Objective. We investigated the prevalence of insulin resistance, elevated liver enzymes, and NAFLD Fibrosis Score (NFS) in obese and severely obese patients. The relationships between inadequate nutrient intakes and the markers of metabolic and hepatic disorders were evaluated. Methods. From Jan to Sept 2009, sixty-three consecutive obese patients (21 M/42 F; age 19–68 years) were admitted to the study. Following the WHO obesity classification, the patients were divided into three subgroups (Class I,II,III). NFS scores <-1.455 were defined as NFS-; the others as NFS+. Insulin resistance (IR) was assessed by the homeostasis model assessment (HOMA-IR). Nutrient intakes and their potential role as risk factors for IR and liver damage were determined. Results. Body Mass Index (BMI) ranged from 30.9 to 73.7 kg/m2 and the majority of the patients (54%) belonged to Class III (BMI≥40). HOMA-IR (>2.5) was recorded in 63.5%. The prevalence of NFS+ was significantly higher in Class III than II and I. Excessive nutrient and energy intake prevalence showed significant differences for protein, fat, and carbohydrate among the obesity classes. Animal protein (OR 3.43, 95%CI = 1.15-10.20) and carbohydrate (OR 3.83, 95%CI = 1.33-10.94) intakes were the risk factors for IR and NFS+. Conclusions. Out-of-normal alanine aminotransferase (ALT) and gamma glutamyl transpeptidase (GGT) values were observed in less than one third of all patients, while NFS+ and IR were significantly prevalent, suggesting a close relationship between the progression of liver fibrosis and the metabolic derangement. The excessive intake of animal protein is associated with an increased risk of insulin resistance. The carbohydrate intake, albeit at the highest limit of the recommended dietary allowance range, is associated with an increased risk of liver fibrosis.
Nutrient intake in Italian obese patients: Relationships with insulin resistance and markers of non-alcoholic fatty liver disease
RICCI, Giorgio;CANDUCCI, Edgardo;RICCI, Enrico;ALVISI, Vittorio
2011
Abstract
Objective. We investigated the prevalence of insulin resistance, elevated liver enzymes, and NAFLD Fibrosis Score (NFS) in obese and severely obese patients. The relationships between inadequate nutrient intakes and the markers of metabolic and hepatic disorders were evaluated. Methods. From Jan to Sept 2009, sixty-three consecutive obese patients (21 M/42 F; age 19–68 years) were admitted to the study. Following the WHO obesity classification, the patients were divided into three subgroups (Class I,II,III). NFS scores <-1.455 were defined as NFS-; the others as NFS+. Insulin resistance (IR) was assessed by the homeostasis model assessment (HOMA-IR). Nutrient intakes and their potential role as risk factors for IR and liver damage were determined. Results. Body Mass Index (BMI) ranged from 30.9 to 73.7 kg/m2 and the majority of the patients (54%) belonged to Class III (BMI≥40). HOMA-IR (>2.5) was recorded in 63.5%. The prevalence of NFS+ was significantly higher in Class III than II and I. Excessive nutrient and energy intake prevalence showed significant differences for protein, fat, and carbohydrate among the obesity classes. Animal protein (OR 3.43, 95%CI = 1.15-10.20) and carbohydrate (OR 3.83, 95%CI = 1.33-10.94) intakes were the risk factors for IR and NFS+. Conclusions. Out-of-normal alanine aminotransferase (ALT) and gamma glutamyl transpeptidase (GGT) values were observed in less than one third of all patients, while NFS+ and IR were significantly prevalent, suggesting a close relationship between the progression of liver fibrosis and the metabolic derangement. The excessive intake of animal protein is associated with an increased risk of insulin resistance. The carbohydrate intake, albeit at the highest limit of the recommended dietary allowance range, is associated with an increased risk of liver fibrosis.I documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
