低碳水化合物饮食对非酒精性脂肪性肝病患者脂肪肝及肝功能的影响

Effect of low-carbohydrate diet on fatty liver and liver function in patients with non-alcoholic fatty liver disease

目的:探讨低碳水化合物饮食干预对非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)患者脂肪肝及肝功能的影响。方法:选取2022年5月—2023年1月在深圳市宝安区中心医院就诊的80例NAFLD患者为研究对象,按随机数字表法分为低碳水化合物饮食组(试验组,55例)和常规饮食组(对照组,25例),试验组男性36例,女性19例,年龄(33.8±1.2)岁,对照组男性20例,女性5例,年龄(33.0±1.3)岁。比较两组饮食干预12周前后体重、血糖、血脂、肝生化功能指标、脂肪肝等变化情况。结果:试验组与对照组在干预前各项指标差异无统计学意义(均P>0.05),而干预12周后,试验组体重、体重指数、腰围、稳态模型胰岛素抵抗指数、空腹血糖、糖化血红蛋白、甘油三酯、丙氨酸氨基转移酶、天冬氨酸氨基转移酶、谷氨酰转肽酶水平低于对照组(均P<0.05),试验组高密度脂蛋白胆固醇水平高于对照组(P=0.027)。试验组干预后,脂肪肝清除率达47.3%(26/55);对照组干预前后脂肪肝水平未见明显改变(P>0.05)。结论:与常规饮食相比,低碳水化合物饮食可以改善NAFLD患者肝生化功能指标和脂肪肝。

Objective:To investigate the effects of low-carbohydrate dietary intervention on fatty liver and liver function in patients with non-alcoholic fatty liver disease(NAFLD).Methods:Eighty cases of NAFLD patients attending Baoan Central Hospital of Shenzhen from May 2022 to January 2023 were selected for the study,and were divided into a low-carbohydrate diet group(test group,55 cases)and a conventional diet group(control group,25 cases)according to the randomized numeric table method,with 36 males and 19 females in the test group,aged(33.8±1.2)years old,20 males and 5 females in the control group,aged(33.0±1.3)years old.Changes in body weight,blood glucose,blood lipids,liver biochemical function indexes and fatty liver before and after 12 weeks of dietary intervention were compared between the two groups.Results:There was no statistically significant difference between the test group and the control group in each index before the intervention(all P>0.05).The levels of body weight,body mass index,waist circumference,homeostasis model assessment of insulin resistance,fasting blood glucose,glycosylated hemoglobin,triglycerides,alanine aminotransferase,aspartate aminotransferase,andγ-glutamyl transferase in the test group were lower than those in the control group after 12 weeks of intervention(all P<0.05).HDL cholesterol levels were higher in the test group than in the control group(P=0.027).After the intervention in the test group,fatty liver clearance reached 47.3%(26/55);no significant change in fatty liver levels was observed in the control group before and after the intervention(P>0.05).Conclusion:A low-carbohydrate diet improves liver biochemical function indices and fatty liver in patients with NAFLD compared with a conventional diet.