改良地中海饮食在代谢性相关脂肪性肝病患者治疗中的效果

Effect of modified Mediterranean diet on patients with metabolic associated fatty liver disease

目的探讨改良地中海饮食在代谢性相关脂肪性肝病患者治疗中的效果。方法前瞻性选取2021年1月至12月在湖南师范大学附属第一医院临床营养科治疗的代谢性相关脂肪性肝病患者106例,按随机数字表法将患者分为实验组(n=53)和对照组(n=53)。两组均给予常规治疗,其中对照组给予常规饮食,观察组给予改良地中海饮食。观察两组临床疗效,治疗前、治疗12周后的肝功能[丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、碱性磷酸酶(ALP)]、血脂[总胆固醇、甘油三酯、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]、血糖、体重指数、腰臀比等水平的差异。结果实验组治疗总有效率为94.34%,优于对照组(81.13%),差异有统计学意义(P<0.05)。实验组治疗12周后ALT、AST、ALP分别为(46.69±9.98)、(43.35±9.44)、(51.13±13.31)U/L,均明显低于对照组[(61.03±9.12)、(55.54±9.13)、(60.03±12.43)U/L],差异均有统计学意义(P<0.05)。实验组治疗12周后总胆固醇、甘油三酯、LDL-C分别为(4.21±0.98)、(1.45±0.64)、(2.50±0.83)mmol/L,明显低于对照组[(5.40±0.99)、(2.13±0.67)、(3.60±0.77)mmol/L],而HDL-C为(1.78±0.40)mmol/L,明显高于对照组[(1.20±0.44)mmol/L],差异均有统计学意义(P<0.05)。实验组治疗12周后空腹血糖、体重指数、腰臀比分别为(5.20±0.99)mmol/L、(24.83±1.92)kg/m^(2)和(0.83±0.19),明显低于对照组[(6.10±0.91)mmol/L、(26.10±2.00)kg/m^(2)和(0.94±0.17)],差异均有统计学意义(P<0.05)。结论改良地中海饮食在代谢性相关脂肪性肝病患者治疗中有较好的效果,可有效改善患者肝功能、血脂、血糖等水平。

Objective To explore the effect of modified Mediterranean diet in the treatment of patients with metabolic related fatty liver disease.Methods A total of 106 patients with metabolic related fatty liver disease treated in the Department of Clinical Nutrition,The First Affiliated Hospital of Hunan Normal University from January to December 2021 were prospectively selected,and divided into experimental group(n=53)control group(n=53)according to the random number table method.Both groups were given conventional treatment,the control group give conventional diet,observation group give modified Mediterranean diet.The differences of clinical efficacy,levels of liver function[alanine aminotransferase(ALT),aspartate aminotransferase(AST),alkaline phosphatase(ALP)],lipid[total cholesterol,triglyceride and low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C],blood glucose,body mass index,waist hip ratio before and after 12 weeks of treatment were observed.Results The total effective rate of the experimental group was 94.34%,which was better than that of the control group(81.13%),the difference was statistically significant(P<0.05).After 4 weeks of treatment,the levels of ALT,AST,ALP in the experimental group were(46.69±9.98),(43.35±9.44),(51.13±13.31)U/L,respectively,which were significantly lower than those in the control group[(61.03±9.12),(55.54±9.13),(60.03±12.43)U/L],the differences were statistically significant(P<0.05).After 12 weeks of treatment,total cholesterol,triglyceride and LDL-C in the experimental group were(4.21±0.98),(1.45±0.64)and(2.50±0.83)mmol/L,respectively,which was significantly lower than those in the control group[(5.40±0.99),(2.13±0.67),(3.60±0.77)mmol/L],while HDL-C was(1.78±0.40)mmol/L,which was significantly higher than those in the control group[(1.20±0.44)mmol/L],the differences were statistically significant(P<0.05).After 12 weeks of treatment,the fasting blood glucose,body mass index and waist hip ratio in the experimental group were(5.20±0.99)mmol/L,(24.83±1.92)kg/m^(2)and(0.83±0.19)respectively,which were significantly lower than those in the control group[(6.10±0.91)mmol/L,(26.10±2.00)kg/m^(2)and(0.94±0.17)],the differences were statistically significant(P<0.05).Conclusion The modified Mediterranean diet has a good effect in the treatment of patients with metabolic related fatty liver disease,and can effectively improve the level of liver function,blood lipid and blood glucose.