Effect of nutritional intervention combined with aerobic exercises on serum adiponectin of nonalcoholic fatty liver patients / 中华临床营养杂志

ABSTRACT

ObjectiveTo study the effect of nutritional intervention combined with aerobic exercises on serum adiponectin and insulin resistance in nonalcoholic fatty liver (NAFL) patients.Methods32 patients confirmed as NAFL between April 2008 and August 2009 were enrolled into NAFL group and 31 health people into control group.NAFL group received nutritional intervention and followed aerobic exercise program.The changes of body mass index (BMI),serum adiponectin,fasting blood glucose (FBG),fasting insulin (FINS) and serum lipids were recorded before and after interventions.Insulin resistance index (HOMA-IR) was calculated.Inter-group difference,changes after intervention,and correlation between serum adiponectin and the other indexes were analyzed.ResultsCompared with the control group,BMI [ (29.84 ±3.16) kg/m2 vs.(22.22 ± 1.81 ) kg/m2,P =0.000],total cholesterol (TC) [ (5.09 ±0.86) mmol/L vs.(4.38 ±0.85) mmol/L,P =0.002],triglyceride (TG) [ (1.99±0.86) mmol/Lvs.(1.10±0.38) mmol/L,P=0.000],FBG[ (6.02±0.63) mmol/Lvs.(5.02±0.71) mmol/L,P=0.000],FINS[ (13.73±3.24) mU/Lvs.(9.55±1.99) mU/L,P=0.000],HOMA-IR [ (3.74±1.21) mmol/L vs.(2.08 ±0.27) mmol/L,P=0.000] in the NAFL group were significantly higher,while serum adiponectin in the NAFL group was significantly lower [ (4.89 ± 1.81 ) ug/L vs.( 12.97 ± 3.15 ) ug/L,P =0.000 ].After nutritional intervention and aerobic exercises,BMI [ ( 26.65 ± 2.39 ) kg,/m2 vs.(29.84 ±3.16) kg/m2,P =0.000] 、FBG [ (5.61 ±0.47) mmol/L vs.(6.02 ±0.63) mmol/L,P =0.004 ],and FINS [ ( 11.12 ± 2.01 ) mU/L vs.( 13.73 ± 3.24) mU/L,P =0.000 ] in the NAFL group were decreased significantly,while serum adiponectin [ (6.54 ±2.12) ug/L vs.(4.89 ± 1.81 ) ug/L,P =0.001 ] was significantly higher than the level before intervention.Serum adiponectin was negatively correlated with BMI,FBG,FINS,HOMA-IR,and TG (P =0.004,0.000,0.000,0.000,and 0.010),and positively correlated with high density lipoprotein cholesterol (P =0.026),but not correlated with TC (P =0.101 ).ConclusionThe combination of nutritional intervention and aerobic exercises can improve the level of serum adiponectin,adjust the level of serum glucose and serum lipids,and alleviate insulin resistance in NAFL patients.