Copyright
©The Author(s) 2017.
World J Gastroenterol. May 7, 2017; 23(17): 3150-3162
Published online May 7, 2017. doi: 10.3748/wjg.v23.i17.3150
Published online May 7, 2017. doi: 10.3748/wjg.v23.i17.3150
Table 1 Main characteristics of 46 patients recruited for the study
Parameter | Value (mean ± SD or frequency) |
Population n (%) | |
Total | 46 |
M | 29 (63%) |
F | 17 (37%) |
Age (yr) | |
Range | 26-71 |
mean ± SD | 47.5 ± 12 |
BMI (kg/m2) | |
Range | 18.9-45.3 |
mean ± SD | 29.3 ± 6.1 |
BMI (kg/m2) | |
Obesity grade | |
18.5-24.9 (normal weight) | 23.90% |
25-29.9 (overweight) | 43.50% |
30-34.9 (class I obesity) | 17.40% |
35-39.9 (class II obesity) | 8.70% |
≥ 40 (class III obesity) | 6.50% |
Waist circumference (cm) | |
M | 100.88 ± 12.97 |
F | 101.88 ± 15.07 |
Obesity central (Waist circumference) | |
M (> 102 cm) | 48.30% |
F (> 88 cm) | 82.40% |
Waist-to-hip ratio | |
Android obesity | |
M (≥ 1) | 41.40% |
F (≥ 0.85) | 70.60% |
Gynoid obesity | |
M (≤ 0.94) | 20.70% |
F (≤ 0.78) | 0.00% |
Components of MS2 | |
0 | 4 (8.7%) |
1 | 20 (43.5%) |
2 | 10 (21.7%) |
3 | 5 (10.9%) |
4 | 5 (10.9%) |
5 | 2 (4.3%) |
Liver steatosis grade | |
1 | 3 (6.5%) |
2 | 19 (41.3%) |
3 | 24 (52.2%) |
MedDiet Score | |
Range | 21-41 |
mean ± SD | 28.4 ± 3.9 |
Physical activity | |
No | 24 (52.2%) |
Yes | 22 (47.8%) |
Times1/wk | |
1 | 6 (13%) |
2 | 7 (15.2%) |
3 | 7 (15.2%) |
> 3 | 2 (4.3%) |
Smoking | |
No | 35 (76.1%) |
Ex | 3 (6.5%) |
Yes | 8 (17.4%) |
Table 2 Frequency of metabolic syndrome’ components in patients with metabolic syndrome
Component | Hypertension | Blood pressure | TG | HDL | Serum glucose |
n | 12 | 6 | 12 | 7 | 8 |
Table 3 Anthropometric, clinical and metabolic parameters at baseline, mid-intervention (3M) and end-intervention (6M) and results of the statistical analysis
Parameter | mean ± SD, BL | mean ± SD, 3M | mean ± SD, 6M | P value | ||
BL vs 3M | 3M vs 6M | BL vs 6M | ||||
BMI (kg/m2) | 29.3 ± 6.11 | 28.0 ± 6.21 | 27.5 ± 6.21 | < 0.01a | < 0.01a | < 0.01a |
Waist circumference (cm) | 101.25 ± 13.63 | 97.50 ± 14.07 | 96.24 ± 13.64 | < 0.01a | < 0.01a | < 0.01a |
Hip-to-waist ratio | 0.95 ± 0.08 | 0.94 ± 0.07 | 0.93 ± 0.08 | < 0.01a | < 0.01a | < 0.01a |
AST (U/L) | 36.16 ± 21.11 | 28.73 ± 11.28 | 24.84 ± 10.70 | < 0.01a | < 0.01a | < 0.01a |
ALT (U/L) | 65.66 ± 31.92 | 48.37 ± 33.44 | 37.33 ± 19.53 | < 0.01a | < 0.01a | < 0.01a |
GGT (U/L) | 60.19 ± 61.43 | 41.35 ± 36.49 | 39.73 ± 35.36 | < 0.01a | 0.545 | < 0.01a |
FA (U/L) | 81.48 ± 37.19 | 79.54 ± 32.04 | 80.04 ± 35.02 | 0.489 | 0.787 | 0.574 |
Total cholesterol (mg/dL) | 215.24 ± 40.78 | 205.04 ± 41.75 | 207.18 ± 38.48 | 0.044a | 0.598 | 0.097 |
LDL cholesterol (mg/dL) | 137.70 ± 32.87 | 131.25 ± 35.88 | 130.16 ± 32.65 | 0.071 | 0.941 | 0.050a |
HDL cholesterol (mg/dL) | 49.72 ± 10.59 | 50.17 ± 11.64 | 53.09 ± 11.86 | 0.550 | < 0.01a | < 0.01a |
TG (mg/dL) | 133.39 ± 67.77 | 123.65 ± 71.31 | 118.24 ± 65.14 | 0.112 | 0.358 | 0.017a |
Serum glucose (mg/dL) | 98.33 ± 15.87 | 94.52 ± 13.07 | 95.76 ± 13.46 | < 0.01a | 0.133 | < 0.01a |
Chol Tot/HDL | 4.50 ± 1.27 | 4.23 ± 1.07 | 3.95 ± 1.15 | 0.013a | 0.010a | < 0.01a |
LDL/HDL | 2.89 ± 0.95 | 2.67 ± 0.93 | 2.56 ± 0.84 | 0.028a | 0.015a | < 0.01a |
TG/HDL | 2.87 ± 1.76 | 2.66 ± 1.89 | 2.39 ± 1.66 | 0.152 | 0.037a | < 0.01a |
AIP | 0.03 ± 0.25 | -0.01 ± 0.23 | -0.06 ± 0.25 | 0.097 | 0.089 | < 0.01a |
HOMA- IR (mU/L) | 3.25 ± 1.96 | 2.96 ± 1.73 | 2.94 ± 1.67 | < 0.01a | 0.841 | < 0.01a |
QUICKI | 0.33 ± 0.04 | 0.34 ± 0.04 | 0.34 ± 0.03 | < 0.01a | 0.330 | < 0.017a |
PLR | 115.37 ± 46.60 | 109.89 ± 51.77 | 113.65 ± 43.77 | 0.195 | 0.281 | 0.816 |
NLR | 1.98 ± 1.12 | 1.88 ± 1.10 | 1.79 ± 0.89 | 0.287 | 0.509 | 0.185 |
FLI | 61.55 ± 26.76 | 50.54 ± 29.37 | 48.83 ± 31.01 | < 0.01a | 0.286 | < 0.01a |
Kotronen index (%) | 6.05 ± 5.02 | 4.10 ± 2.22 | 3.92 ± 2.40 | < 0.01a | 0.277 | < 0.01a |
VAI | 1.85 ± 1.17 | 1.55 ± 0.71 | 1.32 ± 0.65 | 0.011 | 0.010 | < 0.01a |
NAFLD Liver Fat Score | 0.12 ± 1.63 | -0.02 ± 1.42 | -0.70 ± 1.20 | 0.418 | < 0.01a | < 0.01a |
LAP (male) | 48.41 ± 28.14 | 37.01 ± 19.95 | 33.18 ± 17.49 | < 0.01a | 0.166 | < 0.01a |
LAP (female) | 84.15 ± 63.06 | 78.92 ± 70.51 | 74.13 ± 58.89 | 0.290 | 0.452 | < 0.01a |
BARD | 1.09 ± 1.26 | 1.46 ± 1.17 | 1.37 ± 1.04 | 0.011a | 0.486 | 0.091 |
NAFLD | -2.29 ± 0.93 | -2.13 ± 1.01 | -2.28 ± 1.00 | 0.015a | 0.032a | 0.986 |
Table 4 Correlation between steatosis grade and anthropometric, clinical and metabolic parameters considered in this study at baseline and at end-treatment
Parameter | Grade 0 (n = 9) | Grade I (n = 15) | Grade 2 (n = 18) | Grade 3 (n = 4) | P value | |
mean ± STD | mean ± STD | mean ± STD | mean ± STD | |||
BMI (kg/m2) | BL | - | 30.19 ± 2.15 | 28.05 ± 6.47 | 30.11 ± 6.14 | 0.499 |
6M | 23.39 ± 3.52 | 25.94 ± 5.60 | 31.36 ± 6.53 | 25.77 ± 1.14 | 0.013a | |
Waist circumference (cm) | BL | - | 103.00 ± 1.73 | 96.05 ± 12.94 | 105.15 ± 13.91 | 0.122 |
6M | 86.44 ± 11.98 | 90.73 ± 9.24 | 106.03 ± 12.64 | 94.88 ± 9.37 | < 0.01a | |
Hip-to-waist ratio (-) | BL | - | 0.94 ± 0.05 | 0.91 ± 0.08 | 0.98 ± 0.07 | 0.020a |
6M | 0.88 ± 0.06 | 0.91 ± 0.06 | 0.97 ± 0.08 | 0.93 ± 0.09 | < 0.01a | |
Tot Chol (mg/dL) | BL | - | 260.67 ± 27.21 | 210.95 ± 31.20 | 212.96 ± 46.24 | 0.266 |
6M | 215.89 ± 39.78 | 196.27 ± 62.92 | 212.06 ± 34.35 | 154.75 ± 44.90 | 0.078 | |
HDL (mg/dL) | BL | - | 47.00 ± 3.46 | 52.05 ± 13.39 | 48.21 ± 8.39 | 0.532 |
6M | 142.16 ± 33.53 | 130.60 ± 22.94 | 131.33 ± 35.27 | 96.25 ± 38.88 | 0.070 | |
LDL (mg/dL) | BL | - | 186.67 ± 37.63 | 133.52 ± 19.00 | 134.88 ± 37.05 | 0.119 |
6M | 54.33 ± 12.97 | 53.73 ± 14.08 | 53.56 ± 10.74 | 45.75 ± 1.89 | 0.399 | |
TG (mg/dL) | BL | - | 134.00 ± 43.28 | 125.21 ± 42.18 | 139.79 ± 85.63 | 0.597 |
6M | 100.22 ± 31.69 | 119.20 ± 40.40 | 138.22 ± 88.51 | 65.25 ± 42.94 | 0.807 | |
AST | BL | - | 0.72 ± 0.28 | 0.87 ± 0.33 | 0.95 ± 0.67 | 0.435 |
6M | 0.55 ± 0.15 | 0.63 ± 0.19 | 0.67 ± 0.37 | 0.53 ± 0.17 | 0.641 | |
ALT | BL | - | 0.91 ± 0.20 | 1.32 ± 0.68 | 1.35 ± 0.64 | 0.419 |
6M | 0.56 ± 0.14 | 0.79 ± 0.37 | 0.82 ± 0.50 | 0.67 ± 0.23 | 0.334 | |
AST/ALT | BL | - | 0.76 ± 0.15 | 0.71 ± 0.19 | 0.66 ± 0.20 | 0.276 |
6M | 0.95 ± 0.15 | 0.76 ± 0.22 | 0.73 ± 0.26 | 0.78 ± 0.11 | 0.058 | |
GGT | BL | - | 58.67 ± 64.53 | 51.89 ± 54.69 | 42.21 ± 25.60 | 0.392 |
6M | 17.00 ± 4.12 | 43.53 ± 25.67 | 44.39 ± 0.10 | 27.25 ± 0.50 | 0.147 | |
Blood gluc. (mg/dL) | BL | - | 96.67 ± 9.29 | 94.16 ± 15.71 | 101.83 ± 16.26 | 0.181 |
6M | 88.00 ± 1.94 | 91.27 ± 7.33 | 104.33 ± 17.03 | 91.50 ± 8.19 | 0.018a | |
SM (n) | BL | - | 2.67 ± 1.15 | 1.32 ± 1.00 | 2.17 ± 1.43 | 0.350 |
6M | 1.44 ± 1.13 | 1.73 ± 1.28 | 2.28 ± 1.49 | 1.25 ± 0.50 | 0.415 | |
Tot-Chol/HDL | BL | - | 5.60 ± 1.03 | 4.29 ± 1.27 | 4.53 ± 1.26 | 0.637 |
6M | 4.07 ± 0.84 | 3.84 ± 1.55 | 4.09 ± 0.94 | 3.41 ± 1.09 | 0.479 | |
LDL/HDL | BL | - | 4.03 ± 1.14 | 2.72 ± 0.82 | 2.88 ± 0.96 | 0.355 |
6M | 2.70 ± 0.82 | 2.60 ± 0.90 | 2.54 ± 0.82 | 2.12 ± 0.91 | 0.333 | |
TG/HDL | BL | - | 2.83 ± 0.78 | 2.63 ± 1.36 | 3.07 ± 2.11 | 0.516 |
6M | 1.92 ± 0.73 | 2.44 ± 1.25 | 2.79 ± 2.24 | 1.46 ± 1.02 | 0.698 | |
AIP | BL | - | 0.44 ± 0.11 | 0.37 ± 0.21 | 0.39 ± 0.29 | 0.983 |
6M | 0.25 ± 0.19 | 0.34 ± 0.21 | 0.35 ± 0.27 | 0.08 ± 0.31 | 0.780 | |
HOMA-IR (mU/L) | BL | - | 2.77 ± 0.22 | 2.37 ± 1.37 | 4.01 ± 2.18 | 0.015a |
6M | 1.50 ± 0.84 | 2.47 ± 1.06 | 4.12 ± 1.71 | 2.67 ± 1.51 | < 0.01a | |
QUICKI | BL | - | 0.33 ± 0.00 | 0.35 ± 0.04 | 0.32 ± 0.03 | 0.082 |
6M | 0.37 ± 0.05 | 0.34 ± 0.02 | 0.32 ± 0.02 | 0.34 ± 0.03 | < 0.01a | |
PLR | BL | - | 120.89 ± 28.83 | 107.31 ± 32.51 | 121.06 ± 57.08 | 0.467 |
6M | 93.44 ± 22.18 | 106.95 ± 48.08 | 127.33 ± 47.95 | 122.70 ± 30.46 | 0.058 | |
NLR | BL | - | 1.36 ± 0.37 | 1.79 ± 0.80 | 2.21 ± 1.34 | 0.112 |
6M | 1.32 ± 0.21 | 1.67 ± 1.08 | 2.21 ± 0.85 | 1.44 ± 0.50 | 0.097 | |
FLI | BL | - | 98.97 ± 0.30 | 98.84 ± 0.39 | 98.70 ± 0.75 | 0.612 |
6M | 98.48 ± 0.72 | 98.79 ± 0.40 | 98.75 ± 0.67 | 97.08 ± 1.82 | 0.143 | |
Kotronen index (%) | BL | - | 4.63 ± 2.14 | 4.3 ± 2.0 | 7.6 ± 6.4 | 0.047a |
6M | 2.15 ± 0.83 | 3.5 ± 1.0 | 5.3 ± 3.2 | 3.1 ± 0.6 | 0.017a | |
VAI | BL | - | 3.5 ± 1.8 | 1.9 ± 1.0 | 1.6 ± 1.1 | 0.041a |
6M | 1.44 ± 0.64 | 1.38 ± 0.65 | 1.29 ± 0.67 | 0.9 ± 0.67 | 0.224 | |
NAFLD fat liver score | BL | - | -0.42 ± 0.9 | -0.6 ± 1.1 | 0.7 ± 1.8 | 0.016a |
6M | 1.88 ± 0.71 | -0.84 ± 0.78 | 0.07 ± 1.27 | -0.99 ± 0.63 | < 0.01a | |
LAP (male) | BL | - | 52.00 ± 0.00 | 44.27 ± 19.98 | 50.51 ± 32.82 | 0.694 |
6M | 25.67 ± 11.38 | 31.11 ± 14.62 | 42.38 ± 19.13 | 26.11 ± 22.32 | 0.386 | |
LAP (female) | BL | - | 72.10 ± 32.56 | 56.13 ± 31.50 | 130.21 ± 83.11 | 0.377 |
6M | 24.42 ± 16.25 | 52.21 ± 23.70 | 109.22 ± 67.63 | - | 0.147 | |
BARD | BL | - | 2.33 ± 1.15 | 0.79 ± 1.08 | 1.17 ± 1.34 | 0.733 |
6M | 1.89 ± 0.33 | 1.07 ± 1.03 | 1.56 ± 1.15 | 0.50 ± 1.00 | 0.192 | |
NAFLD | BL | - | -3.41 ± 0.48 | -2.25 ± 0.73 | -2.17 ± 1,02 | 0.112 |
6M | -2.44 ± 0.93 | -2.68 ± 0.87 | -1.88 ± 1.07 | -2.27 ± 0.91 | 0.144 | |
MedDiet Score | BL | - | 30.0 ± 3.0 | 29.6 ± 4.6 | 27.2 ± 3.1 | 0.044a |
6M | NA | NA | NA | NA | NA |
Table 5 Correlation between BMI and anthropometric, clinical and metabolic parameters considered in this study at baseline and at end-treatment
Parameter | P value | Parameter | P value | ||
Steatosis grade | BL | 0.499 | TG/HDL | BL | 0.370 |
6M | 0.013a | 6M | 0.416 | ||
Waist circumf. (cm) | BL | < 0.01a | AIP | BL | 0.194 |
6M | < 0.01a | 6M | 0.307 | ||
Hip-to-waist ratio (-) | BL | 0.231 | HOMA-IR (mU/L) | BL | < 0.01a |
6M | 0.020a | 6M | < 0.01a | ||
Tot Chol (mg/dL) | BL | 0.257 | QUICKI | BL | < 0.01a |
6M | < 0.01a | 6M | < 0.01a | ||
HDL (mg/dL) | BL | 0.255 | PLR | BL | 0.213 |
6M | < 0.01a | 6M | 0.645 | ||
LDL (mg/dL) | BL | 0.211 | NLR | BL | 0.066 |
6M | 0.768 | 6M | 0.167 | ||
TG (mg/dL) | BL | 0.352 | FLI | BL | < 0.01a |
6M | 0.229 | 6M | 0.137 | ||
AST | BL | 0.244 | Kotronen index (%) | BL | 0.038a |
6M | 0.093 | 6M | < 0.01a | ||
ALT | BL | 0.504 | VAI | BL | 0.479 |
6M | 0.154 | 6M | 0.373 | ||
AST/ALT | BL | 0.195 | NAFLD fat liver score | BL | < 0.01a |
6M | 0.114 | 6M | < 0.01a | ||
GGT | BL | 0.075 | LAP (male) | BL | < 0.01a |
6M | 0.176 | 6M | < 0.01a | ||
MS (n) | BL | 0.025a | LAP (female) | BL | 0.075 |
6M | 0.025a | 6M | 0.176 | ||
Blood gluc. (mg/dL) | BL | 0.182 | BARD | BL | < 0.01a |
6M | 0.142 | 6M | 0.079 | ||
Tot-Chol/HDL | BL | 0.218 | NAFLD | BL | 0.058 |
6M | 0.090 | 6M | 0.167 | ||
LDL/HDL | BL | 0.185 | MedDiet Score | BL | 0.049a |
6M | 0.087 | 6M | NA |
- Citation: Gelli C, Tarocchi M, Abenavoli L, Di Renzo L, Galli A, De Lorenzo A. Effect of a counseling-supported treatment with the Mediterranean diet and physical activity on the severity of the non-alcoholic fatty liver disease. World J Gastroenterol 2017; 23(17): 3150-3162
- URL: https://www.wjgnet.com/1007-9327/full/v23/i17/3150.htm
- DOI: https://dx.doi.org/10.3748/wjg.v23.i17.3150