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Najafi F, Pasdar Y, Nazar MM, Darbandi M. Association between obesity phenotypes and non-alcoholic fatty liver: a large population- based study. BMC Endocr Disord 2024; 24:96. [PMID: 38918729 PMCID: PMC11197192 DOI: 10.1186/s12902-024-01630-4] [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: 03/06/2024] [Accepted: 06/20/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND The aim of this study was to examine the association between different metabolic obesity phenotypes and the non-alcoholic fatty liver disease (NAFLD). METHODS This cross-sectional analysis utilized data from the baseline phase of the Ravansar non-communicable diseases (RaNCD) cohort study, which involved 8,360 adults. Participants with a Fatty Liver Index (FLI) score of ≥ 60 was classified as having NAFLD. The FLI score was calculated using liver non-invasive markers and anthropometric measurements. Participants were categorized into four phenotypes based on the presence or absence of metabolic syndrome and obesity. Logistic regression analysis was used to evaluate the association of NAFLD and obesity phenotypes. RESULTS According to the FLI index, the prevalence of NAFLD was 39.56%. Participants with FLI scores of ≥ 60 had higher energy intake compared to those in the FLI < 60 group (P = 0.033). In subjects with metabolically unhealthy phenotypes, the level of physical activity was lower compared to those with metabolically healthy phenotypes. The risk of NAFLD in males with the metabolically healthy-obese phenotype increased by 8.92 times (95% CI: 2.20, 15.30), those with the metabolically unhealthy-non-obese phenotype increased by 7.23 times (95% CI: 5.82, 8.99), and those with the metabolically unhealthy-obese phenotype increased by 32.97 times (95% CI: 15.70, 69.22) compared to the metabolically healthy-non-obese phenotype. Similarly, these results were observed in females. CONCLUSION This study demonstrated that the risk of NAFLD is higher in individuals with metabolically healthy/obese, metabolically unhealthy/non-obese, and metabolically unhealthy/obese phenotypes compared to those with non-obese/metabolically healthy phenotypes.
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Affiliation(s)
- Farid Najafi
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Yahya Pasdar
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mehdi Moradi Nazar
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mitra Darbandi
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Wang C, Yang F, Zeng W, Chen X, Qiu Z, Wang Q, Meng Y, Zheng G, Hu J. Vine tea total flavonoids activate the AMPK/mTOR pathway to amelioration hepatic steatosis in mice fed a high-fat diet. J Food Sci 2024; 89:3019-3036. [PMID: 38517018 DOI: 10.1111/1750-3841.17025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 02/07/2024] [Accepted: 02/22/2024] [Indexed: 03/23/2024]
Abstract
Vine tea (Ampelopsis grossedentata), a traditional Chinese tea, is rich in flavonoids with various biological activities. Our study found that Vine tea total flavonoids (TFs) treatment reduced the body mass and blood lipid levels and improved the hepatic tissue morphology in mice fed the high-fat diet (HFD). In vivo, TF treatment activated the hepatic adenosine monophosphate-activated protein kinase (AMPK)/mammalian target of rapamycin (mTOR) pathway, initiated autophagy, and regulated the expression levels of proteins for lipid metabolism in those HFD-fed mice. In vitro, TF treatment dramatically reduced the lipid droplets and triacylglycerol content in HepG2 and L02 cells treated with oleic acid (OA). These were associated with the activation of the AMPK/mTOR pathway and autophagy initiation in OA-treated hepatocytes. This phenotype was abolished in the presence of 3-methyladenine, an autophagy inhibitor. Our results indicated that the TF activation of AMPK/mTOR leads to the stimulation of autophagy and a decrease in the buildup of intracellular lipids in hepatocytes, showing the potential of TF as a therapeutic agent for nonalcoholic fatty liver disease. PRACTICAL APPLICATION: Vine tea, a tea drink, has been consumed by Chinese folk for over a thousand years. The result of this study will provide evidence that vine tea total flavonoids have potential use as a functional material for the prevention and amelioration of nonalcoholic fatty liver disease.
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Affiliation(s)
- Chuting Wang
- College of Pharmacy, Hubei University of Chinese Medicine, Wuhan, Hubei, People's Republic of China
- Hubei Shizhen Laboratory, Wuhan, Hubei, People's Republic of China
| | - Fang Yang
- School of Laboratory Medicine, Hubei University of Chinese Medicine, Wuhan, Hubei, People's Republic of China
| | - Wei Zeng
- Respiratory, The First People's Hospital of Jingzhou, Jingzhou, Hubei, People's Republic of China
| | - Xin Chen
- College of Pharmacy, Hubei University of Chinese Medicine, Wuhan, Hubei, People's Republic of China
| | - Zhenpeng Qiu
- College of Pharmacy, Hubei University of Chinese Medicine, Wuhan, Hubei, People's Republic of China
| | - Qi Wang
- College of Pharmacy, Hubei University of Chinese Medicine, Wuhan, Hubei, People's Republic of China
| | - Yan Meng
- College of Pharmacy, Hubei University of Chinese Medicine, Wuhan, Hubei, People's Republic of China
| | - Guohua Zheng
- College of Pharmacy, Hubei University of Chinese Medicine, Wuhan, Hubei, People's Republic of China
| | - Junjie Hu
- College of Pharmacy, Hubei University of Chinese Medicine, Wuhan, Hubei, People's Republic of China
- Center of Traditional Chinese Medicine Modernization for Liver Diseases, Hubei University of Traditional Chinese Medicine, Wuhan, Hubei, People's Republic of China
- Hubei Shizhen Laboratory, Wuhan, Hubei, People's Republic of China
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Terzo S, Amato A, Magán-Fernández A, Castellino G, Calvi P, Chianetta R, Giglio RV, Patti AM, Nikolic D, Firenze A, Mulè F, Ciaccio M, Rizzo M. A Nutraceutical Containing Chlorogenic Acid and Luteolin Improves Cardiometabolic Parameters in Subjects with Pre-Obesity: A 6-Month Randomized, Double-Blind, Placebo-Controlled Study. Nutrients 2023; 15:nu15020462. [PMID: 36678333 PMCID: PMC9862908 DOI: 10.3390/nu15020462] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/30/2022] [Accepted: 01/09/2023] [Indexed: 01/19/2023] Open
Abstract
Pre-obesity is a condition that predisposes to the risk of developing obesity, cardiovascular diseases (CVD), and diabetes. Our previous study demonstrated that a Cynara cardunculus (L.) based nutraceutical named Altilix® (Bionap, Italy), containing chlorogenic acid and luteolin extracts, was able to improve several hepatic and cardio-metabolic parameters. Given this background, we conducted a post-hoc analysis of the Altilix® study in order to analyze the supplement’s effects in the subgroup of pre-obesity subjects on anthropometry (weight and waist circumference), glucose metabolism (HbA1C, HOMA-IR, and HOMA-β), lipid profile (total cholesterol, triglycerides, LDL-cholesterol and HDL-cholesterol), hepatic functionality (FLI, AST, ALT and AST/ALT), carotid-media thickness (CIMT) and endothelial function (FMD). Fifty subjects from the original study cohort (which consisted of 100 subjects) were chosen with BMI ≥ 25 and < 30 kg/m2. All subjects received the Altilix® supplement (150 mg/day) or placebo using a computer-based random allocation system. After six months of treatment Altilix® significantly reduced body weight, glycemic, and lipid parameters (total cholesterol, triglycerides, LDL-cholesterol) and improved hepatic functionality, CIMT, and FMD. In conclusion, these results confirm that Altilix® supplementation has a significant effect on cardiometabolic parameters not only in obese subjects but also in pre-obesity subjects.
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Affiliation(s)
- Simona Terzo
- Department of Biological, Chemical and Pharmaceutical Sciences and Technologies (STEBICEF), University of Palermo, 90100 Palermo, Italy
| | - Antonella Amato
- Department of Biological, Chemical and Pharmaceutical Sciences and Technologies (STEBICEF), University of Palermo, 90100 Palermo, Italy
| | - Antonio Magán-Fernández
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90100 Palermo, Italy
| | - Giuseppa Castellino
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90100 Palermo, Italy
| | - Pasquale Calvi
- Department of Biological, Chemical and Pharmaceutical Sciences and Technologies (STEBICEF), University of Palermo, 90100 Palermo, Italy
| | - Roberta Chianetta
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90100 Palermo, Italy
| | - Rosaria V. Giglio
- Department of Biomedicine, Neuroscience, and Advanced Diagnostics, Institute of Clinical Biochemistry, Clinical Molecular Medicine, and Laboratory Medicine, University of Palermo, 90100 Palermo, Italy
| | - Angelo M. Patti
- Department of Biomedicine, Neuroscience, and Advanced Diagnostics, Institute of Clinical Biochemistry, Clinical Molecular Medicine, and Laboratory Medicine, University of Palermo, 90100 Palermo, Italy
| | - Dragana Nikolic
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90100 Palermo, Italy
| | - Alberto Firenze
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90100 Palermo, Italy
| | - Flavia Mulè
- Department of Biological, Chemical and Pharmaceutical Sciences and Technologies (STEBICEF), University of Palermo, 90100 Palermo, Italy
| | - Marcello Ciaccio
- Department of Biomedicine, Neuroscience, and Advanced Diagnostics, Institute of Clinical Biochemistry, Clinical Molecular Medicine, and Laboratory Medicine, University of Palermo, 90100 Palermo, Italy
| | - Manfredi Rizzo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90100 Palermo, Italy
- Correspondence:
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Vicente-Herrero MT, Ramírez-Iñiguez de la Torre MV, López González ÁA. Obesidad, hábitos de vida y valoración FLI en la población laboral española durante la pandemia. REVISTA CLÍNICA DE MEDICINA DE FAMILIA 2022. [DOI: 10.55783/rcmf.150205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Antecedentes: el hígado graso no alcohólico es la enfermedad hepática más común en el mundo, habitualmente asintomática y manifestación hepática del síndrome metabólico.
Objetivo: estimar el riesgo de hígado graso mediante el índice de hígado graso (FLI, Fatty Liver Index) y su relación con el índice de masa corporal (IMC), indicadores de adiposidad, hábitos de vida y variables sociodemográficas.
Material y métodos: estudio descriptivo transversal realizado con 815 trabajadores de entre 18-66 años, durante la vigilancia de la salud de las empresas participantes, desde marzo de 2020 hasta junio de 2021.
Se utiliza la calculadora FLI y se establecen relaciones con variables sociodemográficas, índices de adiposidad, hábitos de alimentación y actividad física con el uso de los cuestionarios PREDIMED e IPAQ.
Resultados: el FLI > 60 se relaciona significativamente con el IMC, el perímetro de la cintura y el índice cintura-cadera. El IMC incrementa el riesgo casi 20 veces (odds ratio 19,87; IC 95% 10,84-36,44) de sufrir la enfermedad. Los valores altos son más perjudiciales en hombres y el riesgo aumenta con la edad. Un FLI en rango medio/alto (> 30) muestra una relación significativa con la adherencia a MedDiet y con la actividad física realizada, con diferencias entre géneros (p < 0,0001).
Conclusión: el riesgo de hígado graso aumenta con la obesidad y con los hábitos de vida no saludables, con valores más desfavorables entre los hombres. Destaca la importancia de valorar, junto con el IMC, los indicadores de adiposidad.
Palabras clave: hígado graso, enfermedad del hígado graso no alcohólico, obesidad, salud laboral.
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Affiliation(s)
- M.ª Teófila Vicente-Herrero
- Especialista en Medicina del Trabajo. Grupo Obesidad y Trabajo-Asociación Española de Especialistas en Medicina del Trabajo (AEEMT)
| | - M.ª Victoria Ramírez-Iñiguez de la Torre
- Especialista en Medicina del Trabajo. SPP Grupo Correos-SEPI-Albacete y Cuenca. Grupo Obesidad y Trabajo-Asociación Española de Especialistas en Medicina del Trabajo (AEEMT)
| | - Ángel Arturo López González
- Especialista en Medicina del Trabajo. Servei de Salut de les Illes Balears. Escuela Universitaria ADEMA. Grupo Obesidad y Trabajo-Asociación Española de Especialistas en Medicina del Trabajo (AEEMT)
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Vicente Herrero MT, Ramírez-Iñiguez de la Torre MV, López González ÁA. Obesidad, hábitos de vida y valoración FLI en la población laboral española durante la pandemia. REVISTA CLÍNICA DE MEDICINA DE FAMILIA 2022. [DOI: 10.55783/150205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Antecedentes: el hígado graso no alcohólico es la enfermedad hepática más común en el mundo, habitualmente asintomática y manifestación hepática del síndrome metabólico.
Objetivo: estimar el riesgo de hígado graso mediante el índice de hígado graso (FLI, Fatty Liver Index) y su relación con el índice de masa corporal (IMC), indicadores de adiposidad, hábitos de vida y variables sociodemográficas.
Material y métodos: estudio descriptivo transversal realizado con 815 trabajadores de entre 18-66 años, durante la vigilancia de la salud de las empresas participantes, desde marzo de 2020 hasta junio de 2021.
Se utiliza la calculadora FLI y se establecen relaciones con variables sociodemográficas, índices de adiposidad, hábitos de alimentación y actividad física con el uso de los cuestionarios PREDIMED e IPAQ.
Resultados: el FLI > 60 se relaciona significativamente con el IMC, el perímetro de la cintura y el índice cintura-cadera. El IMC incrementa el riesgo casi 20 veces (odds ratio 19,87; IC 95% 10,84-36,44) de sufrir la enfermedad. Los valores altos son más perjudiciales en hombres y el riesgo aumenta con la edad. Un FLI en rango medio/alto (> 30) muestra una relación significativa con la adherencia a MedDiet y con la actividad física realizada, con diferencias entre géneros (p < 0,0001).
Conclusión: el riesgo de hígado graso aumenta con la obesidad y con los hábitos de vida no saludables, con valores más desfavorables entre los hombres. Destaca la importancia de valorar, junto con el IMC, los indicadores de adiposidad.
Palabras clave: hígado graso, enfermedad del hígado graso no alcohólico, obesidad, salud laboral.
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Affiliation(s)
- M.ª Teófila Vicente Herrero
- Especialista en Medicina del Trabajo. Grupo Obesidad y Trabajo-Asociación Española de Especialistas en Medicina del Trabajo (AEEMT)
| | - M.ª Victoria Ramírez-Iñiguez de la Torre
- Especialista en Medicina del Trabajo. SPP Grupo Correos-SEPI-Albacete y Cuenca. Grupo Obesidad y Trabajo-Asociación Española de Especialistas en Medicina del Trabajo (AEEMT)
| | - Ángel Arturo López González
- Especialista en Medicina del Trabajo. Servei de Salut de les Illes Balears. Escuela Universitaria ADEMA. Grupo Obesidad y Trabajo-Asociación Española de Especialistas en Medicina del Trabajo (AEEMT)
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Evolution of Metabolic Phenotypes of Obesity in Coronary Patients after 5 Years of Dietary Intervention: From the CORDIOPREV Study. Nutrients 2021; 13:nu13114046. [PMID: 34836298 PMCID: PMC8624211 DOI: 10.3390/nu13114046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 11/05/2021] [Accepted: 11/09/2021] [Indexed: 11/17/2022] Open
Abstract
Background: Obesity phenotypes with different metabolic status have been described previously. We analyzed metabolic phenotypes in obese coronary patients during a 5-year follow-up, and examined the factors influencing this evolution. Methods: The CORDIOPREV study is a randomized, long-term secondary prevention study with two healthy diets: Mediterranean and low-fat. All obese patients were classified as either metabolically healthy obese (MHO) or metabolically unhealthy obese (MUO). We evaluated the changes in the metabolic phenotypes and related variables after 5 years of dietary intervention. Results: Initially, 562 out of the 1002 CORDIOPREV patients were obese. After 5 years, 476 obese patients maintained their clinical and dietary visits; 71.8% of MHO patients changed to unhealthy phenotypes (MHO-Progressors), whereas the MHO patients who maintained healthy phenotypes (MHO-Non-Progressors) lost more in terms of their body mass index (BMI) and had a lower fatty liver index (FLI-score) (p < 0.05). Most of the MUO (92%) patients maintained unhealthy phenotypes (MUO-Non-Responders), but 8% became metabolically healthy (MUO-Responders) after a significant decrease in their BMI and FLI-score, with improvement in all metabolic criteria. No differences were found among dietary groups. Conclusions: A greater loss of weight and liver fat is associated with a lower progression of the MHO phenotype to unhealthy phenotypes. Likewise, a marked improvement in these parameters is associated with regression from MUO to healthy phenotypes.
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Metabolically Healthy Obesity (MHO) vs. Metabolically Unhealthy Obesity (MUO) Phenotypes in PCOS: Association with Endocrine-Metabolic Profile, Adherence to the Mediterranean Diet, and Body Composition. Nutrients 2021; 13:nu13113925. [PMID: 34836180 PMCID: PMC8624317 DOI: 10.3390/nu13113925] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/25/2021] [Accepted: 10/27/2021] [Indexed: 01/08/2023] Open
Abstract
Obesity and obesity-related low-grade inflammation are common findings in polycystic ovary syndrome (PCOS), the most common endocrine-metabolic disorder-affecting women in reproductive age. The terms metabolically healthy obese (MHO), and metabolically unhealthy obese (MUO) have been introduced to define individuals with obesity in whom cardio-metabolic risk factors are absent or present, respectively. To date, evidence investigating differences in body composition and adherence to the Mediterranean diet (MD) between MHO and MUO-PCOS women are lacking. Aim of this study was to better characterize the determinants of the metabolic health status in PCOS patients with obesity according to MHO and MUO phenotypes by evaluating endocrine-metabolic profile, inflammatory status, adherence to the MD, and body composition. The study population consisted of 94 treatment-naïve women with PCOS and obesity (BMI = 38.23 ± 6.62 kg/m2 and age = 24.12 ± 3.68 years). Compared PCOS MHO with PCOS MUO patients, the latter had higher levels of high-sensitivity C-reactive protein (hs-CRP) (p < 0.001), testosterone (p < 0.001), and insulin (p < 0.001), worse metabolic parameters, and higher Homeostatic Model Assessment of Insulin Resistance (HoMA-IR), Visceral Adiposity Index (VAI), and Fatty liver Index (FLI) (p < 0.001). Furthermore, PCOS MUO patients had lower adherence to the MD (p < 0.001) in spite of the same total energy intake (p = 0.102) as compared to PCOS MHO. The presence of MUO was associated with highest hs-CRP levels (OR = 1.49, p < 0.001), more severe hyperandrogenism and cardio-metabolic indices (p < 0.001). On the contrary, being PCOS MUO was associated with lower adherence to the MD (OR = 0.28, p < 0.001), and smaller PhAs (OR = 0.04, p < 0.001). Using a regression linear analysis model PREDIMED score entered at the first step (p < 0.001), followed by VAI (p < 0.001), and FLI (p = 0.032) in this analysis. At ROC analysis, a PREDIMED score of ≤4 (p < 0.001, AUC 0.926) could serve as a threshold for a significantly increased risk of presence the MUO-PCOS phenotype. To the best of our knowledge, this is the first study that characterized MHO and MUO-PCOS women on the basis of their adherence to the MD, body composition, and cardio-metabolic indices, providing evidence of the usefulness of adjunctive diagnostic parameters to better differentiate the MHO/MHO phenotypes in this cohort of PCOS patients with obesity.
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