RESUMEN
SCOPE: Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease with poor therapeutic strategies. Mastiha possesses antioxidant/anti-inflammatory and lipid-lowering properties. The authors investigate the effectiveness of Mastiha as a nonpharmacological intervention in NAFLD. METHODS AND RESULTS: Ninety-eight patients with NAFLD in three countries (Greece, Italy, Serbia) are randomly allocated to either Mastiha or Placebo for 6 months, as part of a multicenter, randomized, double-blind, placebo-controlled, parallel-group clinical trial. The authors assess NAFLD severity via magnetic resonance imaging (MRI) scanning and LiverMultiScan technique and evaluate the effectiveness of Mastiha through medical, anthropometric, biochemical, metabolomic, and microbiota assessment. Mastiha is not superior to Placebo on changes in iron-corrected T1 (cT1) and Liver Inflammation Fibrosis score (LIF) in entire patient population; however, after BMI stratification (BMI ≤ 35 kg m-2 and BMI > 35 kg m-2 ), severely obese patients show an improvement in cT1 and LIF in Mastiha versus Placebo. Mastiha increases dissimilarity of gut microbiota, as shown by the Bray-Curtis index, downregulates Flavonifractor, a known inflammatory taxon and decreases Lysophosphatidylcholines-(LysoPC) 18:1, Lysophosphatidylethanolamines-(LysoPE) 18:1, and cholic acid compared to Placebo. CONCLUSION: Mastiha supplementation improves microbiota dysbiosis and lipid metabolite levels in patients with NAFLD, although it reduces parameters of liver inflammation/fibrosis only in severely obese patients.
Asunto(s)
Resina Mástique/administración & dosificación , Enfermedad del Hígado Graso no Alcohólico/tratamiento farmacológico , Adulto , Anciano , Índice de Masa Corporal , Suplementos Dietéticos , Método Doble Ciego , Disbiosis/tratamiento farmacológico , Femenino , Microbioma Gastrointestinal/efectos de los fármacos , Grecia , Humanos , Italia , Hígado/patología , Masculino , Persona de Mediana Edad , Enfermedad del Hígado Graso no Alcohólico/microbiología , Enfermedad del Hígado Graso no Alcohólico/fisiopatología , Obesidad/complicaciones , Placebos , SerbiaRESUMEN
The aim of this study was to compare brain volume reduction in patients with Alzheimer's disease (AD) and amnestic mild cognitive impairment (aMCI) with age-related changes in age- and gender-matched healthy individuals. Sixty-six patients were divided in three groups based on medical history, neurological and neurocognitive assessment: 26 patients with AD, 20 patients with aMCI and 20 healthy controls. All participants underwent high-resolution magnetic resonance (MR) imaging on 3â¯T unit. MR volumetry of cerebral cortex, white matter and lateral ventricles volumes, as well as volumes of subcortical nuclei (hippocampus, amygdala, thalamus) was performed. Global cerebral and grey matter volumes were lower in AD patients compared to aMCI (pâ¯=â¯0.023 and pâ¯=â¯0.001, respectively) and controls (pâ¯<â¯0.001 and pâ¯<â¯0.001, respectively). Volume of lateral ventricles was significantly higher in AD patients compared to controls (right pâ¯=â¯0.007, left pâ¯=â¯0.007). Volumes of thalamus were lower in AD patients (right pâ¯<â¯0.001, left pâ¯<â¯0.001), and in aMCI patients (right pâ¯=â¯0.004, left pâ¯=â¯0.015), compared to controls. Hippocampal volume was lower in AD patients compared to both aMCI patients (right pâ¯=â¯0.047, left pâ¯=â¯0.003) and controls (right pâ¯<â¯0.001, left pâ¯<â¯0.001). In aMCI patients, hippocampal volume was lower than in controls (right pâ¯=â¯0.004, left pâ¯=â¯0.007). Volumes of amygdala were lower in AD patients compared to controls (righ pâ¯=â¯0.003, left pâ¯=â¯0.001). Our results show that thalamic volume loss could be an early sign associated with poorercognitiveperformance in aMCI, preceeding the atrophy of amygdala, global grey and white matter volume loss, and cerebrospinal fluid spaces dilatation.