Adherence to mediterranean diet and non-alcoholic fatty liver disease: effect on insulin resistance

F Baratta, D Pastori, L Polimeni, T Bucci… - Official journal of the …, 2017 - journals.lww.com
F Baratta, D Pastori, L Polimeni, T Bucci, F Ceci, C Calabrese, I Ernesti, G Pannitteri, F Violi
Official journal of the American College of Gastroenterology| ACG, 2017journals.lww.com
Objectives: The prevalence of cardiometabolic disorders, including non-alcoholic fatty liver
disease (NAFLD), is increasing in western countries, because of changes in lifestyle and
dietary habits. Mediterranean Diet (Med-Diet) is effective for cardiovascular prevention, but
its relationship with NAFLD has been scarcely investigated. Methods: We included 584
consecutive outpatients presenting with one or more cardiovascular risk factor such as type
2 diabetes mellitus (T2DM), arterial hypertension, overweight/obesity, and dyslipidemia …
Abstract
Objectives:
The prevalence of cardiometabolic disorders, including non-alcoholic fatty liver disease (NAFLD), is increasing in western countries, because of changes in lifestyle and dietary habits. Mediterranean Diet (Med-Diet) is effective for cardiovascular prevention, but its relationship with NAFLD has been scarcely investigated.
Methods:
We included 584 consecutive outpatients presenting with one or more cardiovascular risk factor such as type 2 diabetes mellitus (T2DM), arterial hypertension, overweight/obesity, and dyslipidemia. Liver steatosis was assessed using ultrasonography. Med-Diet adherence was investigated by a validated semiquantitative nine-item dietary questionnaire; patients were divided into low, intermediate, and high adherence. Insulin resistance was defined by the 75th percentile of homeostasis model of insulin resistance (HOMA-IR;≥ 3.8).
Results:
The mean age was 56.2±12.4 years and 38.2% were women. Liver steatosis was present in 82.7%, and its prevalence decreased from low to high adherence group (96.5% vs. 71.4%, P< 0.001). In a multiple logistic regression analysis, hypertriglyceridemia (odds ratio (OR): 2.913; P= 0.002), log (ALT)(OR: 6.186; P< 0.001), Med-Diet adherence (intermediate vs. low OR: 0.115; P= 0.041, high vs. low OR: 0.093; P= 0.030), T2DM (OR: 3.940; P= 0.003), and high waist circumference (OR: 3.012; P< 0.001) were associated with NAFLD. Among single foods, low meat intake (OR: 0.178; P< 0.001) was inversely significantly associated with NAFLD. In 334 non-diabetic NAFLD patients, age (OR: 1.035, P= 0.025), high waist circumference (OR: 7.855, P< 0.001), hypertriglyceridemia (OR: 2.152, P= 0.011), and Log (ALT)(OR: 2.549, P= 0.002) were directly associated with HOMA-IR, whereas Med-Diet score was inversely associated (OR: 0.801, P= 0.018).
Conclusions:
We found an inverse relationship between Med-Diet and NAFLD prevalence. Among NAFLD patients, good adherence to Med-Diet was associated with lower insulin resistance. Our findings suggest that Med-Diet may be a beneficial nutritional approach in NAFLD patients.
Lippincott Williams & Wilkins