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Serbis A, Polyzos SA, Paschou SA, Siomou E, Kiortsis DN. Diet, exercise, and supplements: what is their role in the management of the metabolic dysfunction-associated steatotic liver disease in children? Endocrine 2024; 85:988-1006. [PMID: 38519764 DOI: 10.1007/s12020-024-03783-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 03/13/2024] [Indexed: 03/25/2024]
Abstract
Metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as nonalcoholic fatty liver disease (NAFLD), is the main cause of chronic liver disease in children and adolescents. Indeed, epidemiological studies have shown that MASLD affects up to 40% of children with obesity. Despite the recent approval of medications that target weight loss in adolescents that could have benefits on pediatric MASLD, lifestyle interventions, such as diet and exercise, remain the mainstay of our therapeutic approach. More specifically, studies on diet alone have focused on the possible role of carbohydrate or fat restriction, albeit without a definite answer on the best approach. Weight loss after dietary intervention in children with obesity and MASLD has a beneficial effect, regardless of the diet used. In relation to the role of exercise in MASLD reversal, indirect evidence comes from studies showing that a sedentary lifestyle leading to poor fitness, and low muscle mass is associated with MASLD. However, research on the direct effect of exercise on MASLD in children is scarce. A combination of diet and exercise seems to be beneficial with several studies showing improvement in surrogate markers of MASLD, such as serum alanine aminotransferase and hepatic fat fraction, the latter evaluated with imaging studies. Several dietary supplements, such as vitamin E, probiotics, and omega-3 fatty acid supplements have also been studied in children and adolescents with MASLD, but with equivocal results. This review aims to critically present available data on the effects of lifestyle interventions, including diet, exercise, and dietary supplements, on pediatric MASLD, thus suggesting a frame for future research that could enhance our knowledge on pediatric MASLD management and optimize clinicians' approach to this vexing medical condition.
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Affiliation(s)
- Anastasios Serbis
- Department of Pediatrics, School of Medicine, University of Ioannina, Ioannina, Greece.
| | - Stergios A Polyzos
- First Laboratory of Pharmacology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stavroula A Paschou
- Endocrine Unit and Diabetes Center, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Ekaterini Siomou
- Department of Pediatrics, School of Medicine, University of Ioannina, Ioannina, Greece
| | - Dimitrios N Kiortsis
- Laboratory of Physiology, Medical School, University of Ioannina, Ioannina, Greece
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Abosheaishaa H, Nassar M, Abdelhalim O, Bahbah AA, Abbas S, Morsi SM, Ghallab M, Alagha Z, Omran A, Elfert K, Bandaru P, Forlemu AN, Reddy M. Relation between non-alcoholic fatty liver disease and carotid artery intimal media thickness as a surrogate for atherosclerosis: a systematic review and meta-analysis. Eur J Gastroenterol Hepatol 2024; 36:592-607. [PMID: 38489662 DOI: 10.1097/meg.0000000000002721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/17/2024]
Abstract
BACKGROUND AND OBJECTIVE Non-alcoholic fatty liver disease (NAFLD), characterized by hepatic steatosis without heavy alcohol consumption or other chronic conditions, encompasses a spectrum from non-alcoholic fatty liver to non-alcoholic steatohepatitis leading to cirrhosis. This analysis aimed to investigate the correlation between NAFLD and carotid intimal media thickness (C-IMT), a non-invasive surrogate for atherosclerosis. METHODOLOGY Database searches, including PubMed, EMBASE and Cochrane Library, yielded studies up to April 2023. Included were studies exploring the NAFLD-C-IMT relationship in populations aged >18 years. Exclusions comprised non-English papers, those involving animals or pediatric populations and studies lacking control groups. RESULTS No statistical significance was noted between mild and moderate NAFLD compared to the control group regarding C-IMT [95% confidence intervals (CI): -0.03, 0.12] and (95% CI: -0.03, 0.21), respectively. There was a statistically significant difference only in the Severe NAFLD group ( P value 0.03). NAFLD with and without metabolic syndrome showed statistically significant differences compared to control regarding C-IMT (95% CI: 0.04, 0.12) and (95% CI: 0.01, 0.07), respectively. Fifty-nine studies were mentioned without classification of NAFLD severity and revealed a high statistically significant difference between NAFLD and controls regarding C-IMT with (95% CI: 0.09, 0.12, P < 0.00001). Stratified analysis according to sex was done in two studies and revealed statistical differences between NAFLD and control regarding C-IMT in both groups. CONCLUSION This meta-analysis underscores a significant association between NAFLD and increased C-IMT, emphasizing the importance of assessing C-IMT in NAFLD patients to identify cardiovascular risk and tailor therapeutic interventions for improved patient outcomes.
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Affiliation(s)
- Hazem Abosheaishaa
- Department of Internal Medicine, Icahn School of Medicine at Mount Sinai/NYC Health + Hospitals Queens, New York
| | - Mahmoud Nassar
- University at Buffalo School of Medicine and Biomedical Sciences, New York, USA
| | - Omar Abdelhalim
- Department of Internal Medicine, Icahn School of Medicine at Mount Sinai/NYC Health + Hospitals Queens, New York
| | | | - Sharif Abbas
- Koc University School of Medicine, Istanbul, Turkey
| | - Samah M Morsi
- John's Hopkins School of Medicine, Department of Radiology, Duke University, Department of Radiology
| | - Muhammad Ghallab
- Department of Internal Medicine, Icahn School of Medicine at Mount Sinai/NYC Health + Hospitals Queens, New York
| | - Zakaria Alagha
- Marshall University, Joan Edward School of Medicine, West Virginia, New York, USA
| | - Ahmed Omran
- Trinitas Regional Medical Center|RWJBH, Lindon
| | | | - Praneeth Bandaru
- Gastroenterology and Hepatology, The Brooklyn Hospital Center, Brooklyn, New York, USA
| | | | - Madhavi Reddy
- Department of Internal Medicine, Icahn School of Medicine at Mount Sinai/NYC Health + Hospitals Queens, New York
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Quek SXZ, Tan EXX, Ren YP, Muthiah M, Loo EXL, Tham EH, Siah KTH. Factors early in life associated with hepatic steatosis. World J Hepatol 2022; 14:1235-1247. [PMID: 35978672 PMCID: PMC9258263 DOI: 10.4254/wjh.v14.i6.1235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/01/2022] [Accepted: 05/28/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The rise in prevalence of non-alcoholic fatty liver disease (NAFLD) mirrors the obesity epidemic. NAFLD is insidious but may gradually progress from simple steatosis to steatohepatitis, fibrosis and cirrhosis and/or hepatocellular carcinoma. Intervention strategies to ameliorate developmental programming of NAFLD may be more efficacious during critical windows of developmental plasticity.
AIM To review the early developmental factors associated with NAFLD.
METHODS Databases MEDLINE via PubMed, and EMBASE and Reference Citation Analysis were searched and relevant publications up to April 30, 2021 were assessed. Original research studies that included risk factors associated with early development of NAFLD in human subjects were included. These factors include: Maternal factors, intrauterine and prenatal factors, post-natal factors, genetic and ethnic predisposition, childhood and adolescence environmental factors. Studies were excluded if they were review articles or animal studies, case reports or conference abstracts, or if NAFLD was not clearly defined and assessed radiologically.
RESULTS Of 1530 citations identified by electronic search, 420 duplicates were removed. Of the 1110 citations screened from title and abstract, 80 articles were included in the final analysis. Genetic polymorphisms such as patatin-like phospholipase domain-containing protein 3 (PNPLA3) and membrane-bound O-acyltransferase domain-containing protein 7 (MBOAT7) were associated with increased risk of NAFLD. Familial factors such as maternal obesogenic environment and parental history of hepatic steatosis was associated with offspring NAFLD. Longer duration of exclusive breastfeeding in infancy was associated with a lower risk of developing NAFLD later in life while metabolic dysfunction and/or obesity in adolescence was associated with increased risk of NAFLD. Studies relating to socioeconomic factors and its association with NAFLD reported confounding results.
CONCLUSION Maternal metabolic dysfunction during pregnancy, being exclusively breastfed for a longer time postnatally, diet and physical activity in childhood and adolescence are potential areas of intervention to decrease risk of NAFLD.
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Affiliation(s)
- Sabrina Xin Zi Quek
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore 119228, Singapore
| | - Eunice Xiang-Xuan Tan
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore 119228, Singapore
- National University Centre for Organ Transplantation, National University Health System, Singapore 119228, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Yi Ping Ren
- Department of Medicine, National University Hospital, Singapore 119228, Singapore
| | - Mark Muthiah
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore 119228, Singapore
- National University Centre for Organ Transplantation, National University Health System, Singapore 119228, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Evelyn Xiu Ling Loo
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore; Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore 119228, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore 117609, Singapore
| | - Elizabeth Huiwen Tham
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore; Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore 119228, Singapore
| | - Kewin Tien Ho Siah
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore 119228, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
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Dâmaso AR, Machado PP, Rhein SO, Masquio DCL, Oyama LM, Boldarine VT, de Oliveira GI, Tock L, Thivel D, da Silveira Campos RM. Effects of an interdisciplinary weight loss program on fibroblast growth factor 21 and inflammatory biomarkers in women with overweight and obesity. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2021; 65:821-831. [PMID: 34762789 PMCID: PMC10065393 DOI: 10.20945/2359-3997000000419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Objective To investigate the effects of an interdisciplinary intervention on biomarkers of inflammation and their relationship with fibroblast growth factor 21 (FGF21) concentrations in women with overweight and obesity. Methods Thirty-one women were enrolled in a 12-week interdisciplinary weight loss program delivered by a team comprising an endocrinologist, nutritionist and exercise physiologist. Body composition; anthropometric measures; metabolic and inflammatory markers including adiponectin, leptin, and atrial natriuretic peptide (ANP) were assessed at baseline and post-therapy. The homeostasis model assessment of insulin resistance (HOMA-IR) and the homeostasis model assessment of adiponectin (HOMA-AD) were calculated. The participants were divided into two groups: those with increased FGF21, and those with decreased FGF21. Results The sample comprised women aged 32 ± 5 years with a body mass index of 33.64 ± 3.49 kg/m2. Body weight, waist circumference and leptin concentration were decreased in the whole sample after therapy. However, only the group with an increase in FGF21 concentration presented significant improvements in adiponectin concentration and adiponectin/leptin ratio. Moreover, although there was a reduction of leptin in both groups, it was greater in the increased FGF21 groups. There was a reduction in ANP in the decreased FGF21 group. Conclusion Changes in FGF21 concentrations were different among the women participating in the weight loss program, with some having increased levels and some reduced levels. Furthermore, improvements in adiponectin and the adiponectin/leptin ratio were found only in the group with increased FGF21 concentration.
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Affiliation(s)
- Ana Raimunda Dâmaso
- Programa de Pós-graduação em Nutrição, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil,
| | - Paola Próspero Machado
- Programa de Pós-graduação em Nutrição, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | - Samantha Ottani Rhein
- Programa de Pós-graduação em Nutrição, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | | | - Lila Missae Oyama
- Programa de Pós-graduação em Nutrição, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil.,Departamento de Fisiologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | - Valter Tadeu Boldarine
- Programa de Pós-graduação em Nutrição, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil.,Departamento de Fisiologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | | | - Lian Tock
- Grupo de Estudos da Obesidade (GEO/UNIFESP), Escola Paulista de Medicina, São Paulo, SP, Brasil
| | - David Thivel
- Clermont Auvergne University, EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont-Ferrand, France; CRNH-Auvergne, Clermont-Ferrand, France
| | - Raquel Munhoz da Silveira Campos
- Departamento de Biociências, Universidade Federal de São Paulo, Campus Baixada Santista, Santos, SP, Brasil, .,Programa de Pós-Graduação Interdisciplinar em Ciências da Saúde, Universidade Federal de São Paulo, Campus Baixada Santista, Santos, SP, Brasil
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Frigerio B, Werba JP, Amato M, Ravani A, Sansaro D, Coggi D, Vigo L, Tremoli E, Baldassarre D. Traditional Risk Factors are Causally Related to Carotid Intima-Media Thickness Progression: Inferences from Observational Cohort Studies and Interventional Trials. Curr Pharm Des 2020; 26:11-24. [PMID: 31838990 DOI: 10.2174/1381612825666191213120339] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 12/02/2019] [Indexed: 12/24/2022]
Abstract
In the present review, associations between traditional vascular risk factors (VRFs) and carotid intimamedial thickness progression (C-IMTp) as well as the effects of therapies for VRFs control on C-IMTp were appraised to infer causality between each VRF and C-IMTp. Cohort studies indicate that smoking, binge drinking, fatness, diabetes, hypertension and hypercholesterolemia are associated with accelerated C-IMTp. An exception is physical activity, with mixed data. Interventions for the control of obesity, diabetes, hypertension and hypercholesterolemia decelerate C-IMTp. Conversely, scarce information is available regarding the effect of smoking cessation, stop of excessive alcohol intake and management of the metabolic syndrome. Altogether, these data support a causative role of several traditional VRFs on C-IMTp. Shortcomings in study design and/or ultrasonographic protocols may account for most negative studies, which underlines the importance of careful consideration of methodological aspects in investigations using C-IMTp as the outcome.
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Affiliation(s)
| | - José P Werba
- Centro Cardiologico Monzino, IRCCS, Milan, Italy
| | - Mauro Amato
- Centro Cardiologico Monzino, IRCCS, Milan, Italy
| | | | | | - Daniela Coggi
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Universita di Milano, Milan, Italy
| | - Lorenzo Vigo
- Centro Cardiologico Monzino, IRCCS, Milan, Italy.,Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Elena Tremoli
- Centro Cardiologico Monzino, IRCCS, Milan, Italy.,Dipartimento di Scienze Farmacologiche e Biomolecolari, Universita di Milano, Milan, Italy
| | - Damiano Baldassarre
- Centro Cardiologico Monzino, IRCCS, Milan, Italy.,Department of Medical Biotechnology and Translational Medicine, Università di Milano, Milan, Italy
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Interdisciplinary therapy had positive effects on inflammatory state, mediated by leptin, adiponectin, and quality of diet in obese women. NUTR HOSP 2020; 34:456-464. [PMID: 32207312 DOI: 10.20960/nh.02777] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction Background: obesity is a chronic disease associated with inadequate eating habits and reduced levels of physical activity. Because of obesity, the risk for comorbidities is increased, especially for cardiovascular diseases, insulin resistance, and increased pro-inflammatory factors. The aim of the present investigation was to analyze potential correlations between pro/anti-inflammatory adipokines, glycemic index, and other markers of diet quality using a metabolic profile in women undergoing interdisciplinary weight loss therapy. Methods: thirty-two women with obesity were enrolled in a 12-week program of interdisciplinary therapy combining a clinical, nutritional, and physical exercise approach. Body composition, quality of diet, metabolic profile, and pro/anti-inflammatory adipokines were analyzed. Results: the therapy showed to be effective in reducing body weight, body mass index, and body fat. There was also an improvement in lipid profile, including total cholesterol, non-HDL-cholesterol, VLDL-cholesterol, triglycerides and glucose metabolism, including glucose, and insulin. As for food intake, there was a decrease in calorie consumption, carbohydrates, lipids, and glycemic load, and an increased consumption of proteins. Positive correlations were demonstrated between insulin concentration and waist circumference; leptin and body fat and abdominal circumference; and LDL-cholesterol fraction and total cholesterol consumption. Negative correlations were demonstrated between leptin and monosaturated fat consumption; and adiponectin and liver enzyme GGT levels. Conclusions: interdisciplinary therapy had positive effects on inflammatory state, mediated by leptin, adiponectin, and quality of diet. Our findings suggest the effectiveness and clinical relevance of the interdisciplinary clinical therapy applied for obesity.
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Li H, Guo M, An Z, Meng J, Jiang J, Song J, Wu W. Prevalence and Risk Factors of Metabolic Associated Fatty Liver Disease in Xinxiang, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17061818. [PMID: 32168920 PMCID: PMC7143027 DOI: 10.3390/ijerph17061818] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 03/06/2020] [Accepted: 03/08/2020] [Indexed: 12/14/2022]
Abstract
Metabolic associated fatty liver disease (MAFLD) is recognized as the liver disease component of metabolic syndrome, which is mainly related to insulin resistance and genetic susceptibility. It is the most prevalent chronic liver disease worldwide. With rapid lifestyle transitions, its prevalence worldwide is increasing, and tremendous challenges in controlling this pandemic are arising. The objective of this study was to investigate the prevalence and risk factors of MAFLD in rural areas of Xinxiang, Henan in 2017. We conducted a cross-sectional analysis of rural inhabitants aged 20–79 years in Xinxiang, Henan in 2017, using cluster random sampling (N = 9140). Physical examinations were conducted at local clinics from April to June 2017. After overnight fasting, all participants underwent physical examinations, blood routine tests, biochemical examinations, and liver ultrasound and completed questionnaires. We investigated the crude and age-adjusted MAFLD prevalence and analyzed the characteristics of those with, and without, MAFLD, using logistic regression. Approximately 2868 (31.38%) participants were diagnosed with MAFLD. The overall age-adjusted MAFLD prevalence was 29.85% (men: 35.36%; women: 26.49%). The MAFLD prevalence increased with age, and peaked at the 50–59-year age group, and then began to decline. Higher body mass index, waist circumference, percentage of lymphocytes, levels of hemoglobin, platelet count, triglyceride, fasting plasma glucose, and serum uric acid were independently and positively correlated with MAFLD; In contrary, active physical activity and high-density lipoprotein cholesterol were negatively correlated with MAFLD. In summary, the MAFLD prevalence in the study population was 29.85%. Higher body mass index, waist circumference, percentage of lymphocytes, levels of hemoglobin, platelet count, triglyceride, fasting plasma glucose, and serum uric acid were risk factors for MAFLD.
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Affiliation(s)
- Hongbin Li
- School of Public Health, Xinxiang Medical University, Xinxiang 453003, Henan, China; (H.L.); (M.G.); (Z.A.); (J.J.); (J.S.)
| | - Meihao Guo
- School of Public Health, Xinxiang Medical University, Xinxiang 453003, Henan, China; (H.L.); (M.G.); (Z.A.); (J.J.); (J.S.)
| | - Zhen An
- School of Public Health, Xinxiang Medical University, Xinxiang 453003, Henan, China; (H.L.); (M.G.); (Z.A.); (J.J.); (J.S.)
| | - Jun Meng
- School of Management, Xinxiang Medical University, Xinxiang 453003, Henan, China;
| | - Jing Jiang
- School of Public Health, Xinxiang Medical University, Xinxiang 453003, Henan, China; (H.L.); (M.G.); (Z.A.); (J.J.); (J.S.)
| | - Jie Song
- School of Public Health, Xinxiang Medical University, Xinxiang 453003, Henan, China; (H.L.); (M.G.); (Z.A.); (J.J.); (J.S.)
| | - Weidong Wu
- School of Public Health, Xinxiang Medical University, Xinxiang 453003, Henan, China; (H.L.); (M.G.); (Z.A.); (J.J.); (J.S.)
- Correspondence:
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Munhoz da Silveira Campos R, Moreira CE, Leão da Silva P, Landi Masquio DC, Campos Corgosinho F, Pelissari Kravchychyn AC, de Castro Ferreira Vicente SE, Tock L, Tufik S, de Mello MT, Dâmaso AR. The effect of aerobic plus resistance training associated with a long-term interdisciplinary weight loss program on visceral fat and isokinetic parameters in adolescents with obesity. J Sports Med Phys Fitness 2019; 60:855-863. [PMID: 31640311 DOI: 10.23736/s0022-4707.19.09857-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Obesity can lead to a number of alterations in biomechanical structures. We aimed to assess the effect of aerobic plus resistance training associated with an interdisciplinary approach on visceral fat and isokinetic parameters in a long-term weight loss therapy program. METHODS Forty-four postpubertal obese adolescents were involved in the 1-year interdisciplinary weight loss therapy program (clinical, nutritional, psychological and physical training). Body composition, and visceral and subcutaneous fat were measured by DXA absorptiometry and ultrasonography, respectively. Peak torque was analyzed using an isokinetic dynamometer. Statistical analysis was performed using t-tests to assess the effect of the intervention. RESULTS There was a significant reduction in body fat with an inverse increase in lean mass. Positive correlations were observed between peak torque and lean body mass and negative correlations with visceral fat, gynoid fat mass, arm fat mass and subcutaneous fat. CONCLUSIONS An interdisciplinary weight loss program can reduce body fat and increase peak torque and improve muscle strength. The results reinforce the importance of this kind of approach to treat obesity and improve the quality of life in this population.
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Affiliation(s)
- Raquel Munhoz da Silveira Campos
- Department of Biosciences, Universidade Federal de São Paulo (UNIFESP), Campus Baixada Santista, Santos, Brazil - .,Post Graduate Program of Interdisciplinary Health Sciences, Universidade Federal de São Paulo (UNIFESP), Campus Baixada Santista, Santos, Brazil -
| | - Carlos E Moreira
- Post Graduate Program of Nutrition, Universidade Federal de São Paulo (UNIFESP), Campus São Paulo, Brazil
| | | | | | | | | | | | - Lian Tock
- Obesity Study Group, Universidade Federal de São Paulo (UNIFESP), Campus São Paulo, SP, Brazil
| | - Sergio Tufik
- Department of Psychobiology, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Marco T de Mello
- School of Physical Education, Physiotherapy and Occupational Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Ana R Dâmaso
- Post Graduate Program of Nutrition, Universidade Federal de São Paulo (UNIFESP), Campus São Paulo, Brazil
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9
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Chung ST, Onuzuruike AU, Magge SN. Cardiometabolic risk in obese children. Ann N Y Acad Sci 2019; 1411:166-183. [PMID: 29377201 DOI: 10.1111/nyas.13602] [Citation(s) in RCA: 99] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Revised: 12/29/2017] [Accepted: 12/31/2017] [Indexed: 02/06/2023]
Abstract
Obesity in childhood remains a significant and prevalent public health concern. Excess adiposity in youth is a marker of increased cardiometabolic risk (CMR) in adolescents and adults. Several longitudinal studies confirm the strong association of pediatric obesity with the persistence of adult obesity and the future development of cardiovascular disease, diabetes, and increased risk of death. The economic and social impact of childhood obesity is further exacerbated by the early onset of the chronic disease burden in young adults during their peak productivity years. Furthermore, rising prevalence rates of severe obesity in youth from disadvantaged and/or minority backgrounds have prompted the creation of additional classification schemes for severe obesity to improve CMR stratification. Current guidelines focus on primary obesity prevention efforts, as well as screening for clustering of multiple CMR factors to target interventions. This review summarizes the scope of the pediatric obesity epidemic, the new severe obesity classification scheme, and examines the association of excess adiposity with cardiovascular and metabolic risk. We will also discuss potential questions for future investigation.
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Affiliation(s)
- Stephanie T Chung
- Section on Ethnicity and Health, National Institute of Diabetes, Digestive and Kidney Diseases, NIH, Bethesda, Maryland.,Division of Pediatric Endocrinology and Diabetes, Children's National Health System, George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Anthony U Onuzuruike
- Section on Ethnicity and Health, National Institute of Diabetes, Digestive and Kidney Diseases, NIH, Bethesda, Maryland
| | - Sheela N Magge
- Division of Pediatric Endocrinology and Diabetes, Children's National Health System, George Washington University School of Medicine and Health Sciences, Washington, DC
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10
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Campos RMDS, Masquio DCL, Corgosinho FC, Caranti DA, Ganen ADP, Tock L, Oyama LM, Dâmaso AR. Effects of magnitude of visceral adipose tissue reduction: Impact on insulin resistance, hyperleptinemia and cardiometabolic risk in adolescents with obesity after long-term weight-loss therapy. Diab Vasc Dis Res 2019; 16:196-206. [PMID: 30688518 DOI: 10.1177/1479164118825343] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
AIM To investigate the association between visceral adipose tissue loss and insulin resistance and hyperleptinemia in adolescents with obesity submitted to interdisciplinary weight-loss therapy. METHODS A total of 172 post-pubertal adolescents (body mass index greater than the 95th percentile of the Centers for Disease Control and Prevention reference growth charts) were recruited for the study. The adolescents were assigned to long-term weight-loss therapy. Body composition, visceral and subcutaneous fat, glucose metabolism, lipid profile, hepatic enzymes and leptin concentration were measured. After the therapy, the adolescents were allocated to three different groups according to the tertile of visceral fat reduction. RESULTS Positive effects on body composition were observed in all analysed groups independent of visceral fat reduction. It was found that visceral fat was an independent predictor of insulin resistance in the investigated population. Obese adolescents who lost a higher proportion of visceral adipose tissue (>1.8 cm) demonstrated improved metabolic and inflammatory parameters twice as much than those who presented smaller losses. Positive correlations between visceral fat reduction and glucose metabolism, lipid profile, hepatic enzymes and homeostasis model assessment of insulin resistance index were demonstrated. CONCLUSION The magnitude of the reduction in visceral fat was an independent predictor of insulin resistance, hyperleptinemia and metabolic disorders related to obese adolescents.
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Affiliation(s)
- Raquel Munhoz da Silveira Campos
- 1 Department of Physiotherapy, Therapeutic Resources Laboratory, Universidade Federal de São Carlos (UFSCar), São Carlos, Brazil
- 5 Department of Biosciences, Universidade Federal de São Paulo (UNIFESP), Santos, Brazil
| | | | | | - Danielle Arisa Caranti
- 4 Post Graduate Program of Interdisciplinary Health Sciences, Universidade Federal de São Paulo (UNIFESP), Santos, Brazil
- 5 Department of Biosciences, Universidade Federal de São Paulo (UNIFESP), Santos, Brazil
| | | | | | - Lila Missae Oyama
- 7 Post Graduate Program of Nutrition, Paulista School of Medicine, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
- 8 Department of Physiology, Paulista School of Medicine, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Ana Raimunda Dâmaso
- 7 Post Graduate Program of Nutrition, Paulista School of Medicine, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
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Guarnotta V, Mineo MI, Radellini S, Pizzolanti G, Giordano C. Dual-release hydrocortisone improves hepatic steatosis in patients with secondary adrenal insufficiency: a real-life study. Ther Adv Endocrinol Metab 2019; 10:2042018819871169. [PMID: 31489172 PMCID: PMC6713956 DOI: 10.1177/2042018819871169] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Accepted: 07/31/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Conventional glucocorticoid treatment has a significant impact on liver in patients with adrenal insufficiency. Dual-release hydrocortisone (DR-HC) provides physiological cortisol exposure, leading to an improvement in anthropometric and metabolic parameters. We aimed to evaluate the effects of 12-month DR-HC treatment on the hepatic steatosis index (HSI), a validated surrogate index of hepatic steatosis, in patients with secondary adrenal insufficiency (SAI). METHODS A total of 45 patients with hypopituitarism, 22 with hypogonadism, hypothyroidism, ACTH, and GH deficiencies, and 23 with hypogonadism, hypothyroidism, and ACTH deficiency, on replacement therapy for all the pituitary deficiencies, were switched from conventional hydrocortisone to DR-HC. At baseline and after 12 months, glucose and insulin levels, surrogate estimates of insulin sensitivity, and hepatic steatosis were evaluated through ultrasonography and HSI. RESULTS At diagnosis, ultrasonography documented steatosis in 31 patients (68.8%) while 33 (73.3%) showed high HSI. Hydrocortisone (HC) dose (β = 1.231, p = 0.010), insulin resistance index (HOMA-IR) (β = 1.431, p = 0.002), and insulin sensitivity index (ISI)-Matsuda (β = -1.389, p = 0.034) were predictors of HSI at baseline. After 12 months of DR-HC, a significant decrease in body mass index (BMI) (p = 0.008), waist circumference (WC) (p = 0.010), fasting insulin (p = 0.041), HOMA-IR (p = 0.047), HSI (p < 0.001) and number of patients with HSI ⩾36 (p = 0.003), and a significant increase in sodium (p < 0.001) and ISI-Matsuda (p = 0.031) were observed. HOMA-IR (β = 1.431, p = 0.002) and ISI-Matsuda (β = -9.489, p < 0.001) were identified as independent predictors of HSI at 12 months. CONCLUSIONS In adults with SAI, DR-HC is associated with an improvement in HSI, regardless of the dose used, mainly related to an improvement in insulin sensitivity.
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Affiliation(s)
- Valentina Guarnotta
- Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza “G. D’Alessandro” (PROMISE), Sezione di Malattie Endocrine, del Ricambio e della Nutrizione, Università di Palermo, Sicilia, Italy
| | - Mariagrazia Irene Mineo
- Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza “G. D’Alessandro” (PROMISE), Sezione di Malattie Endocrine, del Ricambio e della Nutrizione, Università di Palermo, Sicilia, Italy
| | - Stefano Radellini
- Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza “G. D’Alessandro” (PROMISE), Sezione di Malattie Endocrine, del Ricambio e della Nutrizione, Università di Palermo, Sicilia, Italy
| | - Giuseppe Pizzolanti
- Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza “G. D’Alessandro” (PROMISE), Sezione di Malattie Endocrine, del Ricambio e della Nutrizione, Università di Palermo, Sicilia, Italy
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Jung HC, Jeon S, Lee NH, Kim K, Kang M, Lee S. Effects of exercise intervention on visceral fat in obese children and adolescents. J Sports Med Phys Fitness 2018; 59:1045-1057. [PMID: 30035473 DOI: 10.23736/s0022-4707.18.08935-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
INTRODUCTION This meta-analysis study was aimed to assess the effects of exercise intervention on visceral fat in obese children and adolescents. EVIDENCE ACQUISITION Electronic database searches were performed in Academic Search Complete, CINAHL, Healthsource, MEDLINE, and SportDiscus, and from the earliest record to November 2017. Keywords included "exercise or training," "visceral fat," and "child or adolescent or youth." The inclusion criteria for eligible studies were as follows: 1) subjects were obese at baseline; 2) aged 6-19 years; 3) visceral fat was reported at baseline and after an intervention; and 4) studies were published in peer-reviewed journals written in English. EVIDENCE SYNTHESIS A total of 207 studies were observed at the initial search and 73 effect sizes (ESs) were derived from the 34 selected studies. The overall exercise intervention effect was large (Cohen's d [ES]=-1.003, 95% CI=-1.114, -0.892). Moderator analyses results showed that gender (Qb=8.23, df=2, P=0.016), exercise type (Qb=10.68, df=2, P=0.005), and intervention length (Qb=24.71, df=2, P<0.001) influenced the overall ES. CONCLUSIONS The group of both boys and girls (ES=-0.95) who participated combined exercise program (Aerobic + Resistance training; ES=-1.17) for 12 months (ES=-1.24) appeared to be the most effective exercise strategy for reducing visceral fat in obese youth.
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Affiliation(s)
- Hyun C Jung
- Department of Kinesiology, College of Health Sciences, University of Louisiana Monroe, Monroe, LA, USA
| | - Soeun Jeon
- Department of Counseling, Health, and Kinesiology, College of Education and Human Development, Texas A&M University-San Antonio, San Antonio, TX, USA
| | - Nan H Lee
- School of Biological Sciences, College of Sciences, Georgia Institute of Technology, Atlanta, GA, USA
| | - Kyungun Kim
- Department of Nutrition and Kinesiology, College of Health, Science & Technology, University of Central Missouri, Warrensburg, MO, USA
| | - Minsoo Kang
- Health, Exercise Science, and Recreation Management, The University of Mississippi, Oxford, MS, USA
| | - Sukho Lee
- School of Biological Sciences, College of Sciences, Georgia Institute of Technology, Atlanta, GA, USA -
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13
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Middleton MS, Van Natta ML, Heba ER, Alazraki A, Trout AT, Masand P, Brunt EM, Kleiner DE, Doo E, Tonascia J, Lavine JE, Shen W, Hamilton G, Schwimmer JB, Sirlin CB. Diagnostic accuracy of magnetic resonance imaging hepatic proton density fat fraction in pediatric nonalcoholic fatty liver disease. Hepatology 2018; 67:858-872. [PMID: 29028128 PMCID: PMC6211296 DOI: 10.1002/hep.29596] [Citation(s) in RCA: 98] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 09/11/2017] [Accepted: 10/12/2017] [Indexed: 12/11/2022]
Abstract
UNLABELLED We assessed the performance of magnetic resonance imaging (MRI) proton density fat fraction (PDFF) in children to stratify hepatic steatosis grade before and after treatment in the Cysteamine Bitartrate Delayed-Release for the Treatment of Nonalcoholic Fatty Liver Disease in Children (CyNCh) trial, using centrally scored histology as reference. Participants had multiecho 1.5 Tesla (T) or 3T MRI on scanners from three manufacturers. Of 169 enrolled children, 110 (65%) and 83 (49%) had MRI and liver biopsy at baseline and at end of treatment (EOT; 52 weeks), respectively. At baseline, 17% (19 of 110), 28% (31 of 110), and 55% (60 of 110) of liver biopsies showed grades 1, 2, and 3 histological steatosis; corresponding PDFF (mean ± SD) values were 10.9 ± 4.1%, 18.4 ± 6.2%, and 25.7 ± 9.7%, respectively. PDFF classified grade 1 versus 2-3 and 1-2 versus 3 steatosis with areas under receiving operator characteristic curves (AUROCs) of 0.87 (95% confidence interval [CI], 0.80, 0.94) and 0.79 (0.70, 0.87), respectively. PDFF cutoffs at 90% specificity were 17.5% for grades 2-3 steatosis and 23.3% for grade 3 steatosis. At EOT, 47% (39 of 83), 41% (34 of 83), and 12% (10 of 83) of biopsies showed improved, unchanged, and worsened steatosis grade, respectively, with corresponding PDFF (mean ± SD) changes of -7.8 ± 6.3%, -1.2 ± 7.8%, and 4.9 ± 5.0%, respectively. PDFF change classified steatosis grade improvement and worsening with AUROCs (95% CIs) of 0.76 (0.66, 0.87) and 0.83 (0.73, 0.92), respectively. PDFF change cut-off values at 90% specificity were -11.0% and +5.5% for improvement and worsening. CONCLUSION MRI-estimated PDFF has high diagnostic accuracy to both classify and predict histological steatosis grade and change in histological steatosis grade in children with NAFLD. (Hepatology 2018;67:858-872).
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Affiliation(s)
- Michael S. Middleton
- Liver Imaging Group, Department of Radiology, UCSD School of Medicine, San Diego, California
| | - Mark L. Van Natta
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Elhamy R. Heba
- Liver Imaging Group, Department of Radiology, UCSD School of Medicine, San Diego, California
| | - Adina Alazraki
- Emory University School of Medicine, Department of Radiology and Imaging Sciences, Atlanta, Georgia
| | - Andrew T. Trout
- Cincinnati Children’s Hospital, Department of Radiology, Cincinnati, Ohio
| | | | | | | | - Edward Doo
- Liver Diseases Section, Digestive Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases
| | - James Tonascia
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Joel E. Lavine
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Columbia University Medical Center, New York, New York
| | - Wei Shen
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Columbia University Medical Center, New York, New York
| | - Gavin Hamilton
- Liver Imaging Group, Department of Radiology, UCSD School of Medicine, San Diego, California
| | - Jeffrey B. Schwimmer
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California San Diego School of Medicine, La Jolla, California; and Department of Gastroenterology, Rady Children’s Hospital, San Diego, California
| | - Claude B. Sirlin
- Liver Imaging Group, Department of Radiology, UCSD School of Medicine, San Diego, California
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14
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Jin R, Krasinskas A, Le NA, Konomi JV, Holzberg J, Romero R, Vos MB. Association between plasminogen activator inhibitor-1 and severity of liver injury and cardiovascular risk in children with non-alcoholic fatty liver disease. Pediatr Obes 2018; 13:23-29. [PMID: 27764892 DOI: 10.1111/ijpo.12183] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Accepted: 08/23/2016] [Indexed: 12/18/2022]
Abstract
BACKGROUND Plasminogen activator inhibitor-1 (PAI-1) is the primary inhibitor of the endogenous fibrinolytic system and is known to be increased in obesity, insulin resistance and non-alcoholic fatty liver disease (NAFLD). We previously demonstrated that PAI-1 levels were closely related to the amount of hepatic steatosis in children. OBJECTIVES The aim of this study was to characterize plasma PAI-1 in relationship to severity of inflammation and fibrosis, as well as to plasma lipids in children with NAFLD. METHODS In 44 children with NAFLD, plasma PAI-1 levels and lipids were measured at the time of a liver biopsy. Hepatic histological features were systematically scored. Trend analysis was applied to determine the correlation of plasma PAI-1 levels with lipid markers for cardiovascular disease and with the staging of histological features in the liver. RESULTS We found that plasma PAI-1 levels were significantly increased in children with increased severity of steatosis, lobular inflammation, ballooning and fibrosis. Furthermore, PAI-1 was strongly correlated with plasma lipids and insulin resistance indices. CONCLUSIONS PAI-1 appears to be tightly related to both histologic severity of NAFLD as well as systemic features of the disease including insulin resistance and dyslipidemia. PAI-1 may be a mediator of disease progression and future cardiovascular complications in children with NAFLD.
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Affiliation(s)
- R Jin
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA, USA
| | - A Krasinskas
- Department of Pathology and Laboratory Medicine, School of Medicine, Emory University, Atlanta, GA, USA
| | - N-A Le
- Biomarker Core Laboratory, Atlanta Veterans Affairs Medical Center, Decatur, GA, USA
| | - J V Konomi
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA, USA
| | - J Holzberg
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA, USA
| | - R Romero
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA, USA.,Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - M B Vos
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA, USA.,Children's Healthcare of Atlanta, Atlanta, GA, USA
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15
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Ahmed AM, Ebid ME, Ajlan AM, Al-Mallah MH. Low-dose attenuation correction in diagnosis of non-alcoholic fatty liver disease. Abdom Radiol (NY) 2017; 42:2454-2459. [PMID: 28470401 DOI: 10.1007/s00261-017-1166-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Non-enhanced computed tomography (CT) is a valuable modality in the diagnosis of non-alcoholic fatty liver disease (NAFLD). However, it is not clear if low-dose CT attenuation correction (CTAC) scans have the same accuracy to diagnose NAFLD. Our aim is to evaluate the diagnostic accuracy of low-dose CTAC in the diagnosis of NAFLD using non-enhanced CT as a gold standard. METHODS A total of 864 patients who underwent a clinically indicated hybrid nuclear imaging scanning between May 2011 and April 2014 were included in the study. Diagnosis of fatty liver was established if an absolute liver attenuation was <40 Hounsfield units and/or a liver-to-spleen ratio was <1.1. The diagnostic accuracy parameters were calculated to detect NAFLD by low-dose CTAC using unenhanced CT as a gold standard. RESULTS The prevalence of fatty liver by diagnostic CT and low-dose attenuation correction were 9.9 and 12.9% (using liver attenuation <40HU and liver-to-spleen ratio <1.1), respectively, with 32.9 and 34.9% (using absolute liver attenuation or ratio-to-spleen criteria), correspondingly. Low-dose CTAC had sensitivity (81.3%), specificity (94.0%), positive predictive value (60.2%), and negative predictive value (97.8%) using both diagnostic criteria. Using either of the diagnostic criteria resulted in sensitivity (76.8%), specificity (83.5%), PPV (66.3%), and NPV (89.5%). CONCLUSION Low-dose CT could be used as a tool to rule out the presence of fatty liver if neither liver attenuation of less than 40 HU nor liver-to-spleen below 1.1 is present.
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Affiliation(s)
- Amjad M Ahmed
- King Abdulaziz Cardiac Center, King Abdulaziz Medical City for National Guard - Health Affairs, Department Mail Code: 1413, P.O. Box 22490, Riyadh, 11426, Kingdom of Saudi Arabia
| | - Mohamed E Ebid
- King Abdulaziz Cardiac Center, King Abdulaziz Medical City for National Guard - Health Affairs, Department Mail Code: 1413, P.O. Box 22490, Riyadh, 11426, Kingdom of Saudi Arabia
| | - Amr M Ajlan
- King AbdulAziz University Hospital, Jeddah, Kingdom of Saudi Arabia
| | - Mouaz H Al-Mallah
- King Abdulaziz Cardiac Center, King Abdulaziz Medical City for National Guard - Health Affairs, Department Mail Code: 1413, P.O. Box 22490, Riyadh, 11426, Kingdom of Saudi Arabia.
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia.
- King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia.
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16
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Yi M, Chen RP, Yang R, Chen H. Increased prevalence and risk of non-alcoholic fatty liver disease in overweight and obese patients with Type 2 diabetes in South China. Diabet Med 2017; 34:505-513. [PMID: 27334577 DOI: 10.1111/dme.13174] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/21/2016] [Indexed: 02/06/2023]
Abstract
AIMS To investigate the prevalence of and risk factors for non-alcoholic fatty liver disease in overweight and obese patients with Type 2 diabetes mellitus. METHODS We recruited patients with Type 2 diabetes with a BMI ≥ 24 kg/m2 , who visited the diabetes clinics of 60 hospitals in 21 cities in Guangdong Province, China from August 2011 to March 2012. Anthropometric measurements, biochemical tests and abdominal ultrasonography were performed for all the patients. RESULTS The study included 3861 patients (1860 men) with a mean ± sd (range) age of 58.91 ± 13.06 (18-90) years. Non-alcoholic fatty liver disease was found in 1751 patients (45.4%), with a significantly higher prevalence among men than women (48.0 vs 42.9%). The peak of non-alcoholic fatty liver disease prevalence was in patients with a BMI of 34-35 kg/m2 , those with a triglyceride/HDL cholesterol ratio of 5.5-6.0, men aged < 30 years and women aged 40-50 years. Assessment using the BARD (BMI, aspartate aminotransferase/alanine aminotransferase ratio, diabetes) score system showed that the prevalence of advanced fibrosis was 80.52% in all patients and that women had a higher prevalence than men (86.52 vs 74.16%). Multiple logistic regression analyses showed that dyslipidaemia, BMI and 2-h postprandial plasma glucose were independent risk factors for non-alcoholic fatty liver disease, while heart rate and female gender were protective factors. CONCLUSION The prevalence of non-alcoholic fatty liver disease in overweight and obese patients with Type 2 diabetes in South China is high. Multiple metabolic disorders were significantly associated with non-alcoholic fatty liver disease in overweight and obese patients with Type 2 diabetes.
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Affiliation(s)
- M Yi
- Department of Endocrinology, Zhujiang Hospital of Southern Medical University, Guangzhou City, Guangdong Province, China
| | - R-P Chen
- Department of Endocrinology, Zhujiang Hospital of Southern Medical University, Guangzhou City, Guangdong Province, China
| | - R Yang
- Department of Endocrinology, Zhujiang Hospital of Southern Medical University, Guangzhou City, Guangdong Province, China
| | - H Chen
- Department of Endocrinology, Zhujiang Hospital of Southern Medical University, Guangzhou City, Guangdong Province, China
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17
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Bao-Ge Q, Hui W, Yi-Guo J, Ji-Liang S, Zhong-Dong W, Ya-Fei W, Xing-Hai H, Yuan-Xun L, Jin-Dun P, Guang-Ying R. The Correlation and Risk Factors between Carotid Intima-Media Thickening and Alcoholic Liver Disease Coupled with Helicobacter pylori Infection. Sci Rep 2017; 7:43059. [PMID: 28220866 PMCID: PMC5318877 DOI: 10.1038/srep43059] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 01/18/2017] [Indexed: 12/13/2022] Open
Abstract
The aim of this study was to explore the associations and differences in influencing factors between alcoholic liver disease (ALD) coupled with Helicobacter pylori infection and atherosclerosis and to determine whether there is a "double hit phenomenon" in atherosclerosis patients with ALD and H. pylori infections. Included cases (n = 160) were categorized into 4 groups: 41 cases of ALD coupled with H. pylori infections (group A), 35 cases of H. pylori infections without ALD (group B), 37 cases of ALD without H. pylori infections (group C), and 47 normal control cases (group D). CIMT was significantly greater in group A than in groups B and D (P = 0.005 and P = 0.001, respectively). The GLM univariate analysis found that CIMT was significantly greater in group A than in groups B, C and D (P = 0.018, P = 0.001 and P = 0.009, respectively). We found that BMI and ALT, AST and ApoB levels were independent predictors of CIMT (P = 0.000, P = 0.000, P = 0.012 and P = 0.014, respectively). ALD coupled with H. pylori infection may result in significant CIMT thickening, but H. pylori infection without ALD and ALD without H. pylori infection does not, suggesting that a "double hit phenomenon" occurs. Additionally, BMI, and ALT, AST and ApoB levels were independent risk factors for increased CIMT.
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Affiliation(s)
- Qu Bao-Ge
- Taishan Hospital, Taian, Shandong 271000, P. R. China
| | - Wang Hui
- Taishan Hospital, Taian, Shandong 271000, P. R. China
- Taishan Medical College, Taian, Shandong, 271000, P. R. China
| | - Jia Yi-Guo
- Taishan Hospital, Taian, Shandong 271000, P. R. China
- Taishan Medical College, Taian, Shandong, 271000, P. R. China
| | - Su Ji-Liang
- Taishan Hospital, Taian, Shandong 271000, P. R. China
| | | | - Wang Ya-Fei
- Taishan Hospital, Taian, Shandong 271000, P. R. China
| | - Han Xing-Hai
- Taishan Hospital, Taian, Shandong 271000, P. R. China
| | - Liu Yuan-Xun
- Taishan Hospital, Taian, Shandong 271000, P. R. China
- Taishan Medical College, Taian, Shandong, 271000, P. R. China
| | - Pan Jin-Dun
- Taishan Hospital, Taian, Shandong 271000, P. R. China
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Africa JA, Newton KP, Schwimmer JB. Lifestyle Interventions Including Nutrition, Exercise, and Supplements for Nonalcoholic Fatty Liver Disease in Children. Dig Dis Sci 2016; 61:1375-86. [PMID: 27041377 PMCID: PMC4848041 DOI: 10.1007/s10620-016-4126-1] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 03/06/2016] [Indexed: 02/07/2023]
Abstract
Nonalcoholic fatty liver disease (NAFLD) is the most common cause of liver disease among children. Lifestyle interventions, such as diet and exercise, are frequently recommended. Children with NAFLD have a distinct physiology that is different from obesity alone and has the potential to influence lifestyle treatments. Studies of diet alone in the treatment of pediatric NAFLD have focused on sugar and carbohydrate, but did not indicate any one dietary approach that was superior to another. For children who are obese and have NAFLD, weight loss may have a beneficial effect regardless of the diet used. Exercise is widely believed to improve NAFLD because a sedentary lifestyle, poor aerobic fitness, and low muscle mass are all risk factors for NAFLD. However, there have been no randomized controlled trials of exercise as a treatment for children with NAFLD. Studies of the combination of diet and exercise suggest a potential for improvement in serum alanine aminotransferase activity and/or magnetic resonance imaging liver fat fraction with intervention. There is also enthusiasm for the use of dietary supplements; however, studies in children have shown inconsistent effects of vitamin E, fish oil, and probiotics. This review presents the available data from studies of lifestyle intervention and dietary supplements published to date and highlights challenges that must be addressed in order to advance the evidence base for the treatment of pediatric NAFLD.
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Yin S, Fan Y, Zhang H, Zhao Z, Hao Y, Li J, Sun C, Yang J, Yang Z, Yang X, Lu J, Xi JJ. Differential TGFβ pathway targeting by miR-122 in humans and mice affects liver cancer metastasis. Nat Commun 2016; 7:11012. [PMID: 26987776 PMCID: PMC4802055 DOI: 10.1038/ncomms11012] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 02/10/2016] [Indexed: 02/06/2023] Open
Abstract
Downregulation of a predominantly hepatocyte-specific miR-122 is associated with human liver cancer metastasis, whereas miR-122-deficient mice display normal liver function. Here we show a functional conservation of miR-122 in the TGFβ pathway: miR-122 target site is present in the mouse but not human TGFβR1, whereas a noncanonical target site is present in the TGFβ1 5′UTR in humans and other primates. Experimental switch of the miR-122 target between the receptor TGFβR1 and the ligand TGFβ1 changes the metastatic properties of mouse and human liver cancer cells. High expression of TGFβ1 in human primary liver tumours is associated with poor survival. We identify over 50 other miRNAs orthogonally targeting ligand/receptor pairs in humans and mice, suggesting that these are evolutionarily common events. These results reveal an evolutionary mechanism for miRNA-mediated gene regulation underlying species-specific physiological or pathological phenotype and provide a potentially valuable strategy for treating liver-associated diseases. MiR-122 levels correlate with metastasis in human liver cancer but not in mouse models. Here the authors show that miR-122 targets TGFßR1 in mice but TGFß1 in humans, that swapping this specificity affects metastasis, and that many other receptor-ligand pairs are differentially targeted by miRNAs across species.
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Affiliation(s)
- Shenyi Yin
- State Key Laboratory of Natural and Biomimetic Drugs, Department of Biomedical Engineering, College of Engineering, Peking University, Beijing 100871, China
| | - Yu Fan
- State Key Laboratory of Natural and Biomimetic Drugs, Department of Biomedical Engineering, College of Engineering, Peking University, Beijing 100871, China
| | - Hanshuo Zhang
- State Key Laboratory of Natural and Biomimetic Drugs, Department of Biomedical Engineering, College of Engineering, Peking University, Beijing 100871, China
| | - Zhihua Zhao
- State Key Laboratory of Biomembrane and Membrane Biotechnology, Institute of Molecular Medicine, Peking University, Beijing 100871, China
| | - Yang Hao
- State Key Laboratory of Natural and Biomimetic Drugs, Department of Biomedical Engineering, College of Engineering, Peking University, Beijing 100871, China
| | - Juan Li
- State Key Laboratory of Natural and Biomimetic Drugs, Department of Biomedical Engineering, College of Engineering, Peking University, Beijing 100871, China
| | - Changhong Sun
- State Key Laboratory of Natural and Biomimetic Drugs, Department of Biomedical Engineering, College of Engineering, Peking University, Beijing 100871, China
| | - Junyu Yang
- State Key Laboratory of Natural and Biomimetic Drugs, Department of Biomedical Engineering, College of Engineering, Peking University, Beijing 100871, China
| | - Zhenjun Yang
- School of Pharmaceutical Sciences, Peking University, Beijing 100191, China
| | - Xiao Yang
- State Key Laboratory of Proteomics, Genetic Laboratory of Development and Diseases, Institute of Biotechnology, Beijing 100071, China
| | - Jian Lu
- College of Life Science, Peking University, Beijing 100871, China
| | - Jianzhong Jeff Xi
- State Key Laboratory of Natural and Biomimetic Drugs, Department of Biomedical Engineering, College of Engineering, Peking University, Beijing 100871, China.,State Key Laboratory of Biomembrane and Membrane Biotechnology, Institute of Molecular Medicine, Peking University, Beijing 100871, China
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20
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Clemente APG, Netto BDM, de Carvalho-Ferreira JP, da Silveira Campos RM, de Piano Ganen A, Tock L, de Mello MT, Dâmaso AR. Waist circumference as a marker for screening nonalcoholic fatty liver disease in obese adolescents. REVISTA PAULISTA DE PEDIATRIA (ENGLISH EDITION) 2016. [PMID: 26830602 PMCID: PMC4795721 DOI: 10.1016/j.rppede.2015.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Objective: To assess the relationship between the degree of waist circumference (WC) and
nonalcoholic fatty liver disease (NAFLD) in obese adolescents of both genders,
analyzed according to quartiles of WC. Methods: Cross-sectional study that involved 247 obese adolescents aged 12–19 years. Mean
values of the nutritional parameters and serum analyses were compared with the
groups using the independent t-test. Pearson correlation
coefficient was used to determine the relationship of the parameters studied.
Chi-square test for trend was used to determine the relationship between the
prevalence of the NAFLD and WC quartile by gender. Results: NAFLD were presented in 60% of the study participants. Obese adolescents in the
3rd and 4th quartiles of WC presented higher prevalence of NAFLD when compared
with that in the 1st quartile in both genders. The NAFLD patients had
significantly higher values for body weight, BMI (body mass index), BAZ-score
(BMI-for-age z-scores), total fat (% and kg), WC, visceral fat, insulin, insulin
resistance index (HOMA-IR), aspartate aminotransferase and alanine
aminotransferase, when compared with non-NAFLD obese adolescents. Conclusions: In conclusion, the results presented here suggest that an increase in WC can
reliably predict the risk of NAFLD in obese adolescents. This is a low cost and
easy-to-use tool that can help in screening in adolescents.
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Affiliation(s)
| | - Bárbara Dal Molin Netto
- Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brasil
| | | | | | - Aline de Piano Ganen
- Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brasil
| | - Lian Tock
- Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brasil
| | - Marco Túlio de Mello
- Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brasil
| | - Ana Raimunda Dâmaso
- Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brasil
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21
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Wu KT, Kuo PL, Su SB, Chen YY, Yeh ML, Huang CI, Yang JF, Lin CI, Hsieh MH, Hsieh MY, Huang CF, Lin WY, Yu ML, Dai CY, Wang HY. Nonalcoholic fatty liver disease severity is associated with the ratios of total cholesterol and triglycerides to high-density lipoprotein cholesterol. J Clin Lipidol 2016; 10:420-5.e1. [PMID: 27055973 DOI: 10.1016/j.jacl.2015.12.026] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 12/07/2015] [Accepted: 12/22/2015] [Indexed: 02/06/2023]
Abstract
BACKGROUND Limited data support the notion that lipid ratios are risk factors for nonalcoholic fatty liver disease (NAFLD). We evaluated the association between lipid ratios and NAFLD. METHODS This was a large population, cross-sectional, retrospective study. Data on NAFLD severity, blood pressure, fasting glucose, total cholesterol (TC), triglyceride (TG), and high-density lipoprotein cholesterol (HDL-C) levels were obtained from 44,767 examinees at single health checkup center. The enrollees were stratified into four subgroups based on their TC/HDL-C and TG/HDL-C ratios. We used multivariate analyses to evaluate the odds between lipid ratios and NAFLD. RESULTS The prevalence rate of fatty liver in this study was 53.76%. In the baseline subgroup with the lowest TC/HDL-C and TG/HDL-C ratios, the prevalence of NAFLD, hypertension, and diabetes was lower than that of the other three subgroups. Patients with higher lipid ratios had a significantly greater risk for advanced NAFLD. CONCLUSIONS Adults with high TC/HDL-C or TG/HDL-C ratios, or both, have a greater risk for NAFLD, especially advanced NAFLD.
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Affiliation(s)
- Kuan-Ta Wu
- Department of Preventive Medicine, and Health Management Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Po-Lin Kuo
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shih-Bin Su
- Department of Occupational Medicine, Chi-Mei Medical Center, Tainan, Taiwan; Department of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan; Department of Leisure, Recreation and Tourism Management, Southern Taiwan University of Science and Technology, Tainan, Taiwan
| | - Yi-Yu Chen
- Department of Preventive Medicine, and Health Management Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ming-Lum Yeh
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Hepatobiliary Division, Department of Internal Medicine and Hepatitis Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ching-I Huang
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Hepatobiliary Division, Department of Internal Medicine and Hepatitis Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jeng-Fu Yang
- Department of Preventive Medicine, and Health Management Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Hepatobiliary Division, Department of Internal Medicine and Hepatitis Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chia-I Lin
- Department of Preventive Medicine, and Health Management Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Occupational Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Meng-Hsuan Hsieh
- Department of Preventive Medicine, and Health Management Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Occupational Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ming-Yen Hsieh
- Hepatobiliary Division, Department of Internal Medicine and Hepatitis Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Internal Medicine, Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chung-Feng Huang
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Hepatobiliary Division, Department of Internal Medicine and Hepatitis Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Occupational Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wen-Yi Lin
- Hepatobiliary Division, Department of Internal Medicine and Hepatitis Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Occupational Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ming-Lung Yu
- Hepatobiliary Division, Department of Internal Medicine and Hepatitis Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Faculty of Internal Medicine, School of Medicine, College of Medicine, and Center for Infectious Disease and Cancer Research, and Center for Lipid and Glycomedicine Research, Kaohsiung Medical University, Kaohsiung, Taiwan; Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Chia-Yen Dai
- Department of Preventive Medicine, and Health Management Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Hepatobiliary Division, Department of Internal Medicine and Hepatitis Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Occupational Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Faculty of Internal Medicine, School of Medicine, College of Medicine, and Center for Infectious Disease and Cancer Research, and Center for Lipid and Glycomedicine Research, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Hsien-Yi Wang
- Department of Nephrology, Chi-Mei Medical Center, Tainan, Taiwan; Department of Sport Management, College of Leisure and Recreation Management, Chia-Nan University of Pharmacy and Science, Tainan, Taiwan.
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22
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[Waist circumference as a marker for screening nonalcoholic fatty liver disease in obese adolescents]. REVISTA PAULISTA DE PEDIATRIA 2015; 34:47-55. [PMID: 26830602 DOI: 10.1016/j.rpped.2015.05.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2014] [Revised: 04/20/2015] [Accepted: 05/21/2015] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To assess the relationship between the degree of waist circumference (WC) and nonalcoholic fatty liver disease (NAFLD) in obese adolescents of both genders, analyzed according to quartiles of WC. METHODS Cross-sectional study that involved 247 obese adolescents aged 12-19 years. Mean values of the nutritional parameters and serum analyses were compared with the groups using the independent t-test. Pearson correlation coefficient was used to determine the relationship of the parameters studied. Chi-square test for trend was used to determine the relationship between the prevalence of the NAFLD and WC quartile by gender. RESULTS NAFLD were presented in 60% of the study participants. Obese adolescents in the 3rd and 4th quartiles of WC presented higher prevalence of NAFLD when compared with that in the 1st quartile in both genders. The NAFLD patients had significantly higher values for body weight, BMI (body mass index), BAZ-score (BMI-for-age z-scores), total fat (% and kg), WC, visceral fat, insulin, insulin resistance index (HOMA-IR), aspartate aminotransferase and alanine aminotransferase, when compared with non-NAFLD obese adolescents. CONCLUSIONS The results presented here suggest that an increase in WC can reliably predict the risk of NAFLD in obese adolescents. This is a low cost and easy-to-use tool that can help in screening in adolescents.
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23
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Sene-Fiorese M, Duarte FO, de Aquino Junior AE, Campos RMDS, Masquio DCL, Tock L, de Oliveira Duarte ACG, Dâmaso AR, Parizotto NA, Bagnato VS. The potential of phototherapy to reduce body fat, insulin resistance and "metabolic inflexibility" related to obesity in women undergoing weight loss treatment. Lasers Surg Med 2015. [PMID: 26220050 DOI: 10.1002/lsm.22395] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND OBJECTIVE The metabolic flexibility is often impaired in diseases associated with obesity, and many studies are based on the hypothesis that dysfunction in peripheral tissues such as skeletal muscle, liver and adipose tissue represent the etiology of development of metabolic inflexibility. Experimental evidence shows that the use of phototherapy combined with exercise was effective in controlling the lipid profile, reducing the mass of adipose tissue, suggesting increased metabolic activity and changes in lipid metabolism. However, we found few data in the literature involving the use of phototherapy in association to physical training in the obese population. Thus, our objective was to evaluate the effects of exercise training (aerobic plus resistance exercises) plus phototherapy (laser, 808 nm) on metabolic profile and adiponectinemia in obese women. STUDY DESIGN/MATERIALS AND METHODS Sixty-four obese women (BMI 30-40 kg/m2 , age between 20 and 40 years old) were randomly assigned in two groups: Exercise Training plus SHAM group (ET-SHAM, n = 32) and Exercise Training plus Phototherapy group (ET-PHOTO, n = 32). The treatment consisted in physical exercise intervention and the individual application of phototherapy immediately after the end of the training session. However, in the ET-SHAM group the device was turned off simulating the phototherapy application (placebo effect). The study protocol lasted for 20 weeks and comprised of three weekly sessions of aerobic plus resistance training and application of phototherapy (when applicable). The body composition and metabolic parameters were assessed (HOMA, adiponectin, insulin, glucose). RESULTS Comparing the magnitude of effects between groups (ET-PHOTO vs. ET-SHAM), we observed that physical training plus phototherapy was more effective than physical training in reducing the delta of percentage of fat mass (%; -5.60 ± 1.59 vs. -4.33 ± 1.5; P < 0.04); fat mass (kg; -11.26 ± 2.82 vs. -5.80 ± 2.82; P < 0.0002); HOMA-IR index (-38.08 ± 9.23 vs. -20.91 ± 14.42; P < 0.0001). In addition, we observed an increase in delta (%) of total skeletal muscle mass (kg; 0.60 ± 1.09 vs. -1.38 ± 1.70; P < 0.003), adiponectin concentration (ng/ml; 1.08 (0.04-3.62) vs. -0.42 (-3.15 to 2.26); P < 0.03) in the same comparison. CONCLUSION Our results demonstrated for the first time that phototherapy enhances the physical exercise effects in obese women undergoing weight loss treatment promoting significant changes in inflexibility metabolic profile.
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Affiliation(s)
- Marcela Sene-Fiorese
- São Carlos Institute of Physics, University of São Paulo (USP), PO Box 369, 13560-970 São Carlos, Brazil
| | - Fernanda Oliveira Duarte
- Department of Physiotherapy, Therapeutic Resources Laboratory, Federal University of São Carlos (UFSCar), 13565-905 São Carlos, São Paulo, Brazil
| | - Antonio Eduardo de Aquino Junior
- São Carlos Institute of Physics, University of São Paulo (USP), PO Box 369, 13560-970 São Carlos, Brazil.,Post-Graduated Program of Biotechnology, Federal University of São Carlos (UFSCar), 13565-905 São Carlos, São Paulo, Brazil
| | | | | | - Lian Tock
- Weight Science, São Paulo, São Paulo, Brazil
| | - Ana Claudia Garcia de Oliveira Duarte
- Department of Physical Education, Nutrition and Metabolism Applied to Exercise Laboratory, Federal University of São Carlos (UFSCar), 13565-905 São Carlos, São Paulo, Brazil
| | - Ana Raimunda Dâmaso
- Post-Graduated Program of Nutrition, Federal University of São Paulo (UNIFESP), 04021-001 São Paulo, São Paulo, Brazil
| | - Nivaldo Antonio Parizotto
- Department of Physiotherapy, Therapeutic Resources Laboratory, Federal University of São Carlos (UFSCar), 13565-905 São Carlos, São Paulo, Brazil.,Post-Graduated Program of Biotechnology, Federal University of São Carlos (UFSCar), 13565-905 São Carlos, São Paulo, Brazil
| | - Vanderlei Salvador Bagnato
- São Carlos Institute of Physics, University of São Paulo (USP), PO Box 369, 13560-970 São Carlos, Brazil.,Post-Graduated Program of Biotechnology, Federal University of São Carlos (UFSCar), 13565-905 São Carlos, São Paulo, Brazil
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24
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Schwimmer JB, Middleton MS, Behling C, Newton KP, Awai HI, Paiz MN, Lam J, Hooker JC, Hamilton G, Fontanesi J, Sirlin CB. Magnetic resonance imaging and liver histology as biomarkers of hepatic steatosis in children with nonalcoholic fatty liver disease. Hepatology 2015; 61:1887-95. [PMID: 25529941 PMCID: PMC4670559 DOI: 10.1002/hep.27666] [Citation(s) in RCA: 121] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Accepted: 12/13/2014] [Indexed: 12/12/2022]
Abstract
UNLABELLED Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in children. In order to advance the field of NAFLD, noninvasive imaging methods for measuring liver fat are needed. Advanced magnetic resonance imaging (MRI) has shown great promise for the quantitative assessment of hepatic steatosis but has not been validated in children. Therefore, this study was designed to evaluate the correlation and diagnostic accuracy of MRI-estimated liver proton density fat fraction (PDFF), a biomarker for hepatic steatosis, compared to histologic steatosis grade in children. The study included 174 children with a mean age of 14.0 years. Liver PDFF estimated by MRI was significantly (P < 0.01) correlated (0.725) with steatosis grade. The correlation of MRI-estimated liver PDFF and steatosis grade was influenced by both sex and fibrosis stage. The correlation was significantly (P < 0.01) stronger in girls (0.86) than in boys (0.70). The correlation was significantly (P < 0.01) weaker in children with stage 2-4 fibrosis (0.61) than children with no fibrosis (0.76) or stage 1 fibrosis (0.78). The diagnostic accuracy of commonly used threshold values to distinguish between no steatosis and mild steatosis ranged from 0.69 to 0.82. The overall accuracy of predicting the histologic steatosis grade from MRI-estimated liver PDFF was 56%. No single threshold had sufficient sensitivity and specificity to be considered diagnostic for an individual child. CONCLUSIONS Advanced magnitude-based MRI can be used to estimate liver PDFF in children, and those PDFF values correlate well with steatosis grade by liver histology. Thus, magnitude-based MRI has the potential for clinical utility in the evaluation of NAFLD, but at this time no single threshold value has sufficient accuracy to be considered diagnostic for an individual child.
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Affiliation(s)
- Jeffrey B. Schwimmer
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California, San Diego School of Medicine, San Diego, California,Department of Gastroenterology, Rady Children’s Hospital San Diego, San Diego, California,Liver Imaging Group, Department of Radiology, University of California, San Diego School of Medicine, San Diego, California
| | - Michael S. Middleton
- Liver Imaging Group, Department of Radiology, University of California, San Diego School of Medicine, San Diego, California
| | - Cynthia Behling
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California, San Diego School of Medicine, San Diego, California,Department of Pathology, Sharp Medical Center, San Diego, California
| | - Kimberly P. Newton
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California, San Diego School of Medicine, San Diego, California,Department of Gastroenterology, Rady Children’s Hospital San Diego, San Diego, California
| | - Hannah I. Awai
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California, San Diego School of Medicine, San Diego, California,Department of Gastroenterology, Rady Children’s Hospital San Diego, San Diego, California,Liver Imaging Group, Department of Radiology, University of California, San Diego School of Medicine, San Diego, California
| | - Melissa N. Paiz
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California, San Diego School of Medicine, San Diego, California
| | - Jessica Lam
- Liver Imaging Group, Department of Radiology, University of California, San Diego School of Medicine, San Diego, California,School of Medicine, Loma Linda University, Loma Linda, California
| | - Jonathan C. Hooker
- Liver Imaging Group, Department of Radiology, University of California, San Diego School of Medicine, San Diego, California
| | - Gavin Hamilton
- Liver Imaging Group, Department of Radiology, University of California, San Diego School of Medicine, San Diego, California
| | - John Fontanesi
- Center for Management Science in Health, Division of General Internal Medicine, Department of Medicine, University of California, San Diego School of Medicine, La Jolla, California,Department of Family and Preventive Medicine, University of California, San Diego School of Medicine, La Jolla, California,Department of Pediatrics, University of California, San Diego School of Medicine, La Jolla, California
| | - Claude B. Sirlin
- Liver Imaging Group, Department of Radiology, University of California, San Diego School of Medicine, San Diego, California
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25
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Corgosinho FC, Ackel-D'Elia C, Tufik S, Dâmaso AR, de Piano A, Sanches PDL, Campos RMDS, Silva PL, Carnier J, Tock L, Andersen ML, Moreira GA, Pradella-Hallinan M, Oyama LM, de Mello MT. Beneficial Effects of a Multifaceted 1-Year Lifestyle Intervention on Metabolic Abnormalities in Obese Adolescents With and Without Sleep-Disordered Breathing. Metab Syndr Relat Disord 2015; 13:110-8. [DOI: 10.1089/met.2014.0110] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Affiliation(s)
- Flávia Campos Corgosinho
- Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
- Programa de Pós-Graduação em Nutrição, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Carolina Ackel-D'Elia
- Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
- Programa de Pós-Graduação em Nutrição, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Sergio Tufik
- Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
- Departmento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Ana Raimunda Dâmaso
- Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
- Programa de Pós-Graduação em Nutrição, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
- Departamento de Biociências, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
- Departamento Interdisciplinar de Ciências da Saúde, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Aline de Piano
- Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
- Programa de Pós-Graduação em Nutrição, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Priscila de Lima Sanches
- Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
- Programa de Pós-Graduação em Nutrição, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Raquel Munhoz da Silveira Campos
- Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
- Programa de Pós-Graduação em Nutrição, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Patrícia Leão Silva
- Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
- Programa de Pós-Graduação em Nutrição, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - June Carnier
- Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
- Programa de Pós-Graduação em Nutrição, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | | | - Monica Levy Andersen
- Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
- Departmento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Gustavo Antônio Moreira
- Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
- Departmento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Marcia Pradella-Hallinan
- Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
- Departmento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Lila Missae Oyama
- Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
- Programa de Pós-Graduação em Nutrição, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
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26
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Polyzos SA, Kountouras J, Mantzoros CS. Leptin in nonalcoholic fatty liver disease: a narrative review. Metabolism 2015; 64:60-78. [PMID: 25456097 DOI: 10.1016/j.metabol.2014.10.012] [Citation(s) in RCA: 145] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Revised: 10/12/2014] [Accepted: 10/16/2014] [Indexed: 02/06/2023]
Abstract
Leptin, the first described adipokine, interplays with hepatic metabolism. The aim of this review was to summarize available data on the association between leptin and nonalcoholic fatty liver disease (NAFLD). Leptin has a potential dual action on NAFLD experimental models, exerting a possible anti-steatotic, but also a proinflammatory and profibrogenic action. Observational clinical studies have shown higher or similar leptin levels between simple steatosis and nonalcoholic steatohepatitis (NASH) compared with controls. Interventional studies showed that circulating leptin diminishes together with body mass index after successful weight loss following lifestyle modifications or bariatric surgery. Studies providing evidence for the effect of other medications on leptin levels in NAFLD populations are limited and of low power. Data from small studies claim that recombinant leptin administration had a possibly beneficial effect on steatosis, but not fibrosis, in NAFLD patients with hypoleptinemia. Although the aforementioned dual leptin action has not yet been validated in humans, leptin administration in NAFLD patients with normoleptinemia or hyperleptinemia is discouraged. Further well-controlled studies in cautiously selected populations are needed to elucidate whether leptin has any prognostic and therapeutic role in NAFLD patients.
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Affiliation(s)
- Stergios A Polyzos
- Second Medical Clinic, Department of Medicine, Aristotle University of Thessaloniki, Ippokration Hospital, Thessaloniki, Greece; Division of Endocrinology, Diabetes and Metabolism, Department of Internal Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
| | - Jannis Kountouras
- Second Medical Clinic, Department of Medicine, Aristotle University of Thessaloniki, Ippokration Hospital, Thessaloniki, Greece
| | - Christos S Mantzoros
- Division of Endocrinology, Diabetes and Metabolism, Department of Internal Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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