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Metabolic syndrome is associated with greater histologic severity, higher carbohydrate, and lower fat diet in patients with NAFLD.
Am J Gastroenterol 2006; 101(10):2247-53AJ

Abstract

OBJECTIVES

Nonalcoholic fatty liver disease (NAFLD) is considered as the hepatic manifestation of metabolic syndrome. Insulin resistance (IR) is a key component of metabolic syndrome. The aim was to determine the dietary composition, physical activity, and histologic severity between NAFLD patients with and without metabolic syndrome.

METHODS

Ninety-one patients with NAFLD completed the Block Food Frequency Questionnaire and the Paffenbarger Physical Activity Questionnaire. IR was assessed by the homeostasis model assessment (HOMA) index. Metabolic syndrome was defined by the ATP III clinical definition. Nonalcoholic steatohepatitis (NASH) Clinical Network Scoring System was used to determine the histologic severity of NAFLD.

RESULTS

Thirty-one patients (34%) had metabolic syndrome. Patients with metabolic syndrome had a higher HOMA index (7.66 vs 4.45, p = 0.04), and consumed more carbohydrates (51%vs 45%, p = 0.03) and less fat (34%vs 40%, p = 0.01) compared with those without metabolic syndrome; total daily calorie, protein consumption, and physical activity were similar between the two groups. Patients with metabolic syndrome had higher scores for steatosis (2.0 +/- 0.8 vs 1.37 +/- 1, p = 0.02), NASH activity (4.13 +/- 1.4 vs 3.13 +/- 1.7, p = 0.004), and global NASH score (5.9 +/- 1.7 vs 4.4 +/- 2.3, p = 0.0006) compared with those without metabolic syndrome. When controlled for other factors including dietary composition and physical activity, the presence of metabolic syndrome was a significant risk factor for global NASH severity in addition to HOMA index and female gender.

CONCLUSION

Metabolic syndrome in patients with NAFLD is associated with a diet containing more carbohydrate and less fat and greater histologic severity. The role of a carbohydrate-restricted diet in decreasing the risk for metabolic syndrome and histologic severity should be assessed in patients with NAFLD.

Authors+Show Affiliations

Division of Gastroenterology, Department of Medicine, The University of Michigan, Ann Arbor, Michigan 48109-0362, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

17032189

Citation

Kang, Hellan, et al. "Metabolic Syndrome Is Associated With Greater Histologic Severity, Higher Carbohydrate, and Lower Fat Diet in Patients With NAFLD." The American Journal of Gastroenterology, vol. 101, no. 10, 2006, pp. 2247-53.
Kang H, Greenson JK, Omo JT, et al. Metabolic syndrome is associated with greater histologic severity, higher carbohydrate, and lower fat diet in patients with NAFLD. Am J Gastroenterol. 2006;101(10):2247-53.
Kang, H., Greenson, J. K., Omo, J. T., Chao, C., Peterman, D., Anderson, L., ... Conjeevaram, H. S. (2006). Metabolic syndrome is associated with greater histologic severity, higher carbohydrate, and lower fat diet in patients with NAFLD. The American Journal of Gastroenterology, 101(10), pp. 2247-53.
Kang H, et al. Metabolic Syndrome Is Associated With Greater Histologic Severity, Higher Carbohydrate, and Lower Fat Diet in Patients With NAFLD. Am J Gastroenterol. 2006;101(10):2247-53. PubMed PMID: 17032189.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Metabolic syndrome is associated with greater histologic severity, higher carbohydrate, and lower fat diet in patients with NAFLD. AU - Kang,Hellan, AU - Greenson,Joel K, AU - Omo,Jason T, AU - Chao,Cewin, AU - Peterman,Debra, AU - Anderson,Lilian, AU - Foess-Wood,Laura, AU - Sherbondy,Mary A, AU - Conjeevaram,Hari S, PY - 2006/10/13/pubmed PY - 2006/12/21/medline PY - 2006/10/13/entrez SP - 2247 EP - 53 JF - The American journal of gastroenterology JO - Am. J. Gastroenterol. VL - 101 IS - 10 N2 - OBJECTIVES: Nonalcoholic fatty liver disease (NAFLD) is considered as the hepatic manifestation of metabolic syndrome. Insulin resistance (IR) is a key component of metabolic syndrome. The aim was to determine the dietary composition, physical activity, and histologic severity between NAFLD patients with and without metabolic syndrome. METHODS: Ninety-one patients with NAFLD completed the Block Food Frequency Questionnaire and the Paffenbarger Physical Activity Questionnaire. IR was assessed by the homeostasis model assessment (HOMA) index. Metabolic syndrome was defined by the ATP III clinical definition. Nonalcoholic steatohepatitis (NASH) Clinical Network Scoring System was used to determine the histologic severity of NAFLD. RESULTS: Thirty-one patients (34%) had metabolic syndrome. Patients with metabolic syndrome had a higher HOMA index (7.66 vs 4.45, p = 0.04), and consumed more carbohydrates (51%vs 45%, p = 0.03) and less fat (34%vs 40%, p = 0.01) compared with those without metabolic syndrome; total daily calorie, protein consumption, and physical activity were similar between the two groups. Patients with metabolic syndrome had higher scores for steatosis (2.0 +/- 0.8 vs 1.37 +/- 1, p = 0.02), NASH activity (4.13 +/- 1.4 vs 3.13 +/- 1.7, p = 0.004), and global NASH score (5.9 +/- 1.7 vs 4.4 +/- 2.3, p = 0.0006) compared with those without metabolic syndrome. When controlled for other factors including dietary composition and physical activity, the presence of metabolic syndrome was a significant risk factor for global NASH severity in addition to HOMA index and female gender. CONCLUSION: Metabolic syndrome in patients with NAFLD is associated with a diet containing more carbohydrate and less fat and greater histologic severity. The role of a carbohydrate-restricted diet in decreasing the risk for metabolic syndrome and histologic severity should be assessed in patients with NAFLD. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/17032189/Metabolic_syndrome_is_associated_with_greater_histologic_severity_higher_carbohydrate_and_lower_fat_diet_in_patients_with_NAFLD_ L2 - http://Insights.ovid.com/pubmed?pmid=17032189 DB - PRIME DP - Unbound Medicine ER -