Диетологические возможности профилактики и лечения неалкогольной жировой болезни печени
Дзгоева Ф.Х., Варданян Е.М., Комшилова К.А., Стрельникова Т.В., Рафикова Д.С. Диетологические возможности профилактики и лечения неалкогольной жировой болезни печени. FOCUS Эндокринология. 2021; 3: 83–92. DOI: 10.47407/ef2021.2.3.0040
Dzgoeva F.Kh., Vardanyan Е.М., Komshilova К.А., Strelnikova Т.V., Rafikova D.S. Dietary options in prevention and treatment of non-alcoholic fatty liver disease. FOCUS Endocrinology. 2021; 3: 83–92. DOI: 10.47407/ef2021.2.3.0040
Неуклонно нарастающая заболеваемость ожирением и сопряженными с ним заболеваниями все больше диктует необходимость диетологической поддержки в комплексной терапии этой категории пациентов. В данной статье представлена одна из распространенных болезней печени, в большинстве случаев ассоциированная с метаболическим ожирением, отдельное внимание уделяется диетологическим возможностям, направленным на снижение массы тела, способное не только повлиять на риски возникновения и прогрессирования заболевания, но и улучшить качество жизни пациентов.
Ключевые слова: неалкогольная жировая болезнь печени, гепатоцеллюлярная карцинома, метаболический синдром, инсулинорезистентность, сахарный диабет, ожирение, артериальная гипертензия, диетологические рекомендации, нутритивная поддержка.
Ключевые слова: неалкогольная жировая болезнь печени, гепатоцеллюлярная карцинома, метаболический синдром, инсулинорезистентность, сахарный диабет, ожирение, артериальная гипертензия, диетологические рекомендации, нутритивная поддержка.
1. European Association for the Study of the Liver (EASL); European Association for the Study of Diabetes (EASD); European Association for the Study of Obesity (EASO). EASL-EASD-EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease. J Hepatol 2016; 64(6): 1388–402.
2. Estes C, Razavi H, Loomba R et al. Modeling the epidemic of nonalcoholic fatty liver disease demonstrates an exponential increase in burden of disease. Hep-atology 2018; 67(1): 123–33.
3. Younossi ZM. Nonalcoholic fatty liver disease and nonalcoholic steatohepatitis: Implications for liver transplantation. Liver Transpl 2018; 24 (2): 166–70.
4. Комшилова К.А., Трошина Е.А. Абдоминальное ожирение и неалкоголь-ная жировая болезнь печени: клинико-лабораторные и морфологиче-ские сопоставления. Дисс. М., 2015. [Komshilova K.A., Troshina E.A. Abdom-inal'noe ozhirenie i nealkogol'naya zhirovaya bolezn' pecheni: kliniko-labora-tornye i morfologicheskie sopostavleniya. Diss. M., 2015 (in Russian)].
5. Liang Y, Liang S et al. Oral Administration of Compound Probiotics Ameliorates HFD-Induced Gut Microbe Dysbiosis and Chronic Metabolic Inflammation via the G Protein-Coupled Receptor 43 in Non-alcoholic Fatty Liver Disease Rats. Probiotics Antimicrob. Proteins 2019; 11: 175–85.
6. Клинические рекомендации EASL/EASD/EASO по диагностике и лечению неалкогольной жировой болезни печени 2016 г. [Klinicheskie rekomendat-sii EASL/EASD/EASO po diagnostike i lecheniyu nealkogol'noi zhirovoi bolezni pecheni 2016 g. (in Russian)].
7. Междисциплинарные клинические рекомендации «Лечение ожирения и коморбидных заболеваний». Ожирение и метаболизм 2021; 18 (1): 5–99.[Mezhdistsiplinarnye klinicheskie rekomendatsii «Lechenie ozhireniya i ko-morbidnykh zabolevanii». Ozhirenie i metabolizm 2021; 18 (1): 5–99. (in Rus-sian)]. DOI: 10.14341/omet12714
8. Кособян Е.П., Смирнова О.М. Современные концепции патогенеза неалко-гольной жировой болезни печени. Сахарный диабет 2010; 1: 55–64.[Kosobyan E.P., Smirnova O.M. Sovremennye kontseptsii patogeneza nealko-gol'noi zhirovoi bolezni pecheni. Sakharnyi diabet 2010; 1: 55–64. (in Rus-sian)].
9. Diabetes Obesity. EASL-EASD-EASO Clinical Practice Guidelines for the man-agement of non-alcoholic fatty liver disease. J Hepatol 2016; 64: 1388–402.
10. Yang Y et al. Increased intake of vegetables, but not fruit, reduces risk for hep-atocellular carcinoma: a meta-analysis. Gastroenterology 2014; 147: 1031–42.
11. Sobrecases H., Lê K.A., Bortolotti M et al. Effects of short-term overfeeding with fructose, fat and fructose plus fat on plasma and hepatic lipids in healthy men. Diabetes & Metabolism 2010; 36 (3): 244–6.
12. De Chiara F, Ureta Checcllo C, Ramón Azcón J. High Protein Diet and Metabolic Plasticity in Non-Alcoholic Fatty Liver Disease: Myths and Truths. Nutrients 2019; 11 (12): 2985. DOI: 10.3390/nu11122985
13. Lu W, Li S, Li J et al. Effects of omega-3 fatty acid in nonalcoholic fatty liver dis-ease: a meta-analysis. Gastroenterol Res Pract 2016; 2016: 1459790.
14. Capanni M, Calella F, Biagini MR et al. Prolonged n3 polyunsaturated fatty acid supplementation ameliorates hepatic steatosis in patients with non-alcoholic fatty liver disease: a pilot study. Aliment Pharmacol Ther 2006; 23: 1143–51.
15. Sawada N, Inoue M, Iwasaki M et al. Consumption of n-3 fatty acids and fish re-duces risk of hepatocellular carcinoma. Gastroenterology 2012; 142: 1468–75.
16. Abenavoli L, Milanović M. Olive oil antioxidants and non-alcoholic fatty liver disease. Expert Rev Gastroenterol Hepatol 2019; 13 (8): 739–49. DOI: 10.1080/17474124.2019.1634544. Epub 2019 Jun 25. PMID: 31215262.
17. Buckland G, Mayén AL, Agudo A et al. Olive oil intake and mortality within the Spanish population (EPIC-Spain). Am J Clin Nutr 2012; 96 (1): 142–49. DOI: 10.3945/ajcn.111.024216
18. Setiawan V et al. Association of coffee intake with reduced incidence of liver cancer and death from chronic liver disease in the US multiethnic cohort. Gas-troenterology 2015; 148: 118–25.
19. Haufe S et al. Randomized comparison of reduced fat and reduced carbohy-drate hypocaloric diets on intrahepatic fat in overweight and obese human subjects. Hepatology 2011; 53: 1504–14.
20. Panchal SK, Ward L, Brown L. Ellagic acid attenuates high-carbohydrate, high-fat diet-induced metabolic syndrome in rats. Eur J Nutr 2013; 52 (2): 559–68.
21. Based on. Plauth M. ESPEN guideline on clinical nutrition in liver disease. Clin Nutr 2019; 38: 485e521.
22. Gupta H, Youn GS, Shin MJ, Suk KT. Role of Gut Microbiota in Hepatocarcino-genesis. Microorganisms 2019; 7 (5): 121. DOI: 10.3390/microorganisms 7050121
23. Маевская М.В., Ивашкин В.Т. Печень и питание. Оптимальная диета при неалкогольной жировой болезни печени. Российский журнал гастроэн-терологии, гепатологии, колопроктологии 2018; 28 (5): 105–16.
[Maevskaya M.V., Ivashkin V.T. Pechen' i pitanie. Optimal'naya dieta pri nealko-gol'noi zhirovoi bolezni pecheni. Rossiiskii zhurnal gastroenterologii, gepa-tologii, koloproktologii 2018; 28 (5): 105–16. (in Russian)].
24. Perumpail B, Li A, John N et al. The Role of Vitamin E in the Treatment of NAFLD. Diseases 2018; 6 (4): 86. DOI: 10.3390/diseases6040086
25. Hadi H, Vettor R, Rossato M. Vitamin E as a Treatment for Nonalcoholic Fatty Liver Disease: Reality or Myth? Antioxidants. 2018; 7 (1): 12. DOI: 10.3390/an-tiox7010012
26. Nobili V, Alisi A, Valenti L et al. NAFLD in children: new genes, new diagnostic modalities and new drugs. Nat Rev Gastroenterol Hepatol 2019; 16 (9): 517–
30. DOI: 10.1038/s41575-019-0169-z
27. Sharifi N, Amani R, Hajiani E, Cheraghian B. Does Vitamin D improve liver en-zymes, oxidative stress, and inflammatory biomarkers in adults with non-alco-holic fatty liver disease? A randomized clinical trial. Endocrine 2014; 47: 70–80.
28. Raza S, Tewari A, Rajak S, Sinha RA. Vitamins and non-alcoholic fatty liver dis-ease: A molecular insight. Liver Res 2021; 5 (2): 62–71. DOI: 10.1016/j.livres.2021.03.004
29. Chan R, Wong VW, Chu WC et al. Dietquality scores and prevalence of nonalco-holic fatty liver disease: a population study using proton-magnetic resonance spectroscopy. PLoS One 2015; 10: e0139310.
30. Harrison SA, Torgerson S, Hayashi P et al. Vitamin E and vitamin C treatment improves fibrosis in patients with nonalcoholic steatohepatitis. Am J Gastroen-terol 2003; 98: 2485–90.
2. Estes C, Razavi H, Loomba R et al. Modeling the epidemic of nonalcoholic fatty liver disease demonstrates an exponential increase in burden of disease. Hep-atology 2018; 67(1): 123–33.
3. Younossi ZM. Nonalcoholic fatty liver disease and nonalcoholic steatohepatitis: Implications for liver transplantation. Liver Transpl 2018; 24 (2): 166–70.
4. Комшилова К.А., Трошина Е.А. Абдоминальное ожирение и неалкоголь-ная жировая болезнь печени: клинико-лабораторные и морфологиче-ские сопоставления. Дисс. М., 2015. [Komshilova K.A., Troshina E.A. Abdom-inal'noe ozhirenie i nealkogol'naya zhirovaya bolezn' pecheni: kliniko-labora-tornye i morfologicheskie sopostavleniya. Diss. M., 2015 (in Russian)].
5. Liang Y, Liang S et al. Oral Administration of Compound Probiotics Ameliorates HFD-Induced Gut Microbe Dysbiosis and Chronic Metabolic Inflammation via the G Protein-Coupled Receptor 43 in Non-alcoholic Fatty Liver Disease Rats. Probiotics Antimicrob. Proteins 2019; 11: 175–85.
6. Клинические рекомендации EASL/EASD/EASO по диагностике и лечению неалкогольной жировой болезни печени 2016 г. [Klinicheskie rekomendat-sii EASL/EASD/EASO po diagnostike i lecheniyu nealkogol'noi zhirovoi bolezni pecheni 2016 g. (in Russian)].
7. Междисциплинарные клинические рекомендации «Лечение ожирения и коморбидных заболеваний». Ожирение и метаболизм 2021; 18 (1): 5–99.[Mezhdistsiplinarnye klinicheskie rekomendatsii «Lechenie ozhireniya i ko-morbidnykh zabolevanii». Ozhirenie i metabolizm 2021; 18 (1): 5–99. (in Rus-sian)]. DOI: 10.14341/omet12714
8. Кособян Е.П., Смирнова О.М. Современные концепции патогенеза неалко-гольной жировой болезни печени. Сахарный диабет 2010; 1: 55–64.[Kosobyan E.P., Smirnova O.M. Sovremennye kontseptsii patogeneza nealko-gol'noi zhirovoi bolezni pecheni. Sakharnyi diabet 2010; 1: 55–64. (in Rus-sian)].
9. Diabetes Obesity. EASL-EASD-EASO Clinical Practice Guidelines for the man-agement of non-alcoholic fatty liver disease. J Hepatol 2016; 64: 1388–402.
10. Yang Y et al. Increased intake of vegetables, but not fruit, reduces risk for hep-atocellular carcinoma: a meta-analysis. Gastroenterology 2014; 147: 1031–42.
11. Sobrecases H., Lê K.A., Bortolotti M et al. Effects of short-term overfeeding with fructose, fat and fructose plus fat on plasma and hepatic lipids in healthy men. Diabetes & Metabolism 2010; 36 (3): 244–6.
12. De Chiara F, Ureta Checcllo C, Ramón Azcón J. High Protein Diet and Metabolic Plasticity in Non-Alcoholic Fatty Liver Disease: Myths and Truths. Nutrients 2019; 11 (12): 2985. DOI: 10.3390/nu11122985
13. Lu W, Li S, Li J et al. Effects of omega-3 fatty acid in nonalcoholic fatty liver dis-ease: a meta-analysis. Gastroenterol Res Pract 2016; 2016: 1459790.
14. Capanni M, Calella F, Biagini MR et al. Prolonged n3 polyunsaturated fatty acid supplementation ameliorates hepatic steatosis in patients with non-alcoholic fatty liver disease: a pilot study. Aliment Pharmacol Ther 2006; 23: 1143–51.
15. Sawada N, Inoue M, Iwasaki M et al. Consumption of n-3 fatty acids and fish re-duces risk of hepatocellular carcinoma. Gastroenterology 2012; 142: 1468–75.
16. Abenavoli L, Milanović M. Olive oil antioxidants and non-alcoholic fatty liver disease. Expert Rev Gastroenterol Hepatol 2019; 13 (8): 739–49. DOI: 10.1080/17474124.2019.1634544. Epub 2019 Jun 25. PMID: 31215262.
17. Buckland G, Mayén AL, Agudo A et al. Olive oil intake and mortality within the Spanish population (EPIC-Spain). Am J Clin Nutr 2012; 96 (1): 142–49. DOI: 10.3945/ajcn.111.024216
18. Setiawan V et al. Association of coffee intake with reduced incidence of liver cancer and death from chronic liver disease in the US multiethnic cohort. Gas-troenterology 2015; 148: 118–25.
19. Haufe S et al. Randomized comparison of reduced fat and reduced carbohy-drate hypocaloric diets on intrahepatic fat in overweight and obese human subjects. Hepatology 2011; 53: 1504–14.
20. Panchal SK, Ward L, Brown L. Ellagic acid attenuates high-carbohydrate, high-fat diet-induced metabolic syndrome in rats. Eur J Nutr 2013; 52 (2): 559–68.
21. Based on. Plauth M. ESPEN guideline on clinical nutrition in liver disease. Clin Nutr 2019; 38: 485e521.
22. Gupta H, Youn GS, Shin MJ, Suk KT. Role of Gut Microbiota in Hepatocarcino-genesis. Microorganisms 2019; 7 (5): 121. DOI: 10.3390/microorganisms 7050121
23. Маевская М.В., Ивашкин В.Т. Печень и питание. Оптимальная диета при неалкогольной жировой болезни печени. Российский журнал гастроэн-терологии, гепатологии, колопроктологии 2018; 28 (5): 105–16.
[Maevskaya M.V., Ivashkin V.T. Pechen' i pitanie. Optimal'naya dieta pri nealko-gol'noi zhirovoi bolezni pecheni. Rossiiskii zhurnal gastroenterologii, gepa-tologii, koloproktologii 2018; 28 (5): 105–16. (in Russian)].
24. Perumpail B, Li A, John N et al. The Role of Vitamin E in the Treatment of NAFLD. Diseases 2018; 6 (4): 86. DOI: 10.3390/diseases6040086
25. Hadi H, Vettor R, Rossato M. Vitamin E as a Treatment for Nonalcoholic Fatty Liver Disease: Reality or Myth? Antioxidants. 2018; 7 (1): 12. DOI: 10.3390/an-tiox7010012
26. Nobili V, Alisi A, Valenti L et al. NAFLD in children: new genes, new diagnostic modalities and new drugs. Nat Rev Gastroenterol Hepatol 2019; 16 (9): 517–
30. DOI: 10.1038/s41575-019-0169-z
27. Sharifi N, Amani R, Hajiani E, Cheraghian B. Does Vitamin D improve liver en-zymes, oxidative stress, and inflammatory biomarkers in adults with non-alco-holic fatty liver disease? A randomized clinical trial. Endocrine 2014; 47: 70–80.
28. Raza S, Tewari A, Rajak S, Sinha RA. Vitamins and non-alcoholic fatty liver dis-ease: A molecular insight. Liver Res 2021; 5 (2): 62–71. DOI: 10.1016/j.livres.2021.03.004
29. Chan R, Wong VW, Chu WC et al. Dietquality scores and prevalence of nonalco-holic fatty liver disease: a population study using proton-magnetic resonance spectroscopy. PLoS One 2015; 10: e0139310.
30. Harrison SA, Torgerson S, Hayashi P et al. Vitamin E and vitamin C treatment improves fibrosis in patients with nonalcoholic steatohepatitis. Am J Gastroen-terol 2003; 98: 2485–90.