ABSTRACT
BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease worldwide with no specific treatment. Weight loss is the most effective therapeutic strategy in its management; however, there is no consensus on its specifics. Thus, this study was conducted to evaluate the effects of weight loss on liver enzymes, markers of inflammation, oxidative stress and CK18-M30 (cytokeratin 18) as a biomarker of hepatocellular apoptosis. OBJECTIVES: To study the effect of weight reduction diet as an exclusive treatment for NAFLD. PATIENTS AND METHODS: Forty four patients with NAFLD received a diet including a 500 to 1000 kcal per day intake reduction as30% fat, 15% protein, and 55% carbohydrate for six months. Anthropometric parameters, alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamyl transferase (GGT), lipid profile, malondialdehyde (MDA), TNF-α, IL-6, CK18-M30 were measured at baseline and at the end of the study. At the end of follow up, patients were classified as adherent or nonadherent to treatment according to a weight loss of ≥ 5%, or < 5% of initial body weight, respectively. RESULTS: Twenty five patients were classified as adherent group and nineteen as nonadherent group (9.7% vs. 1.9% total body weight loss after 6 months, respectively). After 6 months, changes in adherent and nonadherent groups were as follows: reduction in body weight from 93.7 ± 15.8 kg to 84.2 ± 13.4 kg vs. 94 ± 16.6 kg to 92.2 ± 16.2 kg (P < 0.05), BMI from 32.7 ± 3.9 to 29.5 ± 3.2 vs.31.8 ± 5.4 to 31.1 ± 5.3 (P < 0.001), and waist circumference from 105.1 ± 12.6 cm to 97.4 ± 9.8 cm vs.106.8 ± 14.2 cm to 103.7 ± 14 cm (P < 0.001), respectively. Diastolic blood pressure was significantly decreased in adherent group (from 80.2 ± 5.1 mmHg to 76.9 ± 5 mmHg; P < 0.001). Also, total cholesterol, LDL, triglyceride, ALT, AST, GGT and CK18-M30 levels were significantly decreased in the adherent group compared to nonadherent group (P < 0.05). CONCLUSIONS: This intervention offers a practical approach for treatment of patients with NAFLD with diet therapy.
ABSTRACT
BACKGROUND: It is known that fish oil consumption decreases incidence of cardiovascular disease. However, some studies showed that it increases atherosclerosis as it does not get completely metabolized by the liver. The aim of the present study was to investigate the effects of fish oil on aortic atherosclerosis, hepatic steatosis and serum lipids in rats. METHODS: Twenty pregnant Wistar rats were fed with a fish oil-containing diet or standard diet (containing soy bean oil) during pregnancy and lactation and the pups were weaned onto the same diet. Fasting blood samples, hepatic and aortic specimens were taken from pups on day 70 postnatal. Data were analyzed with SPSS software, using t-test, Mann-Whitney test and Spearman correlation coefficient. Values of p < 0.05 were considered significant. RESULTS: Medians for fatty streak in aorta of fish oil fed and soy bean oil fed pups were 1.00 and 0.00, respectively, and P value was 0.042. Also, medians for ductular cell hyperplasia of liver in fish oil fed and soy bean oil fed pups were 1.00 and 0.00, respectively, and P value was 0.014. Total cholesterol in pups fed with fish oil was 52.20 mg/dl and in pups fed with soy bean oil was 83.90 mg/dl (p < 0.00) and for low density lipoprotein cholesterol (LDL-C) values were 8.79 mg/dl and 13.16 mg/dl, respectively (p = 0.031). CONCLUSIONS: According to the results of the present study, a diet which provided 15.9% of energy from fish oil as the only source of dietary fat, induced aortic atherosclerosis as well as hepatic steatosis in Wistar rat, although it decreased total cholesterol and LDL-C.
