[Comparative analysis of dietary patterns in patients with non-alcoholic fatty liver disease with and without type 2 diabetes mellitus].

Non-alcoholic fatty liver disease (NAFLD) is considered to be metabolically determined and alimentary condition, one of the components of metabolic syndrome. Therefore, dietary patterns of patients with different clinical types of the disease are worth to be studied . The aim of the research was to study the dietary patterns in patients with NAFLD and with type 2 diabetes mellitus (T2DM) (group T2DM+) compared to the control group without T2DM (T2DM-). Material and methods. A retrospective analysis of the database (n=316) of patients with NA FLD, formed in the period from 202 1 to 2023, was carried out. A total of 79 sex- and agem atched pairs of T2D+ and T2D- pat ients were selected for the case-control study. Hepatic steatosis and fibrosis stage assessment was performed using vibration-controlled transient elastography (VCTE) with controlled attenuation parameter (CAP). Actual nutrition was evaluated using a semi-quantitative method of assessing consumption frequency during a personal interview. Consumption of 100 grouped food items was assessed. Blood parameters characterizing lipid and carbohydrate metabolism were assessed. Results. Among patients with T2DM+, patients with NASH (24.1 vs 8.9%, p=0.005) and patients with severe liver fibrosis F3-F4 (32.9 vs 10.1%, p<0.0001) were significantly more common. There were no differences between the T2DM+ and T2DM- groups in energy consumption (1969 [1492; 3098] vs 1870 [1380; 2593] kcal/day; p=0.4), proteins (90.5 [71.5; 130.3] vs 81.0 [59.4; 116.0] g/day; p=0.1), fats (83.0 [66.7; 144.9] vs 78.8 [59.2; 116.4] g/day; p=0.3), carbohydrates (220 [156; 312] vs 209 [155; 282] g/day; p=0.9). The study of dietary patterns revealed greater consumption of meat and meat products (1.23 [0.84; 1.73] vs 0.96 [0.71; 1.37] times a day, p=0.03), fish and seafood (0.37 [0.17; 0.89] vs 0.27 [0.13; 0.51] times a day, p=0.01) in T2DM+ group. It was found that in patients with T2DM the intake of calories and the following nutrients from meat and meat products was more, then without: energy (289.6 [174.9; 420.3] vs 191.9 [148.2; 336.5] kcal/day, p=0.006), proteins (25.8 [17.2; 36.5] vs 18.6 [12.6; 29.6] g/day, p=0.008) and fats (18.9 [10.8; 31.4] g/day vs 13.7 [10.3; 23.6] g/day, p=0.01). Similar data was obtained for fish and seafood, with energy (59.7 [28.3; 117.3] vs 45.2 [20.5; 70.1] kcal/day, p=0.03), proteins (8.1 [6.9; 16.8] vs 6.3 [6.7; 10.2] g/day, p=0.02) and fats (3.0 [1.5; 6.4] vs 1.9 [0.9; 3.8] g/day, p=0.01) consumed more in T2DM+ group. Conclusion. In the traditional analysis of actual nutrition in NAFLD patients with and without T2DM, no significant differences were found. However, the structure of the patients' diet differs significantly due to meat and meat products, fish and seafood. The identified differences may indicate the need to change dietary recommendations for patients with T2DM, and may also become the basis for the development of innovative food for special dietary uses aimed at improving the quality of nutrition of patients and, as a result, remission of the underlying disease.