake (two non-consecutive 24 h-recalls), hepatic fat (MRI) and HOMA-IR were assessed in 110 overweight/obese children (10·6 (sd 1·1) years old). Linear regression analyses were used to examine the association of dietary intake with hepatic fat and HOMA-IR adjusted for potential confounders (sex, age, energy intake, maternal educational level, total and abdominal adiposity and sugar intake). The results showed that there was a negative association between cereal intake and hepatic fat (β=–0·197, P<0·05). In contrast, both SSB consumption (β=0·217; P=0·028) and sugar in SSB (β=0·210, P=0·035), but not DDS or sugar in DDS or other dietary components, were positively associated with hepatic fat regardless of potential confounders including total sugar intake. In conclusion, cereal intake might decrease hepatic fat, whereas SSB consumption and its sugar content may increase the likelihood of having hepatic steatosis. Although these observations need to be confirmed using experimental evidence, these results suggest that healthy lifestyle intervention programs are needed to improve dietary habits as well as to increase the awareness of the detrimental effects of SSB consumption early in life.

scholarly journals Beyond Body Weight-Loss: Dietary Strategies Targeting Intrahepatic Fat in NAFLD

Nutrients ◽  
2020 ◽  
Vol 12 (5) ◽  
pp. 1316 ◽  
Author(s):  
Nicolai Worm
Keyword(s):  
Insulin Resistance ◽  
Weight Loss ◽  
Body Weight ◽  
Liver Disease ◽  
Glycogen Synthesis ◽  
Liver Fat ◽  
Meal Replacement ◽  
Alcoholic Fatty Liver ◽  
Therapeutic Concept ◽  
The Metabolic Syndrome

Non-alcoholic fatty liver disease (NAFLD) has emerged as the most prevalent liver disease in industrialized countries. It is regarded as the hepatic manifestation of the metabolic syndrome (MetS) resulting from insulin resistance. Moreover, insulin resistance impairs glycogen synthesis, postprandially diverting a substantial amount of carbohydrates to the liver and storing them there as fat. NAFLD has far-reaching metabolic consequences involving glucose and lipoprotein metabolism disorders and risk of cardiovascular disease, the leading cause of death worldwide. No pharmaceutical options are currently approved for the treatment of NAFLD. Exercise training and dietary interventions remain the cornerstone of NAFLD treatment. Current international guidelines state that the primary goal of nutritional therapy is to reduce energy intake to achieve a 7%–10% reduction in body weight. Meal replacement therapy (formula diets) results in more pronounced weight loss compared to conventional calorie-restricted diets. However, studies have shown that body mass index (BMI) or weight reduction is not obligatory for decreasing hepatic fat content or to restore normal liver function. Recent studies have achieved significant reductions in liver fat with eucaloric diets and without weight loss through macronutrient modifications. Based on this evidence, an integrative nutritional therapeutic concept was formulated that combines the most effective nutrition approaches termed “liver-fasting.” It involves the temporary use of a low calorie diet (total meal replacement with a specific high-protein, high-soluble fiber, lower-carbohydrate formula), followed by stepwise food reintroduction that implements a Mediterranean style low-carb diet as basic nutrition.

scholarly journals Effect of pilates training on hepatic fat content and liver enzymes in men with non-alcoholic fatty liver disease in Qazvin

2020 ◽  
Vol 22 (1) ◽  
pp. 22-28 ◽  
Author(s):  
Ziba Keymasi ◽  
Abbas Sadeghi ◽  
Hassan Pourrazi
Keyword(s):  
Liver Enzymes ◽  
Serum Levels ◽  
Fat Content ◽  
Liver Fat ◽  
Control Group ◽  
Liver Fat Content ◽  
Anthropometric Indices ◽  
Alcoholic Fatty Liver ◽  
Hepatic Fat ◽  
Alcoholic Fatty Liver Disease

Background and aims: Non-alcoholic fatty liver disease (NAFLD), which is associated with fat accumulation and deposition in liver cells, is a serious risk factor for other diseases such as cardiovascular disorders and diabetes. The aim of this study was to investigate the effect of Pilates training on hepatic fat content and liver enzymes in men with NAFLD in 2019. Methods: In this semi-experimental study, 20 men with NAFLD were randomly divided into Pilates training (n=10) and control (n=10) groups. The Pilates group participated in the Pilates training program for eight weeks (three 60-minute sessions per week), whereas the control group engaged in no regular physical activity. The body composition, anthropometric indices, liver fat content, serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP) were measured before and after the training period. Eventually, data were analyzed using paired and independent t tests at a significance level of 0.05 by SPSS 18. Results: After eight weeks of Pilates training, liver fat content in the Pilates group was significantly lower than that in the control group (P=0.001). Further, the serum levels of ALT, AST, and ALP significantly decreased in the Pilates group compared to the control group (P=0.04, P=0.05, and P=0.02, respectively). In addition, eight weeks of Pilates training significantly reduced body weight, body mass index (BMI), fat percentage, and the waist-to-hip ratio of patients, while no significant changes were observed in the control group. Conclusion: The results of the present study indicated that Pilates training could be effective in improving liver fat content and reducing the serum levels of ALT, AST, and ALP in men with NAFLD. Furthermore, Pilates training helps to improve body composition and anthropometric indices in patients afflicted with NAFLD and can have a role in the management of this condition.

scholarly journals Response of Inflammatory Biomarkers to 10 Weeks of Aerobic Resistance Training in Inactive Postmenopausal Women with Non-alcoholic Fatty Liver

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Masumeh Norouzpour ◽  
Sayed Mohammad Marandi ◽  
Mohsen Ghanbarzadeh ◽  
Abbasali Zare Maivan
Keyword(s):  
Insulin Resistance ◽  
Liver Disease ◽  
Resistance Training ◽  
Fatty Liver ◽  
Postmenopausal Women ◽  
Fatty Liver Disease ◽  
Negative Relationship ◽  
Inflammatory Biomarkers ◽  
Liver Fat ◽  
Alcoholic Fatty Liver

Background: Research evidence shows that non-alcoholic fatty liver disease (NAFLD) is closely related to inflammation. Objectives: This study aimed to evaluate the response of inflammatory biomarkers to 10 weeks of aerobic resistance exercise in inactive postmenopausal women with NAFLD. Methods: In this purposeful quasi-experimental study, conducted in Mahshahr, Iran, in 2019, 24 inactive women aged 50 - 68 years who were diagnosed with fatty liver disease by ultrasound were randomly divided into training or control groups. The training group performed aerobic resistance training for 10 weeks using treadmills and bodybuilding machines. At the beginning and end of the study, serum interleukin 18 (IL18), interleukin 10 (IL10), and other blood parameters were measured, and the subjects underwent liver ultrasound and anthropometric evaluations. Results: The results of intergroup ANCOVA, intragroup paired t-test, and Wilcoxon showed that in response to 10 weeks of training, IL18 levels, anthropometric parameters, insulin resistance (HOMA-IR), liver enzymes, fasting glucose, triglyceride (TG), and liver fat were significantly decreased and plasma IL10 was significantly increased when compared to baseline results (P < 0.05). Also, the results of the Spearman correlation test showed a significant positive relationship between IL18 and waist circumference (WC), alanine aminotransferase (ALT), and HOMA-IR and a significant negative relationship between IL10 and weight, WC, TG, HOMA-IR, and liver fat (P < 0.05). Conclusions: Ten weeks of aerobic resistance training has a significant effect on reducing serum IL18 and increasing IL10 levels in postmenopausal women with fatty liver and can be effective in improving NAFLD by losing weight, improving body composition, and reducing insulin resistance.

LLF580, an FGF21 Analog, Reduces Triglycerides and Hepatic Fat in Obese Adults With Modest Hypertriglyceridemia

2021 ◽  
Author(s):  
Daniel J Rader ◽  
Eleftheria Maratos-Flier ◽  
Amanda Nguyen ◽  
Doug Hom ◽  
Michael Ferriere ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Substantial Reduction ◽  
Density Lipoprotein ◽  
The United States ◽  
Lipoprotein Cholesterol ◽  
Liver Fat ◽  
Fibroblast Growth Factor 21 ◽  
Type Iii Collagen ◽  
Model Assessment ◽  
Hepatic Fat

Abstract Purpose To evaluate the safety and potential efficacy of LLF580, a genetically engineered variant of human fibroblast growth factor-21, for triglyceride lowering, weight loss, and hepatic fat reduction. Methods A multicenter, double-blind, parallel design trial in obese, mildly hypertriglyceridemic adults randomized (1:1) to LLF580 300 mg or placebo subcutaneously every 4 weeks for 3 doses. Results Of 64 randomized study participants, 61 (mean ± SD: age 45 ± 11 years, 49% male, 80/15/5% Caucasian/African American/other, body mass index 36.1 ± 3.8 kg/m2) received LLF580 (n = 30) or placebo (n = 31) at 7 research sites in the United States. LLF580 lowered serum triglycerides by 54% (least square mean placebo adjusted change from baseline), total cholesterol 7%, low-density lipoprotein cholesterol 12%, and increased high-density lipoprotein cholesterol 36% compared with placebo (all P &lt; 0.001) over 12 weeks. Substantial reduction of liver fat of 52% over placebo (P &lt; 0.001) was also demonstrated in the setting of improved liver function tests including alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase, the composite enhanced liver fibrosis score, and N-terminal type III collagen propeptide (all P &lt; 0.05). Insulin and C-peptide levels and insulin resistance by homeostatic model assessment for insulin resistance were all lower, and adiponectin higher with LLF580 treatment compared with placebo, whereas fasting glucose and glycated hemoglobin were unchanged. Reductions in biomarkers of bone formation without differences in markers of bone resorption were observed. LLF580 was generally safe and well tolerated, except for higher incidence of generally mild to moderate gastrointestinal adverse effects. Conclusions In obese, mildly hypertriglyceridemic adults, LLF580 was generally safe and demonstrated beneficial effects on serum lipids, liver fat, and biomarkers of liver injury, suggesting it may be effective for treatment of select metabolic disorders including hypertriglyceridemia and nonalcoholic fatty liver disease. Assessments of longer term safety and efficacy are warranted. ClinicalTrials.gov Identifier NCT03466203

scholarly journals Role of ceramide-to-dihydroceramide ratios for insulin resistance and non-alcoholic fatty liver disease in humans

2020 ◽  
Vol 8 (2) ◽  
pp. e001860
Author(s):  
Maria Apostolopoulou ◽  
Ruth Gordillo ◽  
Sofiya Gancheva ◽  
Klaus Strassburger ◽  
Christian Herder ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Adipose Tissue ◽  
Visceral Adipose Tissue ◽  
Fatty Liver Disease ◽  
Liver Fat ◽  
Liver Fat Content ◽  
Alcoholic Fatty Liver ◽  
Visceral Adipose ◽  
Alcoholic Fatty Liver Disease

IntroductionSphingolipid accumulation has been linked to obesity, type 2 diabetes and non-alcoholic fatty liver disease (NAFLD). A recent study showed that depletion of dihydroceramide desaturase-1 (DES-1) in adipose and/or liver tissue decreases ceramide-to-dihydroceramide ratios (ceramide/dihydroceramide) in several tissues and improves the metabolic profile in mice. We tested the hypothesis that ceramide/dihydroceramide would also be elevated and relate positively to liver fat content and insulin resistance in humans.Research design and methodsThus, we assessed total and specific ceramide/dihydroceramide in various biosamples of 7 lean and 21 obese volunteers without or with different NAFLD stages, who were eligible for abdominal or bariatric surgery, respectively. Biosamples were obtained from serum, liver, rectus abdominis muscle as well as subcutaneous abdominal and visceral adipose tissue during surgery.ResultsSurprisingly, certain serum and liver ceramide/dihydroceramide ratios were reduced in both obesity and non-alcoholic steatohepatitis (NASH) and related inversely to liver fat content. Specifically, hepatic ceramide/dihydroceramide (species 16:0) related negatively to hepatic mitochondrial capacity and lipid peroxidation. In visceral adipose tissue, ceramide/dihydroceramide (species 16:0) associated positively with markers of inflammation.ConclusionThese results failed to confirm the relationships of ceramide/dihydroceramide in humans with different degree of insulin resistance. However, the low hepatic ceramide/dihydroceramide favor a role for dihydroceramide accumulation in NASH, while a specific ceramide/dihydroceramide ratio in visceral adipose tissue suggests a role of ceramides in obesity-associated low-grade inflammation.

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