ABSTRACT
Objective: To evaluate the effect of Non-alcoholic fatty liver disease (NAFLD) status in the impact of lifestyle over Health-related quality of life (HRQoL) in patients with metabolic syndrome (MetS). Methods: Baseline and 1 year follow up data from the PREDIMED-plus cohort (men and women, 55-75 years old with overweight/obesity and MetS) were studied. Adherence to an energy-restricted Mediterranean Diet (er-MeDiet) and Physical Activity (PA) were assessed with a validated screeners. Hepatic steatosis index (HSI) was implemented to evaluate NAFLD while the SF-36 questionnaire provided HRQoL evaluation. Statistical analyses were performed to evaluate the influence of baseline NAFLD on HRQoL as affected by lifestyle during 1 year of follow up. Results: Data from 5205 patients with mean age of 65 years and a 48% of female participants. Adjusted linear multivariate mixed regression models showed that patients with lower probability of NAFLD (HSI < 36 points) were more responsive to er-MeDiet (ß 0.64 vs ß 0.05 per er-MeDiet adherence point, p< 0.01) and PA (ß 0.05 vs ß 0.01 per MET-h/week, p = 0.001) than those with high probability for NAFLD in terms Physical SF-36 summary in the 1 year follow up. 10 points of er-MeDiet adherence and 50 MET-h/week were thresholds for a beneficial effect of lifestyle on HRQoL physical domain in patients with lower probability of NAFLD. Conclusion: The evaluation of NAFLD by the HSI index in patients with MetS might identify subjects with different prospective sensitivity to lifestyle changes in terms of physical HRQoL (http://www.isrctn.com/ISRCTN89898870).
Subject(s)
Metabolic Syndrome , Non-alcoholic Fatty Liver Disease , Aged , Female , Humans , Life Style , Male , Middle Aged , Prospective Studies , Quality of LifeABSTRACT
INTRODUCCIÓN: el hígado graso no alcohólico (HGNA) es una enfermedad hepática crónica más prevalente en los países occidentales. OBJETIVOS: evaluar factores de riesgo asociados a HGNA en hombres y mujeres diagnosticados con SM estratificados según terciles del índice de esteatosis hepática (HSI). MÉTODOS: análisis transversal del estudio PREDIMED Plus (incluyendo únicamente información del nodo Navarra-Nutrición). Un total de 278 participantes (141 hombres y 137 mujeres) con SM fueron estratificados según terciles de HSI. El estudio analizó variables clínicas, bioquímicas e información sobre el estilo de vida, como grado de adherencia a la dieta mediterránea y práctica de actividad física. RESULTADOS: el análisis multivariante reveló que las mujeres tienen 4,54 unidades más de HSI (95% IC: 3,41 a 5,68) respecto a los hombres. Ambos sexos mostraron un incremento en los niveles de triglicéridos, TG/colesterol HDL e índice triglicéridos-glucosa (TyG) entre los terciles de HSI. Asimismo, se observó una asociación negativa entre la actividad física y el HSI (hombres: r = -0,19, p = 0,025; mujeres: r = -0,18, p = 0,031). La grasa visceral mostró una asociación positiva con el HSI en ambos sexos (hombres: r = 0,64, p < 0,001; mujeres: r = 0,46, p < 0,001). La adherencia a la dieta mediterránea es menor en los pacientes con HSI más elevado (hombres r = -0,18, p = 0,032; mujeres r = -0,19, p = 0,027). CONCLUSIONES: las mujeres presentan mayor riesgo de daño hepático y se sugieren importantes diferencias de sexo en relación a la EHGNA. La adherencia a la dieta mediterránea y la actividad física se reafirman como factores clave frente a la regulación de enfermedades cardiovasculares entre las que se encuentra la EHGNA. El riesgo de esteatosis hepática en población adulta obesa y con SM disminuye
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Subject(s)
Humans , Male , Female , Middle Aged , Aged , Metabolic Syndrome/complications , Non-alcoholic Fatty Liver Disease/etiology , Multivariate Analysis , Cross-Sectional Studies , Diet, Mediterranean , Risk Factors , Life Style , Motor Activity , Sex FactorsABSTRACT
BACKGROUND AND AIMS: non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in western countries. This study aimed to investigate putative risk factors differentially related with NAFLD in obese males and females diagnosed with metabolic syndrome (MetS), stratified using the non-invasive hepatic steatosis index (HSI). METHODS AND RESULTS: a cross-sectional analysis of the PREDIMED Plus study was performed of 278 participants with MetS (141 males and 137 females) of the Navarra-Nutrition node. Subjects were categorized by HSI tertiles and gender. Baseline clinical, biochemical variants and adherence to a Mediterranean diet and physical activity were evaluated. RESULTS: multivariate analyses showed that females had 4.54 more units of HSI (95% CI: 3.41 to 5.68) than males. Both sexes showed increased levels of triglycerides, TG/HDL cholesterol ratio and triglyceride glucose index across the HSI tertiles. Physical activity exhibited a negative statistical association with HSI (males: r = -0.19, p = 0.025; females: r = -0.18, p = 0.031). The amount of visceral fat showed a positive association with HSI in both sexes (males: r = 0.64, p < 0.001; females: r = 0.46, p < 0.001). Adherence to the Mediterranean diet was lower in those subjects with higher HSI values (males: r = -0.18, p = 0.032; females r= -0.19, p = 0.027). CONCLUSION: females had a poor liver status, suggesting gender differences related to NAFLD. Adherence to a Mediterranean diet and physical activity were associated with beneficial effects on cardiovascular disease features. Thus, reducing the risk of hepatic steatosis in subjects with MetS and obesity.
