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Cano-Lallave L, Ruiz-Tovar J, Martin-de-Bernardo L, Martinez-Oribe M, Rodriguez-Obispo C, Carrascosa-Corrochano S, Martín-Nieto A, Baeza I, Gonzalez-Ramos M, Benito M, Olazabal I. Influence of Adherence to the Mediterranean Diet and Level of Physical Activity with Liver Steatosis in People Aged > 50 Years and with a BMI > 25 kg/m 2: Association with Biochemical Markers. Nutrients 2024; 16:1996. [PMID: 38999744 PMCID: PMC11243416 DOI: 10.3390/nu16131996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2024] [Revised: 06/19/2024] [Accepted: 06/20/2024] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND The main objective of this study is to determine the accuracy of different biochemical markers of hepatic steatosis and to correlate liver steatosis with adherence to the Mediterranean diet and level of physical activity. METHODS A cross-sectional study was carried out, including subjects over 50 years of age, with a BMI > 25 kg/m2, but excluding any patient with documented hepatic pathology other than hepatic steatosis. Participants were divided into two groups: patients with hepatic steatosis diagnosed by ultrasound (SG) and a control group of individuals without hepatic steatosis (CG). The level of physical activity was recorded by the IPAQ-SF questionnaire and the adherence to the Mediterranean diet was recorded using the PREDIMED questionnaire. Biochemical markers analyzed included the Hepatic steatosis index (HSI), AST-to-Platelet ratio (APRI) and Fibrosis-4 (FIB-4). RESULTS A total of 116 patients were included, 71 belonging to the SG and 45 to the CG. A total of 58.6% of the patients showed low adherence to the Mediterranean diet, 35.4% moderate adherence and 6% high adherence. The median estimated physical activity was 495 METS, with most participants reporting light activity. In the SG, significantly higher HSI values were observed (p < 0.001). A cut-off point of a HSI of 40 was established, with a sensitivity of 73.2% and a specificity of 65.8%. Significantly higher FIB-4 values (p = 0.039) were also observed in the SG. A cut-off point of FIB-4 was set at 0.27, with a sensitivity of 69% and a specificity of 57.9%. Patients in the SG showed lower scores in the PREDIMED. Patients in the SG tended to show lower METS scores. However, the higher number of patients with intense activity in the CG group stands out (p = 0.008). CONCLUSIONS The HSI and FIB-4 showed a significant correlation with liver steatosis. Hepatic steatosis is associated with low adherence to the Mediterranean diet and patients with hepatic steatosis tended to have lower METS scores.
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Affiliation(s)
- Laura Cano-Lallave
- Department of Health Sciences, School of Medicine, Alfonso X University, 28691 Madrid, Spain
| | - Jaime Ruiz-Tovar
- San Juan de Dios Foundation, 28015 Madrid, Spain
- Health Sciences Department, San Juan de Dios School of Nursing and Physical Therapy, Comillas Pontifical University, 28015 Madrid, Spain
| | | | | | | | | | - Ana Martín-Nieto
- San Juan de Dios Foundation, 28015 Madrid, Spain
- Health Sciences Department, San Juan de Dios School of Nursing and Physical Therapy, Comillas Pontifical University, 28015 Madrid, Spain
| | - Isabel Baeza
- San Juan de Dios Foundation, 28015 Madrid, Spain
- Health Sciences Department, San Juan de Dios School of Nursing and Physical Therapy, Comillas Pontifical University, 28015 Madrid, Spain
| | - Marta Gonzalez-Ramos
- San Juan de Dios Foundation, 28015 Madrid, Spain
- Health Sciences Department, San Juan de Dios School of Nursing and Physical Therapy, Comillas Pontifical University, 28015 Madrid, Spain
| | - Marta Benito
- San Juan de Dios Foundation, 28015 Madrid, Spain
- Health Sciences Department, San Juan de Dios School of Nursing and Physical Therapy, Comillas Pontifical University, 28015 Madrid, Spain
| | - Isabel Olazabal
- Department of Biomedicine, Alfonso X University, 28691 Madrid, Spain
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Goldberg DT, Yaskolka Meir A, Tsaban G, Rinott E, Kaplan A, Zelicha H, Klöting N, Ceglarek U, Iserman B, Shelef I, Rosen P, Blüher M, Stumvoll M, Etzion O, Stampfer MJ, Hu FB, Shai I. Novel proteomic signatures may indicate MRI-assessed intrahepatic fat state and changes: The DIRECT PLUS clinical trial. Hepatology 2024:01515467-990000000-00821. [PMID: 38537153 DOI: 10.1097/hep.0000000000000867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 03/03/2024] [Indexed: 05/08/2024]
Abstract
BACKGROUND AND AIMS We demonstrated in the randomized 18-month DIRECT PLUS trial (n = 294) that a Mediterranean (MED) diet, supplemented with polyphenol-rich Mankai duckweed, green tea, and walnuts and restricted in red/processed meat, caused substantial intrahepatic fat (IHF%) loss compared with 2 other healthy diets, reducing NAFLD by half, regardless of similar weight loss. Here, we investigated the baseline proteomic profile associated with IHF% and the changes in proteomics associated with IHF% changes induced by lifestyle intervention. APPROACH AND RESULTS We calculated IHF% by proton magnetic resonance spectroscopy (normal IHF% <5% and abnormal IHF% ≥5%). We assayed baseline and 18-month samples for 95 proteomic biomarkers.Participants (age = 51.3 ± 10.8 y; 89% men; and body mass index = 31.3 ± 3.9 kg/m 2 ) had an 89.8% 18-month retention rate; 83% had eligible follow-up proteomics measurements, and 78% had follow-up proton magnetic resonance spectroscopy. At baseline, 39 candidate proteins were significantly associated with IHF% (false discovery rate <0.05), mostly related to immune function pathways (eg, hydroxyacid oxidase 1). An IHF% prediction based on the DIRECT PLUS by combined model ( R2 = 0.47, root mean square error = 1.05) successfully predicted IHF% ( R2 = 0.53) during testing and was stronger than separately inputting proteins/traditional markers ( R2 = 0.43/0.44). The 18-month lifestyle intervention induced changes in 18 of the 39 candidate proteins, which were significantly associated with IHF% change, with proteins related to metabolism, extracellular matrix remodeling, and immune function pathways. Thrombospondin-2 protein change was higher in the green-MED compared to the MED group, beyond weight and IHF% loss ( p = 0.01). Protein principal component analysis revealed differences in the third principal component time distinct interactions across abnormal/normal IHF% trajectory combinations; p < 0.05 for all). CONCLUSIONS Our findings suggest novel proteomic signatures that may indicate MRI-assessed IHF state and changes during lifestyle intervention. Specifically, carbonic anhydrase 5A, hydroxyacid oxidase 1, and thrombospondin-2 protein changes are independently associated with IHF% change, and thrombospondin-2 protein change is greater in the green-MED/high polyphenols diet.
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Affiliation(s)
- Dana T Goldberg
- The Health & Nutrition Innovative International Research Center, Department of Epidemiology, Biostatistics and Community Health Sciences, Faculty of Health Sciences, School of Public Health, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Anat Yaskolka Meir
- The Health & Nutrition Innovative International Research Center, Department of Epidemiology, Biostatistics and Community Health Sciences, Faculty of Health Sciences, School of Public Health, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Gal Tsaban
- The Health & Nutrition Innovative International Research Center, Department of Epidemiology, Biostatistics and Community Health Sciences, Faculty of Health Sciences, School of Public Health, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ehud Rinott
- The Health & Nutrition Innovative International Research Center, Department of Epidemiology, Biostatistics and Community Health Sciences, Faculty of Health Sciences, School of Public Health, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Alon Kaplan
- The Health & Nutrition Innovative International Research Center, Department of Epidemiology, Biostatistics and Community Health Sciences, Faculty of Health Sciences, School of Public Health, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Hila Zelicha
- The Health & Nutrition Innovative International Research Center, Department of Epidemiology, Biostatistics and Community Health Sciences, Faculty of Health Sciences, School of Public Health, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Nora Klöting
- Department of Medicine, University of Leipzig, Leipzig, Germany
| | - Uta Ceglarek
- Department of Medicine, University of Leipzig, Leipzig, Germany
- Institute of Laboratory Medicine, Clinical Chemistry, and Molecular Diagnostics, University of Leipzig Medical Center, Leipzig, Germany
| | - Berend Iserman
- Department of Medicine, University of Leipzig, Leipzig, Germany
- Institute of Laboratory Medicine, Clinical Chemistry, and Molecular Diagnostics, University of Leipzig Medical Center, Leipzig, Germany
| | - Ilan Shelef
- Department of Diagnostic Imaging, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Philip Rosen
- Department of Diagnostic Imaging, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Matthias Blüher
- Department of Medicine, University of Leipzig, Leipzig, Germany
- Helmholtz Institute for Metabolic, Obesity and Vascular Research (HI-MAG) of the Helmholtz Zentrum München at the University of Leipzig and University Hospital Leipzig, Leipzig, Germany
| | - Michael Stumvoll
- Department of Medicine, University of Leipzig, Leipzig, Germany
- Helmholtz Institute for Metabolic, Obesity and Vascular Research (HI-MAG) of the Helmholtz Zentrum München at the University of Leipzig and University Hospital Leipzig, Leipzig, Germany
| | - Ohad Etzion
- Department of Gastroenterology and Liver Diseases, Soroka University Medical Center, Beersheba, Israel
| | - Meir J Stampfer
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Frank B Hu
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Iris Shai
- The Health & Nutrition Innovative International Research Center, Department of Epidemiology, Biostatistics and Community Health Sciences, Faculty of Health Sciences, School of Public Health, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Department of Medicine, University of Leipzig, Leipzig, Germany
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Ahmed L, Gebran S, Persaud A, Saeed K, Khan K, Saeed S, Alothman S, Passos-Fox B, DePaz H, Suman P. The Use of Noninvasive Scores in Predicting NAFLD Progression After Bariatric Surgery. Obes Surg 2023; 33:4026-4033. [PMID: 37884692 DOI: 10.1007/s11695-023-06912-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 10/11/2023] [Accepted: 10/18/2023] [Indexed: 10/28/2023]
Abstract
BACKGROUND Bariatric surgery has been postulated to impact liver function resulting in favorable effects on nonalcoholic fatty liver disease (NAFLD). We aimed to analyze the long-term impact of bariatric surgery on noninvasive scores predicting the progression of liver fibrosis in a bariatric population. METHODS We retrospectively reviewed the records of patients without pre-existing liver disease who underwent sleeve gastrectomy or Roux-en-Y gastric bypass (RYGB) at our center between 2010 and 2018. Four predictive scores for liver fibrosis (AST/ALT, APRI, Fib-4, and BARD) were calculated preoperatively, 6 months post-operatively, and annually up to 5 years. Correlations were analyzed with Pearson R. Subgroup and sensitivity analyses were performed to identify populations at increased risk. RESULTS A total of 2769 patients were included. The mean age was 40 years, and the majority was females (88.5%) and of Hispanic ethnicity (59.2%). There was a steady post-operative increase in the percentage of patients at increased risk of progression of liver fibrosis. The Fib-4 score showed the largest increase in the population at risk for liver fibrosis (11.3% preoperatively to 28.9% at 5 years). Patients with diabetes and those who underwent a sleeve gastrectomy continued to display a higher risk for liver fibrosis than did patients without diabetes and those who underwent RYGB, respectively. CONCLUSION There was an overall trend to increased liver fibrosis scores over the 5-year post-operative follow-up, but this increase remained lower than that reported in previous literature. Bariatric surgery offers NAFLD risk reduction in a high-risk population.
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Affiliation(s)
- Leaque Ahmed
- Department of Surgery, Harlem Hospital Center, 506 Lenox Ave, New York, NY, 10037, USA
- Department of Surgery, Wyckoff Heights Medical Center, 374 Stockholm St, Room C-408, Brooklyn, NY, Brooklyn, NY, 11237, USA
| | - Selim Gebran
- Department of Surgery, Wyckoff Heights Medical Center, 374 Stockholm St, Room C-408, Brooklyn, NY, Brooklyn, NY, 11237, USA.
| | - Amrita Persaud
- Department of Surgery, Harlem Hospital Center, 506 Lenox Ave, New York, NY, 10037, USA
- Department of Surgery, Wyckoff Heights Medical Center, 374 Stockholm St, Room C-408, Brooklyn, NY, Brooklyn, NY, 11237, USA
| | - Kashif Saeed
- Department of Surgery, Harlem Hospital Center, 506 Lenox Ave, New York, NY, 10037, USA
- Department of Surgery, Wyckoff Heights Medical Center, 374 Stockholm St, Room C-408, Brooklyn, NY, Brooklyn, NY, 11237, USA
| | - Khuram Khan
- Department of Surgery, Harlem Hospital Center, 506 Lenox Ave, New York, NY, 10037, USA
- Department of Surgery, Wyckoff Heights Medical Center, 374 Stockholm St, Room C-408, Brooklyn, NY, Brooklyn, NY, 11237, USA
| | - Saqib Saeed
- Department of Surgery, Harlem Hospital Center, 506 Lenox Ave, New York, NY, 10037, USA
| | - Sara Alothman
- Department of Surgery, Harlem Hospital Center, 506 Lenox Ave, New York, NY, 10037, USA
- Department of Surgery, Wyckoff Heights Medical Center, 374 Stockholm St, Room C-408, Brooklyn, NY, Brooklyn, NY, 11237, USA
| | - Bianca Passos-Fox
- Department of Surgery, Harlem Hospital Center, 506 Lenox Ave, New York, NY, 10037, USA
- Department of Surgery, Wyckoff Heights Medical Center, 374 Stockholm St, Room C-408, Brooklyn, NY, Brooklyn, NY, 11237, USA
| | - Hector DePaz
- Department of Surgery, Harlem Hospital Center, 506 Lenox Ave, New York, NY, 10037, USA
- Department of Surgery, Wyckoff Heights Medical Center, 374 Stockholm St, Room C-408, Brooklyn, NY, Brooklyn, NY, 11237, USA
| | - Paritosh Suman
- Department of Surgery, Harlem Hospital Center, 506 Lenox Ave, New York, NY, 10037, USA
- Department of Surgery, Wyckoff Heights Medical Center, 374 Stockholm St, Room C-408, Brooklyn, NY, Brooklyn, NY, 11237, USA
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Kheirvari M, Dadkhah Nikroo N, Jaafarinejad H, Farsimadan M, Eshghjoo S, Hosseini S, Anbara T. The advantages and disadvantages of sleeve gastrectomy; clinical laboratory to bedside review. Heliyon 2020; 6:e03496. [PMID: 32154399 PMCID: PMC7052082 DOI: 10.1016/j.heliyon.2020.e03496] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 12/01/2019] [Accepted: 02/24/2020] [Indexed: 02/06/2023] Open
Abstract
Sleeve gastrectomy is a surgical technique and a leading method in metabolic surgery. Sleeve gastrectomy gained ever-increasing popularity among laparoscopic surgeons involved in bariatric surgery and has proved to be a successful method in achieving considerable weight loss in a short time. There are some disparate effects that patients may experience after sleeve gastrectomy including a reduction in BMI, weight, blood pressure, stroke, and cancer and also a significant remission in obesity-related diseases including type 2 diabetes (T2D), Non-alcoholic fatty liver (NAFLD), cardiovascular disease, obstructive sleep apnea, and craniopharyngioma-related hypothalamic obesity as well as non-obesity-related diseases such as gout, musculoskeletal problems, ovarian disorders and urinary incontinence. The most common complications of sleeve gastrectomy are bleeding, nutrient deficiencies, and leakage. There are several studies on the impact of gender and ethnic disparities on post-operative complications. This study collects state of the art of reports on sleeve gastrectomy. The aim of this study was to analyze recent studies and review the advantages and disadvantages of sleeve gastrectomy.
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Affiliation(s)
- Milad Kheirvari
- Microbiology Research Centre, Pasteur Institute of Iran, Tehran, Iran
| | | | - Habib Jaafarinejad
- Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
| | - Marziye Farsimadan
- Department of Biology, Faculty of Sciences, University of Guilan, Rasht Iran
| | - Sahar Eshghjoo
- Department of Microbial Pathogenesis and Immunology, College of Medicine, Texas A&M University, Health Science Center, Bryan, TX, USA
| | - Sara Hosseini
- Department of Surgery, Erfan Niayesh Hospital, Tehran, Iran
| | - Taha Anbara
- Department of Surgery, Erfan Niayesh Hospital, Tehran, Iran
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Current Status in Testing for Nonalcoholic Fatty Liver Disease (NAFLD) and Nonalcoholic Steatohepatitis (NASH). Cells 2019; 8:cells8080845. [PMID: 31394730 PMCID: PMC6721710 DOI: 10.3390/cells8080845] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 08/05/2019] [Accepted: 08/06/2019] [Indexed: 12/19/2022] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in Western countries with almost 25% affected adults worldwide. The growing public health burden is getting evident when considering that NAFLD-related liver transplantations are predicted to almost double within the next 20 years. Typically, hepatic alterations start with simple steatosis, which easily progresses to more advanced stages such as nonalcoholic steatohepatitis (NASH), fibrosis and cirrhosis. This course of disease finally leads to end-stage liver disease such as hepatocellular carcinoma, which is associated with increased morbidity and mortality. Although clinical trials show promising results, there is actually no pharmacological agent approved to treat NASH. Another important problem associated with NASH is that presently the liver biopsy is still the gold standard in diagnosis and for disease staging and grading. Because of its invasiveness, this technique is not well accepted by patients and the method is prone to sampling error. Therefore, an urgent need exists to find reliable, accurate and noninvasive biomarkers discriminating between different disease stages or to develop innovative imaging techniques to quantify steatosis.
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