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Maroto-García J, Moreno Álvarez A, Sanz de Pedro MP, Buño-Soto A, González Á. Serum biomarkers for liver fibrosis assessment. ADVANCES IN LABORATORY MEDICINE 2024; 5:115-130. [PMID: 38939201 PMCID: PMC11206202 DOI: 10.1515/almed-2023-0081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 10/12/2023] [Indexed: 06/29/2024]
Abstract
Liver fibrosis is the result of chronic liver injury of different etiologies produced by an imbalance between the synthesis and degeneration of the extracellular matrix and dysregulation of physiological mechanisms. Liver has a high regenerative capacity in the early stage of chronic diseases so a prompt liver fibrosis detection is important. Consequently, an easy and economic tool that could identify patients with liver fibrosis at the initial stages is needed. To achieve this, many non-invasive serum direct, such as hyaluronic acid or metalloproteases, and indirect biomarkers have been proposed to evaluate liver fibrosis. Also, there have been developed formulas that combine these biomarkers, some of them also introduce clinical and/or demographic parameters, like FIB-4, non-alcoholic fatty liver disease fibrosis score (NFS), enhance liver fibrosis (ELF) or Hepamet fibrosis score (HFS). In this manuscript we critically reviewed different serum biomarkers and formulas for their utility in the diagnosis and progression of liver fibrosis.
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Affiliation(s)
| | - Ana Moreno Álvarez
- Biochemistry Department, Clínica Universidad de Navarra, Pamplona, Spain
| | | | - Antonio Buño-Soto
- Laboratory Medicine Department, Hospital Universitario La Paz, Madrid, Spain
- Hospital La Paz Institute for Health Research (IdiPaz), Madrid, Spain
| | - Álvaro González
- Biochemistry Department, Clínica Universidad de Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
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2
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Maroto-García J, Moreno-Álvarez A, Sanz de Pedro MP, Buño-Soto A, González Á. Biomarcadores séricos para la evaluación de la fibrosis hepática. ADVANCES IN LABORATORY MEDICINE 2024; 5:131-147. [PMID: 38939202 PMCID: PMC11206201 DOI: 10.1515/almed-2023-0172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 10/12/2023] [Indexed: 06/29/2024]
Abstract
La fibrosis hepática se desarrolla como respuesta a la presencia de daño hepático crónico de diferentes etiologías, provocando un desequilibrio entre la síntesis y degeneración de la matriz extracelular y la desregulación de diversos mecanismos fisiológicos. En los estadios iniciales de las patologías crónicas, el hígado posee una elevada capacidad de regeneración, por lo que la detección temprana de la fibrosis hepática resulta esencial. En este contexto, es preciso contar con herramientas sencillas y económicas que permitan detectar la fibrosis hepática en sus fases iniciales. Para evaluar la fibrosis hepática, se han propuesto multitud de biomarcadores séricos no invasivos, tanto directos, como el ácido hialurónico o las metaloproteasas, como indirectos. Así mismo, se han desarrollado diversas fórmulas que combinan dichos biomarcadores junto con parámetros demográficos, como el índice FIB-4, el índice de fibrosis en la enfermedad de hígado graso no alcohólico (NFS, por sus siglas en inglés), la prueba ELF o el score de fibrosis Hepamet (HFS, por sus siglas en inglés). En el presente manuscrito, realizamos una revisión crítica del valor diagnóstico y pronóstico de los diferentes biomarcadores séricos y fórmulas actualmente existentes.
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Affiliation(s)
- Julia Maroto-García
- Departamento de Bioquímica, Clínica Universidad de Navarra, Pamplona, España
| | - Ana Moreno-Álvarez
- Departamento de Bioquímica, Clínica Universidad de Navarra, Pamplona, España
| | | | - Antonio Buño-Soto
- Departamento de Análisis Clínicos, Hospital Universitario La Paz, Madrid, España
- Instituto de investigación en salud del Hospital La (IdiPaz), Madrid, España
| | - Álvaro González
- Departamento de Bioquímica, Clínica Universidad de Navarra, Pamplona, España
- Instituto Navarro de investigación en salud (IdiSNA), Pamplona, España
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3
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Tobaruela-Resola AL, Riezu-Boj JI, Milagro FI, Mogna-Pelaez P, Herrero JI, Elorz M, Benito-Boillos A, Tur JA, Martínez JA, Abete I, Zulet MA. Multipanel Approach including miRNAs, Inflammatory Markers, and Depressive Symptoms for Metabolic Dysfunction-Associated Steatotic Liver Disease Diagnosis during 2-Year Nutritional Intervention. Nutrients 2024; 16:1547. [PMID: 38892481 PMCID: PMC11174705 DOI: 10.3390/nu16111547] [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: 04/23/2024] [Revised: 05/17/2024] [Accepted: 05/18/2024] [Indexed: 06/21/2024] Open
Abstract
Metabolic dysfunction-associated steatotic liver disease (MASLD), with a prevalence of 30% of adults globally, is considered a multifactorial disease. There is a lack of effective non-invasive methods for accurate diagnosis and monitoring. Therefore, this study aimed to explore associations between changes in circulating miRNA levels, inflammatory markers, and depressive symptoms with hepatic variables in MASLD subjects and their combined potential to predict the disease after following a dietary intervention. Biochemical markers, body composition, circulating miRNAs and hepatic and psychological status of 55 subjects with MASLD with obesity and overweight from the FLiO study were evaluated by undergoing a 6-, 12- and 24-month nutritional intervention. The highest accuracy values of combined panels to predict the disease were identified after 24 months. A combination panel that included changes in liver stiffness, high-density lipoprotein cholesterol (HDL-c), body mass index (BMI), depressive symptoms, and triglycerides (TG) yielded an AUC of 0.90. Another panel that included changes in hepatic fat content, total cholesterol (TC), miR15b-3p, TG, and depressive symptoms revealed an AUC of 0.89. These findings identify non-invasive biomarker panels including circulating miRNAs, inflammatory markers, depressive symptoms and other metabolic variables for predicting MASLD presence and emphasize the importance of precision nutrition in MASLD management and the sustained adherence to healthy lifestyle patterns.
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Affiliation(s)
- Ana Luz Tobaruela-Resola
- Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain; (A.L.T.-R.); (J.I.R.-B.); (F.I.M.); (P.M.-P.); (I.A.)
| | - José I. Riezu-Boj
- Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain; (A.L.T.-R.); (J.I.R.-B.); (F.I.M.); (P.M.-P.); (I.A.)
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain; (J.I.H.); (M.E.); (A.B.-B.)
| | - Fermin I. Milagro
- Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain; (A.L.T.-R.); (J.I.R.-B.); (F.I.M.); (P.M.-P.); (I.A.)
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain; (J.I.H.); (M.E.); (A.B.-B.)
- Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain; (J.A.T.); (J.A.M.)
| | - Paola Mogna-Pelaez
- Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain; (A.L.T.-R.); (J.I.R.-B.); (F.I.M.); (P.M.-P.); (I.A.)
| | - José I. Herrero
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain; (J.I.H.); (M.E.); (A.B.-B.)
- Liver Unit, Clínica Universidad de Navarra, 31008 Pamplona, Spain
- Biomedical Research Centre Network in Hepatic and Digestive Diseases (CIBERehd), 28029 Madrid, Spain
| | - Mariana Elorz
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain; (J.I.H.); (M.E.); (A.B.-B.)
- Department of Radiology, Clínica Universidad de Navarra, 31008 Pamplona, Spain
| | - Alberto Benito-Boillos
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain; (J.I.H.); (M.E.); (A.B.-B.)
- Department of Radiology, Clínica Universidad de Navarra, 31008 Pamplona, Spain
| | - Josep A. Tur
- Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain; (J.A.T.); (J.A.M.)
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands-IUNICS & IDISBA, 07122 Palma, Spain
| | - J. Alfredo Martínez
- Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain; (J.A.T.); (J.A.M.)
- Precision Nutrition and Cardiovascular Health Program, IMDEA Food, CEI UAM + CSIC, 28049 Madrid, Spain
| | - Itziar Abete
- Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain; (A.L.T.-R.); (J.I.R.-B.); (F.I.M.); (P.M.-P.); (I.A.)
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain; (J.I.H.); (M.E.); (A.B.-B.)
- Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain; (J.A.T.); (J.A.M.)
| | - M. Angeles Zulet
- Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain; (A.L.T.-R.); (J.I.R.-B.); (F.I.M.); (P.M.-P.); (I.A.)
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain; (J.I.H.); (M.E.); (A.B.-B.)
- Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain; (J.A.T.); (J.A.M.)
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4
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Mogna-Peláez P, Romo-Hualde A, Riezu-Boj JI, Milagro FI, Muñoz-Prieto D, Herrero JI, Elorz M, Benito-Boillos A, Monreal JI, Tur JA, Martínez A, Abete I, Zulet MA. Isoliquiritigenin in combination with visceral adipose tissue and related markers as a predictive tool for nonalcoholic fatty liver disease. J Physiol Biochem 2023:10.1007/s13105-023-00998-6. [PMID: 37996653 DOI: 10.1007/s13105-023-00998-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 11/15/2023] [Indexed: 11/25/2023]
Abstract
Nonalcoholic fatty liver disease (NAFLD) is the most prevalent form of chronic liver disease in the world. New non-invasive diagnostic tools are needed to promptly treat this disease and avoid its complications. This study aimed to find key metabolites and related variables that could be used to predict and diagnose NAFLD. Ninety-eight subjects with NAFLD and 45 controls from the Fatty Liver in Obesity (FLiO) Study (NCT03183193) were analyzed. NAFLD was diagnosed and graded by ultrasound and classified into two groups: 0 (controls) and ≥ 1 (NAFLD). Hepatic status was additionally assessed through magnetic resonance imaging (MRI), elastography, and determination of transaminases. Anthropometry, body composition (DXA), biochemical parameters, and lifestyle factors were evaluated as well. Non-targeted metabolomics of serum was performed with high-performance liquid chromatography coupled to time-of-flight mass spectrometry (HPLC-TOF-MS). Isoliquiritigenin (ISO) had the strongest association with NAFLD out of the determinant metabolites. Individuals with higher concentrations of ISO had healthier metabolic and hepatic status and were less likely to have NAFLD (OR 0.13). Receiver operating characteristic (ROC) curves demonstrated the predictive power of ISO in panel combination with other NAFLD and IR-related variables, such as visceral adipose tissue (VAT) (AUROC 0.972), adiponectin (AUROC 0.917), plasmatic glucose (AUROC 0.817), and CK18-M30 (AUROC 0.810). Individuals with lower levels of ISO have from 71 to 82% more risk of presenting NAFLD compared to individuals with higher levels. Metabolites such as ISO, in combination with visceral adipose tissue, IR, and related markers, constitute a potential non-invasive tool to predict and diagnose NAFLD.
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Affiliation(s)
- Paola Mogna-Peláez
- Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, Centre for Nutrition Research, University of Navarra, 31008, Pamplona, Spain
| | - Ana Romo-Hualde
- Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, Centre for Nutrition Research, University of Navarra, 31008, Pamplona, Spain
| | - José I Riezu-Boj
- Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, Centre for Nutrition Research, University of Navarra, 31008, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), 31008, Pamplona, Spain
| | - Fermin I Milagro
- Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, Centre for Nutrition Research, University of Navarra, 31008, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), 31008, Pamplona, Spain
- Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - David Muñoz-Prieto
- Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, Centre for Nutrition Research, University of Navarra, 31008, Pamplona, Spain
| | - José I Herrero
- Navarra Institute for Health Research (IdiSNA), 31008, Pamplona, Spain
- Liver Unit, Clínica Universidad de Navarra, 31008, Pamplona, Spain
- Biomedical Research Centre Network in Hepatic and Digestive Diseases (CIBERehd), 28029, Madrid, Spain
| | - Mariana Elorz
- Navarra Institute for Health Research (IdiSNA), 31008, Pamplona, Spain
- Department of Radiology, Clínica Universidad de Navarra, 31008, Pamplona, Spain
| | - Alberto Benito-Boillos
- Navarra Institute for Health Research (IdiSNA), 31008, Pamplona, Spain
- Department of Radiology, Clínica Universidad de Navarra, 31008, Pamplona, Spain
| | - J Ignacio Monreal
- Clinical Chemistry Department, Clínica Universidad de Navarra, 31008, Pamplona, Spain
| | - Josep A Tur
- Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, 07122, Palma, Spain
| | - Alfredo Martínez
- Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, Centre for Nutrition Research, University of Navarra, 31008, Pamplona, Spain
| | - Itziar Abete
- Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, Centre for Nutrition Research, University of Navarra, 31008, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), 31008, Pamplona, Spain
- Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - M Angeles Zulet
- Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, Centre for Nutrition Research, University of Navarra, 31008, Pamplona, Spain.
- Navarra Institute for Health Research (IdiSNA), 31008, Pamplona, Spain.
- Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain.
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5
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Unalp-Arida A, Ruhl CE. Transient Elastography-Assessed Hepatic Steatosis and Fibrosis Are Associated With Body Composition in the United States. Clin Gastroenterol Hepatol 2022; 20:e808-e830. [PMID: 33549867 DOI: 10.1016/j.cgh.2021.02.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 01/28/2021] [Accepted: 02/02/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS We examined transient elastography assessed hepatic steatosis and fibrosis distributions and relationships with body composition in a representative United States population sample. METHODS Liver stiffness and controlled attenuation parameter (CAP) were assessed on 4870 non-Hispanic White, non-Hispanic Black, non-Hispanic Asian, and Hispanic men and women aged 20 years and over in the National Health and Nutrition Examination Survey (NHANES) 2017-2018. Participants underwent anthropometry and dual-energy x-ray absorptiometry (DXA). RESULTS Compared to women, men had higher mean CAP (274.2 dB/m vs 254.4 dB/m) and liver stiffness (6.4 kPa vs 5.5 kPa). CAP and liver stiffness increased through middle age and markedly with BMI. In multivariate-adjusted analysis, CAP in the upper quartile was associated with increased age, BMI, waist-to-hip ratio, diabetes, hypertension, alanine aminotransferase (ALT) and C-reactive protein and decreased HDL cholesterol. After adjustment, non-Hispanic Blacks had lower CAP and non-Hispanic Asians had higher CAP. In multivariate-adjusted analysis, liver stiffness in the upper quartile was associated with male sex, increased age, BMI, diabetes, hepatitis C virus positivity, ALT and CAP. Lower stiffness among Non-Hispanic Asians was not significant after adjustment for BMI. DXA trunk and extremity fat mass were positively related to both CAP and liver stiffness with multivariate adjustment (P < .001 for each). Results were similar with CAP and liver stiffness as continuous characteristics. CONCLUSIONS In the United States population, increased anthropometric and DXA body composition measures were associated with higher CAP and liver stiffness. Racial-ethnic differences observed merit further research to elucidate the burden of obesity and liver health disparities.
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Affiliation(s)
- Aynur Unalp-Arida
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, US Department of Health and Human Services, Bethesda, Maryland
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6
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Abstract
Helicobacter pylori is the most prevalent infection worldwide, while non-alcoholic fatty liver disease emerged as the most frequent liver disease. The common occurrence can be either by chance or due to certain pathogenetic factors. Epidemiologic studies revealed that the risk of non-alcoholic liver disease is increased in patients infected with Helicobacter pylori. DNA fragments of Helicobacter pylori were rarely identified in human samples of liver carcinoma and fatty liver. Helicobacter pylori could influence the development of non-alcoholic fatty liver either by hormonal (ghrelin? gastrin? insulin?), or by effect of pro-inflammatory cytokines (interleukin 1 and 8, tumor necrosis factor ɑ, interferon ɣ) and by changes of gut microbiome as well. Probiotic supplementation could improve some clinical parameters of non-alcoholic fatty liver disease and eradication rates of Helicobacter pylori. Regimens used for eradication can be safely administered, although non-alcoholic fatty liver increases the risk of drug-induced liver damage. Controlled studies of the effect of eradication on the development and progression of non-alcoholic fatty liver are warranted.
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Affiliation(s)
- György M Buzás
- Department of Gastroenterology, Ferencváros Health Center, Budapest, Hungary -
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7
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Marin-Alejandre BA, Cantero I, Perez-Diaz-Del-Campo N, Monreal JI, Elorz M, Herrero JI, Benito-Boillos A, Quiroga J, Martinez-Echeverria A, Uriz-Otano JI, Huarte-Muniesa MP, Tur JA, Martinez JA, Abete I, Zulet MA. Effects of two personalized dietary strategies during a 2-year intervention in subjects with nonalcoholic fatty liver disease: A randomized trial. Liver Int 2021; 41:1532-1544. [PMID: 33550706 DOI: 10.1111/liv.14818] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 01/11/2021] [Accepted: 01/27/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND AND OBJECTIVES Nonalcoholic fatty liver disease (NAFLD) management is focused on lifestyle modifications, but long-term maintenance is a challenge for many individuals. This study aimed to evaluate the long-term effects of two personalized energy-restricted dietary strategies on weight loss, metabolic and hepatic outcomes in overweight/obese subjects with NAFLD. METHODS Ninety-eight subjects from the Fatty Liver in Obesity (FLiO) study (NCT03183193) were randomly assigned to the American Heart Association (AHA) or the FLiO dietary group in a 2-year controlled trial. Anthropometry, body composition (DXA), biochemical parameters and hepatic status (ultrasonography, Magnetic Resonance Imaging, and elastography) were assessed at baseline, 6, 12 and 24 months. RESULTS Both the AHA and FLiO diets significantly reduced body weight at 6 (-9.7% vs -10.1%), 12 (-6.7% vs -9.6%), and 24 months (-4.8% vs -7.6%) with significant improvements in body composition, biochemical and liver determinations throughout the intervention. At the end of the follow-up, the FLiO group showed a greater decrease in ALT, liver stiffness and Fatty Liver Index, among others, compared to AHA group, although these differences were attenuated when the analyses were adjusted by weight loss percentage. The FLiO group also showed a greater increase in adiponectin compared to AHA group. CONCLUSIONS The AHA and FLiO diets were able to improve body weight and body composition, as well as metabolic and hepatic status of participants with overweight/obesity and NAFLD within a 2-year follow-up. These findings show that both strategies are suitable alternatives for NAFLD management. However, the FLiO strategy may provide more persistent benefits in metabolic and hepatic parameters.
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Affiliation(s)
- Bertha A Marin-Alejandre
- Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, Pamplona, Spain
| | - Irene Cantero
- Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, Pamplona, Spain
| | - Nuria Perez-Diaz-Del-Campo
- Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, Pamplona, Spain
| | - Jose I Monreal
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.,Clinical Chemistry Department, Clinica Universidad de Navarra, Pamplona, Spain
| | - Mariana Elorz
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.,Department of Radiology, Clinica Universidad de Navarra, Pamplona, Spain
| | - Jose I Herrero
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.,Liver Unit, Clinica Universidad de Navarra, Pamplona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | - Alberto Benito-Boillos
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.,Department of Radiology, Clinica Universidad de Navarra, Pamplona, Spain
| | - Jorge Quiroga
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain.,Department of Internal Medicine, Clinica Universidad de Navarra, Pamplona, Spain
| | - Ana Martinez-Echeverria
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.,Department of Gastroenterology, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Juan I Uriz-Otano
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.,Department of Gastroenterology, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Maria P Huarte-Muniesa
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.,Department of Gastroenterology, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Josep A Tur
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands & Balearic Islands Institute for Health Research (IDISBA), Palma, Spain.,Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Jose A Martinez
- Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, Pamplona, Spain.,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.,Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Itziar Abete
- Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, Pamplona, Spain.,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.,Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Maria A Zulet
- Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, Pamplona, Spain.,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.,Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
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8
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Three Different Genetic Risk Scores Based on Fatty Liver Index, Magnetic Resonance Imaging and Lipidomic for a Nutrigenetic Personalized Management of NAFLD: The Fatty Liver in Obesity Study. Diagnostics (Basel) 2021; 11:diagnostics11061083. [PMID: 34199237 PMCID: PMC8231822 DOI: 10.3390/diagnostics11061083] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/03/2021] [Accepted: 06/11/2021] [Indexed: 12/20/2022] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) affects 25% of the global population. The pathogenesis of NAFLD is complex; available data reveal that genetics and ascribed interactions with environmental factors may play an important role in the development of this morbid condition. The purpose of this investigation was to assess genetic and non-genetic determinants putatively involved in the onset and progression of NAFLD after a 6-month weight loss nutritional treatment. A group of 86 overweight/obese subjects with NAFLD from the Fatty Liver in Obesity (FLiO) study were enrolled and metabolically evaluated at baseline and after 6 months. A pre-designed panel of 95 genetic variants related to obesity and weight loss was applied and analyzed. Three genetic risk scores (GRS) concerning the improvement on hepatic health evaluated by minimally invasive methods such as the fatty liver index (FLI) (GRSFLI), lipidomic-OWLiver®-test (GRSOWL) and magnetic resonance imaging (MRI) (GRSMRI), were derived by adding the risk alleles genotypes. Body composition, liver injury-related markers and dietary intake were also monitored. Overall, 23 SNPs were independently associated with the change in FLI, 16 SNPs with OWLiver®-test and 8 SNPs with MRI, which were specific for every diagnosis tool. After adjusting for gender, age and other related predictors (insulin resistance, inflammatory biomarkers and dietary intake at baseline) the calculated GRSFLI, GRSOWL and GRSMRI were major contributors of the improvement in hepatic status. Thus, fitted linear regression models showed a variance of 53% (adj. R2 = 0.53) in hepatic functionality (FLI), 16% (adj. R2 = 0.16) in lipidomic metabolism (OWLiver®-test) and 34% (adj. R2 = 0.34) in liver fat content (MRI). These results demonstrate that three different genetic scores can be useful for the personalized management of NAFLD, whose treatment must rely on specific dietary recommendations guided by the measurement of specific genetic biomarkers.
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Liver fat scores do not reflect interventional changes in liver fat content induced by high-protein diets. Sci Rep 2021; 11:8843. [PMID: 33893355 PMCID: PMC8065150 DOI: 10.1038/s41598-021-87360-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 02/03/2021] [Indexed: 11/16/2022] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is common in Metabolic Syndrome and type 2 diabetes (T2DM), driven by energy imbalance, saturated fats and simple carbohydrates. NAFLD requires screening and monitoring for late complications. Liver fat indices may predict NAFLD avoiding expensive or invasive gold-standard methods, but they are poorly validated for use in interventional settings. Recent data indicate a particular insensitivity to weight-independent liver fat reduction. We evaluated 31 T2DM patients, completing a randomized intervention study on isocaloric high-protein diets. We assessed anthropometric measures, intrahepatic lipid (IHL) content and serum liver enzymes, allowing AUROC calculations as well as cross-sectional and longitudinal Spearman correlations between the fatty liver index, the NAFLD-liver fat score, the Hepatosteatosis Index, and IHL. At baseline, all indices predicted NAFLD with moderate accuracy (AUROC 0.731–0.770), supported by correlation analyses. Diet-induced IHL changes weakly correlated with changes of waist circumference, but no other index component or the indices themselves. Liver fat indices may help to easily detect NAFLD, allowing cost-effective allocation of further diagnostics to patients at high risk. IHL reduction by weight-independent diets is not reflected by a proportional change in liver fat scores. Further research on the development of treatment-sensitive indices is required. Trial registration: The trial was registered at clinicaltrials.gov: NCT02402985.
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Perez-Diaz-Del-Campo N, Marin-Alejandre BA, Cantero I, Monreal JI, Elorz M, Herrero JI, Benito-Boillos A, Riezu-Boj JI, Milagro FI, Tur JA, Martinez JA, Abete I, Zulet MA. Differential response to a 6-month energy-restricted treatment depending on SH2B1 rs7359397 variant in NAFLD subjects: Fatty Liver in Obesity (FLiO) Study. Eur J Nutr 2021; 60:3043-3057. [PMID: 33474638 DOI: 10.1007/s00394-020-02476-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 12/21/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE Non-alcoholic fatty liver disease (NAFLD) is worldwide recognized as the most common cause of chronic liver disease. Current NAFLD clinical management relies on lifestyle change, nevertheless, the importance of the genetic make-up on liver damage and the possible interactions with diet are still poorly understood. The aim of the study was to evaluate the influence of the SH2B1 rs7359397 genetic variant on changes in body composition, metabolic status and liver health after 6-month energy-restricted treatment in overweight/obese subjects with NAFLD. In addition, gene-treatment interactions over the course of the intervention were examined. METHODS The SH2B1 genetic variant was genotyped in 86 overweight/obese subjects with NAFLD from the FLiO study (Fatty Liver in Obesity study). Subjects were metabolically evaluated at baseline and at 6-months. Liver assessment included ultrasonography, Magnetic Resonance Imaging, elastography, a lipidomic test (OWL®-test) and specific blood liver biomarkers. Additionally, body composition, general biochemical markers and dietary intake were determined. RESULTS Both genotypes significantly improved their body composition, general metabolic status and liver health after following an energy-restricted strategy. Liver imaging techniques showed a greater decrease in liver fat content (- 44.3%, p < 0.001) and in serum ferritin levels (p < 0.001) in the carriers of the T allele after the intervention. Moreover, lipidomic analysis, revealed a higher improvement in liver status when comparing risk vs. no-risk genotype (p = 0.006 vs. p = 0.926, respectively). Gene-treatment interactions showed an increase in fiber intake and omega-3 fatty acid in risk genotype (p interaction = 0.056 and p interaction = 0.053, respectively), while a significant increase in MedDiet score was observed in both genotype groups (p = 0.020). Moreover, no-risk genotype presented a relevant decrease in hepatic iron as well as in MUFA intake (p = 0.047 and p = 0.034, respectively). CONCLUSION Subjects carrying the T allele of the rs7359397 polymorphism may benefit more in terms of hepatic health and liver status when prescribed an energy-restricted treatment, where a Mediterranean dietary pattern rich in fiber and other components such as omega-3 fatty acids might boost the benefits. TRIAL REGISTRATION The Fatty Liver in Obesity was approved by the Research Ethics Committee of the University of Navarra and retrospectively registered (NCT03183193; www.clinicaltrials.gov ); June 2017.
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Affiliation(s)
- Nuria Perez-Diaz-Del-Campo
- Department of Nutrition, Food Sciences and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008, Pamplona, Spain
- Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, 31008, Pamplona, Spain
| | - Bertha Araceli Marin-Alejandre
- Department of Nutrition, Food Sciences and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008, Pamplona, Spain
- Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, 31008, Pamplona, Spain
| | - Irene Cantero
- Department of Nutrition, Food Sciences and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008, Pamplona, Spain
- Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, 31008, Pamplona, Spain
| | - J Ignacio Monreal
- Navarra Institute for Health Research (IdiSNA), 31008, Pamplona, Spain
- Clinical Chemistry Department, Clínica Universidad de Navarra, 31008, Pamplona, Spain
| | - Mariana Elorz
- Navarra Institute for Health Research (IdiSNA), 31008, Pamplona, Spain
- Department of Radiology, Clínica Universidad de Navarra, 31008, Pamplona, Spain
| | - José Ignacio Herrero
- Navarra Institute for Health Research (IdiSNA), 31008, Pamplona, Spain
- Liver Unit, Clínica Universidad de Navarra, 31008, Pamplona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), 28029, Madrid, Spain
| | - Alberto Benito-Boillos
- Navarra Institute for Health Research (IdiSNA), 31008, Pamplona, Spain
- Department of Radiology, Clínica Universidad de Navarra, 31008, Pamplona, Spain
| | - Jose I Riezu-Boj
- Department of Nutrition, Food Sciences and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008, Pamplona, Spain
- Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, 31008, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), 31008, Pamplona, Spain
| | - Fermín I Milagro
- Department of Nutrition, Food Sciences and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008, Pamplona, Spain
- Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, 31008, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), 31008, Pamplona, Spain
- Biochemical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Josep A Tur
- Biochemical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands & Balearic Islands Institute for Health Research (IDISBA), 07122, Palma, Spain
| | - J Alfredo Martinez
- Department of Nutrition, Food Sciences and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008, Pamplona, Spain
- Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, 31008, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), 31008, Pamplona, Spain
- Biochemical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Itziar Abete
- Department of Nutrition, Food Sciences and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008, Pamplona, Spain.
- Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, 31008, Pamplona, Spain.
- Navarra Institute for Health Research (IdiSNA), 31008, Pamplona, Spain.
- Biochemical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain.
| | - M Angeles Zulet
- Department of Nutrition, Food Sciences and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008, Pamplona, Spain.
- Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, 31008, Pamplona, Spain.
- Navarra Institute for Health Research (IdiSNA), 31008, Pamplona, Spain.
- Biochemical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain.
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Li X, Wu X, Jia Y, Fu J, Zhang L, Jiang T, Liu J, Wang G. Liraglutide Decreases Liver Fat Content and Serum Fibroblast Growth Factor 21 Levels in Newly Diagnosed Overweight Patients with Type 2 Diabetes and Nonalcoholic Fatty Liver Disease. J Diabetes Res 2021; 2021:3715026. [PMID: 34660809 PMCID: PMC8519721 DOI: 10.1155/2021/3715026] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 09/14/2021] [Accepted: 09/20/2021] [Indexed: 12/14/2022] Open
Abstract
PURPOSES In this study, we aimed to verify plasma fibroblast growth factor 21 (FGF21) elevation in newly diagnosed overweight patients with type 2 diabetes mellitus (T2DM) and nonalcoholic fatty liver disease (NAFLD) and to evaluate the effectiveness of liraglutide on reducing liver fat content and serum (FGF21) levels in those patients. METHODS A 12-week, single-center, prospective study was conducted. Twenty newly diagnosed overweight patients with T2DM and NAFLD were recruited. Twenty healthy age, sex, and body mass index (BMI) matched subjects were enrolled as the control group. Enzyme-linked immunosorbent assay was used to measure serum FGF21 levels. Liver fat content was determined using the 3.0 T whole-body MRI scanner. RESULTS Those newly diagnosed overweight patients with T2DM and NAFLD had a BMI of 27.6 ± 0.5 kg/m2. They had higher levels of FGF21 (159.6 ± 35.7 vs. 124.1 ± 42.9 pg/ml, P < 0.001) and increased liver fat content (19.3 ± 9.4 vs. 4.5 ± 0.6%, P < 0.001) compared to the controls. Liraglutide treatment for 12 weeks induced a significant 4.9 kg weight loss (95% confidence interval (CI): -6.1, -3.7, P < 0.001), which was equivalent to a relative reduction of 6.8% (95% CI: 5.3%, 8.3%, P < 0.001). FGF21 levels decreased after the 12-week liraglutide treatment (159.6 ± 35.7 vs. 124.2 ± 27.8 pg/ml, P = 0.006). There was a positive correlation between relative changes of liver fat content and relative change of FGF21 (r = 0.645, P = 0.002). FGF21 levels significantly decreased in patients who had a significant decrease in liver fat content (≥29%) (95% CI: -262.8, -55.1, P = 0.006); however, there was no significant change in the patients without a significant decrease in liver fat content (<29%) (95% CI: -60.0, 54.1, P = 0.899). CONCLUSIONS Liraglutide treatment reduced both liver fat content and FGF21 levels in newly diagnosed overweight patients with T2DM and NAFLD. FGF21 may be a potential biomarker for evaluating the effects of liraglutide treatment on hepatic fat and glucose metabolism.
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Affiliation(s)
- Xinyue Li
- Department of Radiology, Beijing Chao Yang Hospital, Capital Medical University, No. 8, Gong ti South Road, Chao Yang District, Beijing 100020, China
| | - Xiaojuan Wu
- Department of Endocrinology, Beijing Chao Yang Hospital, Capital Medical University, No. 8, Gong ti South Road, Chao Yang District, Beijing 100020, China
| | - Yumei Jia
- Department of Endocrinology, Beijing Chao Yang Hospital, Capital Medical University, No. 8, Gong ti South Road, Chao Yang District, Beijing 100020, China
| | - Jing Fu
- Department of Endocrinology, Beijing Chao Yang Hospital, Capital Medical University, No. 8, Gong ti South Road, Chao Yang District, Beijing 100020, China
| | - Lin Zhang
- Department of Endocrinology, Beijing Chao Yang Hospital, Capital Medical University, No. 8, Gong ti South Road, Chao Yang District, Beijing 100020, China
| | - Tao Jiang
- Department of Radiology, Beijing Chao Yang Hospital, Capital Medical University, No. 8, Gong ti South Road, Chao Yang District, Beijing 100020, China
| | - Jia Liu
- Department of Endocrinology, Beijing Chao Yang Hospital, Capital Medical University, No. 8, Gong ti South Road, Chao Yang District, Beijing 100020, China
| | - Guang Wang
- Department of Endocrinology, Beijing Chao Yang Hospital, Capital Medical University, No. 8, Gong ti South Road, Chao Yang District, Beijing 100020, China
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Galarregui C, Marin-Alejandre BA, Perez-Diaz-Del-Campo N, Cantero I, Monreal JI, Elorz M, Benito-Boillos A, Herrero JI, Tur JA, Martínez JA, Zulet MA, Abete I. Predictive Value of Serum Ferritin in Combination with Alanine Aminotransferase and Glucose Levels for Noninvasive Assessment of NAFLD: Fatty Liver in Obesity (FLiO) Study. Diagnostics (Basel) 2020; 10:diagnostics10110917. [PMID: 33171699 PMCID: PMC7695258 DOI: 10.3390/diagnostics10110917] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/03/2020] [Accepted: 11/07/2020] [Indexed: 12/13/2022] Open
Abstract
The identification of affordable noninvasive biomarkers for the diagnosis and characterization of nonalcoholic fatty liver disease (NAFLD) is a major challenge for the research community. This study aimed to explore the usefulness of ferritin as a proxy biomarker of NAFLD condition, alone or in combination with other routine biochemical parameters. Subjects with overweight/obesity and ultrasound-confirmed liver steatosis (n = 112) from the Fatty Liver in Obesity (FLiO) study were assessed. The hepatic evaluation considered magnetic resonance imaging, ultrasonography, and credited routine blood liver biomarkers. Anthropometry and body composition, dietary intake (by means of a validated 137-item food frequency questionnaire), and specific biochemical markers were also determined. Serum ferritin levels were analyzed using a chemiluminescent microparticle immunoassay kit. Lower serum ferritin concentrations were associated with general better liver health and nutritional status. The evaluation of ferritin as a surrogate of liver damage by means of quantile regression analyses showed a positive association with alanine aminotransferase (ALT) (β = 19.21; p ≤ 0.001), liver fat content (β = 8.70; p = 0.008), and hepatic iron (β = 3.76; p ≤ 0.001), after adjusting for potential confounders. In receiver operating characteristic (ROC) analyses, the panel combination of blood ferritin, glucose, and ALT showed the best prediction for liver fat mass (area under the curve (AUC) 0.82). A combination of ferritin and ALT showed the higher predictive ability for estimating liver iron content (AUC 0.73). This investigation demonstrated the association of serum ferritin with liver health as well as with glucose and lipid metabolism markers in subjects with NAFLD. Current findings led to the identification of ferritin as a potential noninvasive predictive biomarker of NAFLD, whose surrogate value increased when combined with other routine biochemical measurements (glucose/ALT).
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Affiliation(s)
- Cristina Galarregui
- Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, Irunlarrea 1, 31008 Pamplona, Spain; (C.G.); (B.A.M.-A.); (N.P.-D.-D.-C.); (I.C.); (J.A.M.)
| | - Bertha Araceli Marin-Alejandre
- Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, Irunlarrea 1, 31008 Pamplona, Spain; (C.G.); (B.A.M.-A.); (N.P.-D.-D.-C.); (I.C.); (J.A.M.)
| | - Nuria Perez-Diaz-Del-Campo
- Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, Irunlarrea 1, 31008 Pamplona, Spain; (C.G.); (B.A.M.-A.); (N.P.-D.-D.-C.); (I.C.); (J.A.M.)
| | - Irene Cantero
- Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, Irunlarrea 1, 31008 Pamplona, Spain; (C.G.); (B.A.M.-A.); (N.P.-D.-D.-C.); (I.C.); (J.A.M.)
| | - J. Ignacio Monreal
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain; (J.I.M.); (M.E.); (A.B.-B.); (J.I.H.)
- Clinical Chemistry Department, Clinica Universidad de Navarra, 31008 Pamplona, Spain
| | - Mariana Elorz
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain; (J.I.M.); (M.E.); (A.B.-B.); (J.I.H.)
- Department of Radiology, Clinica Universidad de Navarra, 31008 Pamplona, Spain
| | - Alberto Benito-Boillos
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain; (J.I.M.); (M.E.); (A.B.-B.); (J.I.H.)
- Department of Radiology, Clinica Universidad de Navarra, 31008 Pamplona, Spain
| | - José Ignacio Herrero
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain; (J.I.M.); (M.E.); (A.B.-B.); (J.I.H.)
- Liver Unit, Clinica Universidad de Navarra, 31008 Pamplona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), 28029 Madrid, Spain
| | - Josep A. Tur
- Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain;
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands & Balearic Islands Institute for Health Research (IDISBA), 07122 Palma, Spain
| | - J. Alfredo Martínez
- Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, Irunlarrea 1, 31008 Pamplona, Spain; (C.G.); (B.A.M.-A.); (N.P.-D.-D.-C.); (I.C.); (J.A.M.)
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain; (J.I.M.); (M.E.); (A.B.-B.); (J.I.H.)
- Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain;
| | - M. Angeles Zulet
- Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, Irunlarrea 1, 31008 Pamplona, Spain; (C.G.); (B.A.M.-A.); (N.P.-D.-D.-C.); (I.C.); (J.A.M.)
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain; (J.I.M.); (M.E.); (A.B.-B.); (J.I.H.)
- Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain;
- Correspondence: (M.A.Z.); (I.A.); Tel.: +34-948-42-56-00 (ext. 806317) (M.A.Z.); +34-948-42-56-00 (ext. 806357) (I.A.)
| | - Itziar Abete
- Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, Irunlarrea 1, 31008 Pamplona, Spain; (C.G.); (B.A.M.-A.); (N.P.-D.-D.-C.); (I.C.); (J.A.M.)
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain; (J.I.M.); (M.E.); (A.B.-B.); (J.I.H.)
- Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain;
- Correspondence: (M.A.Z.); (I.A.); Tel.: +34-948-42-56-00 (ext. 806317) (M.A.Z.); +34-948-42-56-00 (ext. 806357) (I.A.)
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Marin-Alejandre BA, Abete I, Monreal JI, Elorz M, Benito-Boillos A, Herrero JI, Navarro-Blasco I, Tur JA, Bandarra NM, Zulet MA, Martinez JA. Effects of a 6-month dietary-induced weight loss on erythrocyte membrane omega-3 fatty acids and hepatic status of subjects with nonalcoholic fatty liver disease: The Fatty Liver in Obesity study. J Clin Lipidol 2020; 14:837-849.e2. [DOI: 10.1016/j.jacl.2020.08.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 08/18/2020] [Accepted: 08/18/2020] [Indexed: 02/07/2023]
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14
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Monserrat-Mesquida M, Quetglas-Llabrés M, Abbate M, Montemayor S, Mascaró CM, Casares M, Tejada S, Abete I, Zulet MA, Tur JA, Martínez JA, Sureda A. Oxidative Stress and Pro-Inflammatory Status in Patients with Non-Alcoholic Fatty Liver Disease. Antioxidants (Basel) 2020; 9:E759. [PMID: 32824349 PMCID: PMC7463614 DOI: 10.3390/antiox9080759] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 08/06/2020] [Accepted: 08/13/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Nonalcoholic fatty liver disease (NAFLD) is characterized by excessive fat accumulation, especially triglycerides, in hepatocytes. If the pathology is not properly treated, it can progress to nonalcoholic steatohepatitis (NASH) and continue to fibrosis, cirrhosis or hepatocarcinoma. OBJECTIVE The aim of the current research was to identify the plasma biomarkers of liver damage, oxidative stress and inflammation that facilitate the early diagnosis of the disease and control its progression. METHODS Antioxidant and inflammatory biomarkers were measured in the plasma of patients diagnosed with NAFLD (n = 100 adults; 40-60 years old) living in the Balearic Islands, Spain. Patients were classified according to the intrahepatic fat content (IFC) measured by magnetic resonance imaging (MRI). RESULTS Circulating glucose, glycosylated haemoglobin, triglycerides, low-density lipoprotein-cholesterol, aspartate aminotransferase and alanine aminotransferase were higher in patients with an IFC ≥ 2 of NAFLD in comparison to patients with an IFC of 0 and 1. The plasma levels of catalase, irisin, interleukin-6, malondialdehyde, and cytokeratin 18 were higher in stage ≥2 subjects, whereas the resolvin D1 levels were lower. No differences were observed in xanthine oxidase, myeloperoxidase, protein carbonyl and fibroblast growth factor 21 depending on liver status. CONCLUSION The current available data show that the severity of NAFLD is associated with an increase in oxidative stress and proinflammatory status. It may be also useful as diagnostic purpose in clinical practice.
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Affiliation(s)
- Margalida Monserrat-Mesquida
- Research Group in Community Nutrition and Oxidative Stress, University of the Balearic Islands and Health Research Institute of Balearic Islands (IdISBa), 07122 Palma de Mallorca, Spain; (M.M.-M.); (M.Q.-L.); (M.A.); (S.M.); (C.M.M.); (S.T.); (A.S.)
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (I.A.); (M.A.Z.); (J.A.M.)
- Health Research Institute of Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
| | - Magdalena Quetglas-Llabrés
- Research Group in Community Nutrition and Oxidative Stress, University of the Balearic Islands and Health Research Institute of Balearic Islands (IdISBa), 07122 Palma de Mallorca, Spain; (M.M.-M.); (M.Q.-L.); (M.A.); (S.M.); (C.M.M.); (S.T.); (A.S.)
- Health Research Institute of Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
| | - Manuela Abbate
- Research Group in Community Nutrition and Oxidative Stress, University of the Balearic Islands and Health Research Institute of Balearic Islands (IdISBa), 07122 Palma de Mallorca, Spain; (M.M.-M.); (M.Q.-L.); (M.A.); (S.M.); (C.M.M.); (S.T.); (A.S.)
- Health Research Institute of Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
| | - Sofía Montemayor
- Research Group in Community Nutrition and Oxidative Stress, University of the Balearic Islands and Health Research Institute of Balearic Islands (IdISBa), 07122 Palma de Mallorca, Spain; (M.M.-M.); (M.Q.-L.); (M.A.); (S.M.); (C.M.M.); (S.T.); (A.S.)
- Health Research Institute of Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
| | - Catalina M. Mascaró
- Research Group in Community Nutrition and Oxidative Stress, University of the Balearic Islands and Health Research Institute of Balearic Islands (IdISBa), 07122 Palma de Mallorca, Spain; (M.M.-M.); (M.Q.-L.); (M.A.); (S.M.); (C.M.M.); (S.T.); (A.S.)
- Health Research Institute of Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
| | - Miguel Casares
- Radiodiagnosis Service, Red Asistencial Juaneda, 07011 Palma de Mallorca, Spain;
| | - Silvia Tejada
- Research Group in Community Nutrition and Oxidative Stress, University of the Balearic Islands and Health Research Institute of Balearic Islands (IdISBa), 07122 Palma de Mallorca, Spain; (M.M.-M.); (M.Q.-L.); (M.A.); (S.M.); (C.M.M.); (S.T.); (A.S.)
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (I.A.); (M.A.Z.); (J.A.M.)
- Health Research Institute of Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
- Laboratory of Neurophysiology, University of the Balearic Islands, 07122 Palma de Mallorca, Spain
| | - Itziar Abete
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (I.A.); (M.A.Z.); (J.A.M.)
- Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, University of Navarra, 31008 Pamplona, Spain
| | - Maria Angeles Zulet
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (I.A.); (M.A.Z.); (J.A.M.)
- Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, University of Navarra, 31008 Pamplona, Spain
| | - Josep A. Tur
- Research Group in Community Nutrition and Oxidative Stress, University of the Balearic Islands and Health Research Institute of Balearic Islands (IdISBa), 07122 Palma de Mallorca, Spain; (M.M.-M.); (M.Q.-L.); (M.A.); (S.M.); (C.M.M.); (S.T.); (A.S.)
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (I.A.); (M.A.Z.); (J.A.M.)
- Health Research Institute of Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
| | - J. Alfredo Martínez
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (I.A.); (M.A.Z.); (J.A.M.)
- Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, University of Navarra, 31008 Pamplona, Spain
- Cardiometabolics Precision Nutrition Program, IMDEA Food, CEI UAM-CSIC, 28049 Madrid, Spain
| | - Antoni Sureda
- Research Group in Community Nutrition and Oxidative Stress, University of the Balearic Islands and Health Research Institute of Balearic Islands (IdISBa), 07122 Palma de Mallorca, Spain; (M.M.-M.); (M.Q.-L.); (M.A.); (S.M.); (C.M.M.); (S.T.); (A.S.)
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (I.A.); (M.A.Z.); (J.A.M.)
- Health Research Institute of Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
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15
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Perez-Diaz-del-Campo N, Abete I, Cantero I, Marin-Alejandre BA, Monreal JI, Elorz M, Herrero JI, Benito-Boillos A, Riezu-Boj JI, Milagro FI, Tur JA, Martinez JA, Zulet MA. Association of the SH2B1 rs7359397 Gene Polymorphism with Steatosis Severity in Subjects with Obesity and Non-Alcoholic Fatty Liver Disease. Nutrients 2020; 12:nu12051260. [PMID: 32365683 PMCID: PMC7282006 DOI: 10.3390/nu12051260] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 04/24/2020] [Accepted: 04/27/2020] [Indexed: 12/12/2022] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is a major cause of liver disease worldwide. Some genetic variants might be involved in the progression of this disease. The study hypothesized that individuals with the rs7359397 T allele have a higher risk of developing severe stages of NAFLD compared with non-carriers where dietary intake according to genotypes could have a key role on the pathogenesis of the disease. SH2B1 genetic variant was genotyped in 110 overweight/obese subjects with NAFLD. Imaging techniques, lipidomic analysis and blood liver biomarkers were performed. Body composition, general biochemical and dietary variables were also determined. The SH2B1 risk genotype was associated with higher HOMA-IR p = 0.001; and Fatty Liver Index (FLI) p = 0.032. Higher protein consumption (p = 0.028), less mono-unsaturated fatty acid and fiber intake (p = 0.045 and p = 0.049, respectively), was also referred to in risk allele genotype. Lipidomic analysis showed that T allele carriers presented a higher frequency of non-alcoholic steatohepatitis (NASH) (69.1% vs. 44.4%; p = 0.006). In the genotype risk group, adjusted logistic regression models indicated a higher risk of developing an advanced stage of NAFLD measured by FLI (OR 2.91) and ultrasonography (OR 4.15). Multinomial logistic regression models showed that risk allele carriers had higher liver fat accumulation risk (RRR 3.93) and an increased risk of NASH (RRR 7.88). Consequently, subjects carrying the T allele were associated with a higher risk of developing a severe stage of NAFLD. These results support the importance of considering genetic predisposition in combination with a healthy dietary pattern in the personalized evaluation and management of NAFLD.
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Affiliation(s)
- Nuria Perez-Diaz-del-Campo
- Department of Nutrition, Food Science and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain; (N.P-D.-d.-C.); (I.C.); (B.A.M.-A.); (J.I.R.-B.); (F.I.M.); (J.A.M.)
- Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain
| | - Itziar Abete
- Department of Nutrition, Food Science and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain; (N.P-D.-d.-C.); (I.C.); (B.A.M.-A.); (J.I.R.-B.); (F.I.M.); (J.A.M.)
- Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain
- Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain;
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain; (J.I.M.); (M.E.); (J.I.H.); (A.B.-B.)
- Correspondence: (I.A.); (M.A.Z.); Tel.: +34-948-25-60-00 (I.A.)
| | - Irene Cantero
- Department of Nutrition, Food Science and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain; (N.P-D.-d.-C.); (I.C.); (B.A.M.-A.); (J.I.R.-B.); (F.I.M.); (J.A.M.)
- Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain
| | - Bertha Araceli Marin-Alejandre
- Department of Nutrition, Food Science and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain; (N.P-D.-d.-C.); (I.C.); (B.A.M.-A.); (J.I.R.-B.); (F.I.M.); (J.A.M.)
- Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain
| | - J. Ignacio Monreal
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain; (J.I.M.); (M.E.); (J.I.H.); (A.B.-B.)
- Clinical Chemistry Department, Clínica Universidad de Navarra, 31008 Pamplona, Spain
| | - Mariana Elorz
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain; (J.I.M.); (M.E.); (J.I.H.); (A.B.-B.)
- Department of Radiology, Clínica Universidad de Navarra, 31008 Pamplona, Spain
| | - José Ignacio Herrero
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain; (J.I.M.); (M.E.); (J.I.H.); (A.B.-B.)
- Liver Unit, Clinica Universidad de Navarra, 31008 Pamplona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), 28029 Madrid, Spain
| | - Alberto Benito-Boillos
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain; (J.I.M.); (M.E.); (J.I.H.); (A.B.-B.)
- Department of Radiology, Clínica Universidad de Navarra, 31008 Pamplona, Spain
| | - Jose I. Riezu-Boj
- Department of Nutrition, Food Science and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain; (N.P-D.-d.-C.); (I.C.); (B.A.M.-A.); (J.I.R.-B.); (F.I.M.); (J.A.M.)
- Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain; (J.I.M.); (M.E.); (J.I.H.); (A.B.-B.)
| | - Fermín I. Milagro
- Department of Nutrition, Food Science and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain; (N.P-D.-d.-C.); (I.C.); (B.A.M.-A.); (J.I.R.-B.); (F.I.M.); (J.A.M.)
- Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain
- Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain;
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain; (J.I.M.); (M.E.); (J.I.H.); (A.B.-B.)
| | - Josep A. Tur
- Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain;
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands & Balearic Islands Institute for Health Research (IDISBA), 07122 Palma, Spain
| | - J. Alfredo Martinez
- Department of Nutrition, Food Science and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain; (N.P-D.-d.-C.); (I.C.); (B.A.M.-A.); (J.I.R.-B.); (F.I.M.); (J.A.M.)
- Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain
- Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain;
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain; (J.I.M.); (M.E.); (J.I.H.); (A.B.-B.)
| | - M. Angeles Zulet
- Department of Nutrition, Food Science and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain; (N.P-D.-d.-C.); (I.C.); (B.A.M.-A.); (J.I.R.-B.); (F.I.M.); (J.A.M.)
- Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain
- Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain;
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain; (J.I.M.); (M.E.); (J.I.H.); (A.B.-B.)
- Correspondence: (I.A.); (M.A.Z.); Tel.: +34-948-25-60-00 (I.A.)
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16
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Bullón-Vela V, Abete I, Tur JA, Konieczna J, Romaguera D, Pintó X, Corbella E, Martínez-González MA, Sayón-Orea C, Toledo E, Corella D, Macías-Gonzalez M, Tinahones FJ, Fitó M, Estruch R, Ros E, Salas-Salvadó J, Daimiel L, Mascaró CM, Zulet MA, Martínez JA. Relationship of visceral adipose tissue with surrogate insulin resistance and liver markers in individuals with metabolic syndrome chronic complications. Ther Adv Endocrinol Metab 2020; 11:2042018820958298. [PMID: 33149882 PMCID: PMC7586032 DOI: 10.1177/2042018820958298] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 08/20/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Visceral adipose tissue (VAT) has a hazardous influence on systemic inflammation, insulin resistance and an adverse metabolic profile, which increases the risk of developing non-alcoholic fatty liver disease (NAFLD) and chronic complications of diabetes. In our study we aimed to evaluate the association of VAT and the triglyceride glucose (TyG) as a proxy of insulin resistance surrogated with metabolic and liver risk factors among subjects diagnosed with metabolic syndrome (MetS). METHODS A cross-sectional study was performed including 326 participants with MetS (55-75 years) from the PREDIMED-Plus study. Liver-status markers, VAT and TyG were assessed. Participants were stratified by tertiles according to VAT (n = 254) and TyG (n = 326). A receiver operating characteristic curve was used to analyse the efficiency of TyG for VAT. RESULTS Subjects with greater visceral fat depots showed worse lipid profile, higher homeostatic model assessment for insulin resistance (HOMA-IR), TyG, alanine transaminase (ALT), fibroblast growth factor-21 (FGF-21), fatty liver index (FLI) and hepatic steatosis index (HSI) compared with participants in the first tertile. The multi-adjusted linear-regression analyses indicated that individuals in the third tertile of TyG (>9.1-10.7) had a positive association with HOMA-IR [β = 3.07 (95% confidence interval (CI) 2.28-3.86; p trend < 0.001)], ALT [β = 7.43 (95% CI 2.23-12.63; p trend = 0.005)], gamma glutamyl transferase (GGT) [β = 14.12 (95% CI 3.64-24.61; p trend = 0.008)], FGF-21 [β = 190.69 (95% CI 93.13-288.25; p trend < 0.001)], FLI [β = 18.65 (95% CI 14.97-22.23; p trend < 0.001)] and HSI [β = 3.46 (95% CI, 2.23-4.68; p trend < 0.001)] versus participants from the first tertile. Interestingly, the TyG showed the largest area under the receiver operating curve (AUC) for women (AUC = 0.713; 95% CI 0.62-0.79) compared with men (AUC = 0.570; 95% CI 0.48-0.66). CONCLUSIONS A disrupted VAT enlargement and impairment of TyG are strongly associated with liver status and cardiometabolic risk factors linked with NAFLD in individuals diagnosed with MetS. Moreover, the TyG could be used as a suitable and reliable marker estimator of VAT.
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Affiliation(s)
| | | | - Josep A. Tur
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERobn), Institute of Health Carlos III (ISCIII), Madrid, Spain
- Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands, Palma de Mallorca, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - Jadwiga Konieczna
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERobn), Institute of Health Carlos III (ISCIII), Madrid, Spain
- Research Group on Nutritional Epidemiology & Cardiovascular Physiopathology (NUTRECOR), Health Research Institute of the Balearic Islands (IdIsBa), University Hospital of the Balearic Islands, Palma de Mallorca, Spain
| | - Dora Romaguera
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERobn), Institute of Health Carlos III (ISCIII), Madrid, Spain
- Research Group on Nutritional Epidemiology & Cardiovascular Physiopathology (NUTRECOR), Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - Xavier Pintó
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERobn), Institute of Health Carlos III (ISCIII), Madrid, Spain
- Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - Emili Corbella
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERobn), Institute of Health Carlos III (ISCIII), Madrid, Spain
- Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - Miguel A. Martínez-González
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERobn), Institute of Health Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdisNA), Pamplona, Spain
| | - Carmen Sayón-Orea
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERobn), Institute of Health Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdisNA), Pamplona, Spain
| | - Estefanía Toledo
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERobn), Institute of Health Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdisNA), Pamplona, Spain
| | - Dolores Corella
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERobn), Institute of Health Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Manuel Macías-Gonzalez
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERobn), Institute of Health Carlos III (ISCIII), Madrid, Spain
- Department of Endocrinology, Virgen de la Victoria Hospital, Institute of Biomedical Research in Málaga (IBIMA), University of Málaga, Málaga, Spain
| | - Francisco J. Tinahones
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERobn), Institute of Health Carlos III (ISCIII), Madrid, Spain
- Department of Endocrinology, Virgen de la Victoria Hospital, Institute of Biomedical Research in Málaga (IBIMA), University of Málaga, Málaga, Spain
| | - Montserrat Fitó
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERobn), Institute of Health Carlos III (ISCIII), Madrid, Spain
- Cardiovascular Risk and Nutrition Research Group (CARIN), Hospital del Mar Research Institute (IMIM), Barcelona, Spain
| | - Ramon Estruch
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERobn), Institute of Health Carlos III (ISCIII), Madrid, Spain
- Department of Internal Medicine, University of Barcelona, Barcelona, Spain
| | - Emilio Ros
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERobn), Institute of Health Carlos III (ISCIII), Madrid, Spain
- Department of Endocrinology and Nutrition, Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain
| | - Jordi Salas-Salvadó
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERobn), Institute of Health Carlos III (ISCIII), Madrid, Spain
- Unversitat Rovira i Virgili, Department de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Reus, Spain
- Institut d’Investigació Pere Virgili (IISPV), Hospital Universitari Sant Joan de Reus, Reus, Spain
| | - Lidia Daimiel
- Precision Nutrition Programme, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | - Catalina M. Mascaró
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERobn), Institute of Health Carlos III (ISCIII), Madrid, Spain
- Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands, Palma de Mallorca, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | | | - José Alfredo Martínez
- Department of Nutrition, Food Science and Physiology, Center for Nutrition Research, University of Navarra, Pamplona, Spain
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERobn), Institute of Health Carlos III (ISCIII), Madrid, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- Precision Nutrition Programme, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
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17
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Marin-Alejandre BA, Abete I, Cantero I, Monreal JI, Elorz M, Herrero JI, Benito-Boillos A, Quiroga J, Martinez-Echeverria A, Uriz-Otano JI, Huarte-Muniesa MP, Tur JA, Martinez JA, Zulet MA. The Metabolic and Hepatic Impact of Two Personalized Dietary Strategies in Subjects with Obesity and Nonalcoholic Fatty Liver Disease: The Fatty Liver in Obesity (FLiO) Randomized Controlled Trial. Nutrients 2019; 11:nu11102543. [PMID: 31652512 PMCID: PMC6836315 DOI: 10.3390/nu11102543] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 10/11/2019] [Accepted: 10/15/2019] [Indexed: 02/07/2023] Open
Abstract
The prevalence of nonalcoholic fatty liver disease (NAFLD) is increasing worldwide. NAFLD management is mainly focused on weight loss, but the optimal characteristics of the diet demand further investigation. This study aims to evaluate the effects of two personalized energy-restricted diets on the liver status in overweight or obese subjects with NAFLD after a 6 months follow-up. Ninety-eight individuals from the Fatty Liver in Obesity (FLiO) study were randomized into two groups and followed different energy-restricted diets. Subjects were evaluated at baseline and after 6 months. Diet, anthropometry, body composition, and biochemical parameters were evaluated. Liver assessment included ultrasonography, Magnetic Resonance Imaging, elastography, and determination of transaminases. Both dietary groups significantly improved their metabolic and hepatic markers after the intervention, with no significant differences between them. Multivariate regression models evidenced a relationship between weight loss, adherence to the Mediterranean Diet (MedDiet), and a decrease in liver fat content, predicting up to 40.9% of its variability after 6 months. Moreover, the antioxidant capacity of the diet was inversely associated with liver fat content. Participants in the group with a higher adherence to the MedDiet showed a greater reduction in body weight, total fat mass, and hepatic fat. These results support the benefit of energy-restricted diets, high adherence to the MedDiet, and high antioxidant capacity of the diet for the management of NAFLD in individuals with overweight or obesity.
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Affiliation(s)
- Bertha Araceli Marin-Alejandre
- Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain.
| | - Itziar Abete
- Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain.
- Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain.
| | - Irene Cantero
- Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain.
| | - J Ignacio Monreal
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain.
- Clinical Chemistry Department, Clinica Universidad de Navarra 31008, Pamplona, Spain.
| | - Mariana Elorz
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain.
- Department of Radiology, Clinica Universidad de Navarra, 31008 Pamplona, Spain.
| | - José Ignacio Herrero
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain.
- Liver Unit, Clinica Universidad de Navarra 31008, Pamplona, Spain.
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), 28029 Madrid, Spain.
| | - Alberto Benito-Boillos
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain.
- Department of Radiology, Clinica Universidad de Navarra, 31008 Pamplona, Spain.
| | - Jorge Quiroga
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain.
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), 28029 Madrid, Spain.
- Department of Internal Medicine, Clinica Universidad de Navarra, 31008 Pamplona, Spain.
| | - Ana Martinez-Echeverria
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain.
- Department of Gastroenterology, Complejo Hospitalario de Navarra, 31008 Pamplona, Spain.
| | - Juan Isidro Uriz-Otano
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain.
- Department of Gastroenterology, Complejo Hospitalario de Navarra, 31008 Pamplona, Spain.
| | - María Pilar Huarte-Muniesa
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain.
- Department of Gastroenterology, Complejo Hospitalario de Navarra, 31008 Pamplona, Spain.
| | - Josep A Tur
- Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain.
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, 07122 Palma, Spain.
| | - J Alfredo Martinez
- Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain.
- Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain.
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain.
| | - M Angeles Zulet
- Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain.
- Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain.
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain.
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18
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Recaredo G, Marin-Alejandre BA, Cantero I, Monreal JI, Herrero JI, Benito-Boillos A, Elorz M, Tur JA, Martínez JA, Zulet MA, Abete I. Association between Different Animal Protein Sources and Liver Status in Obese Subjects with Non-Alcoholic Fatty Liver Disease: Fatty Liver in Obesity (FLiO) Study. Nutrients 2019; 11:nu11102359. [PMID: 31623368 PMCID: PMC6836147 DOI: 10.3390/nu11102359] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 09/27/2019] [Accepted: 09/30/2019] [Indexed: 12/22/2022] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is considered the hepatic manifestation of metabolic syndrome. Obesity and unhealthy dietary habits are described as risk factors for NAFLD. The aim of this study was to investigate the association between the consumption of different animal protein sources and hepatic status in NAFLD adults. A total of 112 overweight/obese participants with NAFLD from Fatty Liver in Obesity (FLiO) study were evaluated at baseline. Diet, body composition, and biochemical variables were evaluated. Hepatic status was also assessed by Magnetic Resonance Imaging, ultrasonography, and elastography. Red meat consumption showed a positive relationship with liver iron content (r = 0.224; p = 0.021) and ferritin concentration (r = 0.196; p = 0.037). Processed meat consumption exhibited a positive association with liver iron content (r = 0.308; p = 0.001), which was also found in the quantile regression (β = 0.079; p = 0.028). Fish consumption was related with lower concentration of ferritin (r = -0.200; p = 0.034). This association was further evidenced in the regression model (β = -0.720; p = 0.033). These findings suggest that the consumption of different animal protein sources differentially impact on liver status in obese subjects with NAFLD, showing fish consumption as a healthier alternative for towards NAFLD features.
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Affiliation(s)
- Gregorio Recaredo
- Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain.
| | - Bertha Araceli Marin-Alejandre
- Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain.
| | - Irene Cantero
- Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain.
| | - J Ignacio Monreal
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain.
- Clinical Chemistry Department, University Clinic of Navarra, University of Navarra, 31008 Pamplona, Spain.
| | - José Ignacio Herrero
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain.
- Liver Unit, Clinica Universidad de Navarra, 31008 Pamplona, Spain.
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), 28029 Madrid, Spain.
| | - Alberto Benito-Boillos
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain.
- Department of Radiology, Clinica Universidad de Navarra, 31008 Pamplona, Spain.
| | - Mariana Elorz
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain.
- Department of Radiology, Clinica Universidad de Navarra, 31008 Pamplona, Spain.
| | - Josep A Tur
- Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain.
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, 07122 Palma, Spain.
| | - J Alfredo Martínez
- Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain.
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain.
- Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain.
| | - M Angeles Zulet
- Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain.
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain.
- Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain.
| | - Itziar Abete
- Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain.
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain.
- Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain.
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Association between Sleep Disturbances and Liver Status in Obese Subjects with Nonalcoholic Fatty Liver Disease: A Comparison with Healthy Controls. Nutrients 2019; 11:nu11020322. [PMID: 30717355 PMCID: PMC6412197 DOI: 10.3390/nu11020322] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 01/18/2019] [Accepted: 01/21/2019] [Indexed: 02/06/2023] Open
Abstract
The relevance of sleep patterns in the onset or evolution of nonalcoholic fatty liver disease (NAFLD) is still poorly understood. Our aim was to investigate the association between sleep characteristics and hepatic status indicators in obese people with NAFLD compared to normal weight non-NAFLD controls. Ninety-four overweight or obese patients with NAFLD and 40 non-NAFLD normal weight controls assessed by abdominal ultrasonography were enrolled. Hepatic status evaluation considered liver stiffness determined by Acoustic Radiation Force Impulse elastography (ARFI) and transaminases. Additionally, anthropometric measurements, clinical characteristics, and biochemical profiles were determined. Sleep features were evaluated using the Pittsburgh Sleep Quality Index (PSQI). Hepatic status parameters, anthropometric measurements, and clinical and biochemical markers differed significantly in NAFLD subjects compared to controls, as well as sleep efficiency, sleep disturbance score, and sleep quality score. In the NAFLD group, a higher prevalence of short sleep duration (p = 0.005) and poor sleep quality (p = 0.041) were found. Multivariate-adjusted odds ratio (95% confidence interval) for NAFLD considering sleep disturbance was 1.59 (1.11–2.28). Regression models that included either sleep disturbance or sleep quality predicted up to 20.3% and 20.4% of the variability of liver stiffness, respectively, and after adjusting for potential confounders. Current findings suggest that sleep disruption may be contributing to the pathogenesis of NAFLD as well as the alteration of the liver may be affecting sleep patterns. Consequently, sleep characteristics may be added to the list of modifiable behaviors to consider in health promotion strategies and in the prevention and management of NAFLD.
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