María Fernanda Castillo, Daniela Salgado-Canales, Marco Arrese, Francisco Barrera, Dimitri P Mikhailidis
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引用次数: 0
Abstract
Background: The first-line treatment for non-alcoholic fatty liver disease (NAFLD) is lifestyle modification; this should accompany any pharmacological intervention. Intermittent fasting (IF) has shown benefits over metabolic and cardiovascular parameters. Non-religious IF includes Time-Restricted Feeding (TRF), Alternate-Day Fasting (ADF), and 5:2 IF interventions. Objective: To evaluate the effects of IF on anthropometric, liver damage, and lipid profile markers in subjects with NAFLD. Methods: A bibliographic search was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using PubMed and Scopus databases. Results: Five studies involving 470 patients with NAFLD were included. In relation to anthropometric markers, all the articles reported body weight reduction (2.48-7.63%), but only ADF and 5:2 IF reported a body weight reduction >5%; also, all the articles reported fat mass reduction. Concerning hepatic markers, all the articles reported a reduction in hepatic steatosis and alanine aminotransferase activity, but no changes in fat-free mass and high-density lipoprotein cholesterol levels. There were variable results on fibrosis, other liver enzymes, waist circumference and body mass index, as well as the levels of triglycerides, total cholesterol, and low-density lipoprotein cholesterol. Conclusion: Any form of IF could be potentially beneficial for NAFLD treatment and some associated cardiometabolic parameters. However, it is necessary to evaluate the effects and safety of IF in long-term studies involving a higher number of participants with different stages of NAFLD. The effect of IF on NAFLD-associated vascular risk also needs evaluation.
背景:非酒精性脂肪肝(NAFLD)的一线治疗方法是改变生活方式;这应与任何药物干预同时进行。间歇性禁食(IF)已显示出对代谢和心血管参数的益处。非宗教性 IF 包括限时进食 (TRF)、隔日禁食 (ADF) 和 5:2 IF 干预。目的评估 IF 对非酒精性脂肪肝受试者的人体测量、肝损伤和血脂指标的影响。方法根据系统综述和荟萃分析首选报告项目(PRISMA)指南,使用 PubMed 和 Scopus 数据库进行文献检索。结果:共纳入五项研究,涉及 470 名非酒精性脂肪肝患者。在人体测量指标方面,所有文章均报告体重减轻(2.48%-7.63%),但只有ADF和5:2 IF报告体重减轻>5%;此外,所有文章均报告脂肪量减少。在肝脏指标方面,所有文章都报告肝脏脂肪变性和丙氨酸氨基转移酶活性降低,但无脂质量和高密度脂蛋白胆固醇水平没有变化。关于肝纤维化、其他肝酶、腰围和体重指数以及甘油三酯、总胆固醇和低密度脂蛋白胆固醇水平的研究结果各不相同。结论任何形式的 IF 都可能有益于非酒精性脂肪肝的治疗和一些相关的心脏代谢指标。然而,有必要在涉及更多不同阶段非酒精性脂肪肝参与者的长期研究中评估 IF 的效果和安全性。IF对非酒精性脂肪肝相关血管风险的影响也需要评估。
期刊介绍:
Current Vascular Pharmacology publishes clinical and research-based reviews/mini-reviews, original research articles, letters, debates, drug clinical trial studies and guest edited issues to update all those concerned with the treatment of vascular disease, bridging the gap between clinical practice and ongoing research.
Vascular disease is the commonest cause of death in Westernized countries and its incidence is on the increase in developing countries. It follows that considerable research is directed at establishing effective treatment for acute vascular events. Long-term treatment has also received considerable attention (e.g. for symptomatic relief). Furthermore, effective prevention, whether primary or secondary, is backed by the findings of several landmark trials. Vascular disease is a complex field with primary care physicians and nurse practitioners as well as several specialties involved. The latter include cardiology, vascular and cardio thoracic surgery, general medicine, radiology, clinical pharmacology and neurology (stroke units).