Lee, Won Myung; Bae, Jea Hurn; Chang, Young; Lee, Sae Hwan; Moon, Ji Eun; Jeong, Soung Won; Jang, Jae Young; Kim, Sang Gyune; Kim, Hong Soo; Yoo, Jeong-Ju; Kim, Young Seok
Nutrients
2021Dec ; 13 ( 12 ) :.
PMID : 34960005
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Lee, Won Myung - Department of Internal Medicine, Digestive Disease Center and Research Institute, SoonChunHyang University School of Medicine, Bucheon 14584, Korea.
Bae, Jea Hurn - Department of Food Science and Nutrition, SoonChunHyang University Bucheon Hospital,
Chang, Young - Department of Internal Medicine, Division of Gastroenterology and Hepatology,
Lee, Sae Hwan - Department of Internal Medicine, Division of Gastroenterology and Hepatology,
Moon, Ji Eun - Clinical Trial Center, Department of Biostatistics, SoonChunHyang University Bucheon
Jeong, Soung Won - Department of Internal Medicine, Division of Gastroenterology and Hepatology,
Jang, Jae Young - Department of Internal Medicine, Division of Gastroenterology and Hepatology,
Kim, Sang Gyune - Department of Internal Medicine, Digestive Disease Center and Research Institute,
Kim, Hong Soo - Department of Internal Medicine, Division of Gastroenterology and Hepatology,
Yoo, Jeong-Ju - Department of Internal Medicine, Digestive Disease Center and Research Institute,
Kim, Young Seok - Department of Internal Medicine, Digestive Disease Center and Research Institute,
ABSTRACT
BACKGROUND: Patients with non-alcoholic fatty liver disease (NAFLD) have a high prevalence of combined hyperlipidemia. The importance of nutritional education is well-known in NAFLD, but the impact of medical nutrition therapy (MNT) is unclear in patients with NAFLD with hyperlipidemia. The purpose of this study is to investigate the effect of MNT on the improvement of steatohepatitis in patients with NAFLD taking antihyperlipidemic medications.
METHODS: Nondiabetic patients with dyslipidemia were prospectively randomized (1:1) either to the MNT group or the control group with standard advice for 48 weeks with simultaneous statin/ezetimibe combination pharmacotherapy at three tertiary centers in Korea.
RESULTS: Sixty-six patients were enrolled. Among them, 18 patients dropped out and, overall, 48 patients (MNT group 27, control group 21) were prospectively analyzed in the study. The serum ALT level at 48 weeks between the two groups was not significantly different (66.6 ± 37.7 IU/L vs. 57.4 ± 36.7 IU/L, p = 0.40). Serum liver enzymes, controlled attenuation parameter and fibrosis-4 index were significantly improved within the MNT group after 48 weeks compared to baseline. There was no significant difference between the two groups other than the NAFLD fibrosis score (p = 0.017).
CONCLUSIONS: Although there were no significant differences between the two groups in terms of steatosis, metabolic and fibrosis surrogate indicators after 48 weeks, MNT groups showed significant improvement within patient analysis over time. Future studies with a larger number of subjects and a longer study period regarding the effect of MNT are warranted.
keyword
health education; hyperlipidemia; non-alcoholic fatty liver disease; nutrition; nutrition education
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