Nutritional investigation of non-obese patients with non-alcoholic fatty liver disease: the significance of dietary cholesterol.
OBJECTIVE
The onset and progression of non-alcoholic fatty liver disease (NAFLD) seem to be affected by nutritive intake; however, detailed examinations have not been performed in non-obese NAFLD patients. The purpose of this study was to identify potential nutritive factors that affect NAFLD and its related nutritional problems.


METHODS
We investigated the distribution of abdominal fat, dietary intake, and biochemical data in patients with NAFLD and compared non-obese with obese patients.


RESULTS
There was no significant difference in the percentage of patients with diabetes or dyslipidemia between the obese and non-obese groups. Waist circumference, total abdominal fat levels, and subcutaneous fat levels were significantly higher in the obese group, while visceral fat levels were not significantly different between the two groups. Immunoreactive insulin (IRI) and homeostasis model assessment-insulin resistance (HOMA-IR) were significantly lower in the non-obese group, suggesting that the non-obese patients were not overtly insulin resistant. Although serum adiponectin and TNF-alpha levels were similar in both groups, leptin levels were significantly higher in the obese group. Total energy and carbohydrate intake tended to be higher in the obese group. A characteristic feature was that dietary cholesterol intake was significantly higher, while the intake of polyunsaturated fatty acids (PUFAs) was significantly lower in the non-obese group.


CONCLUSIONS
In non-obese NAFLD patients: 1) although visceral fat was increased, insulin resistance and/or dysregulated secretion of adipocytokines was not necessarily shown; 2) intakes of total energy and carbohydrates were not excessive, although dietary cholesterol was superabundant and dietary PUFAs were significantly lower compared with those in obese patients; and 3) characteristic fat intake may be associated with the formation of NAFLD.
Yasutake
Kenichiro
K
Dietetic Laboratory, Kyushu Medical Center, National Hospital Organization, Fukuoka, Japan.
Nakamuta
Makoto
M
Shima
Yuki
Y
Ohyama
Akiko
A
Masuda
Kaori
K
Haruta
Noriko
N
Fujino
Tatsuya
T
Aoyagi
Yoko
Y
Fukuizumi
Kunitaka
K
Yoshimoto
Tsuyoshi
T
Takemoto
Ryosuke
R
Miyahara
Toshihiko
T
Harada
Naohiko
N
Hayata
Fukuko
F
Nakashima
Manabu
M
Enjoji
Munechika
M
D050153:Abdominal Fat; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D016022:Case-Control Studies; D002784:Cholesterol / Q000097:blood; D002791:Cholesterol, Dietary / Q000008:administration & dosage*; D004032:Diet; D005234:Fatty Liver / Q000150:complications* / Q000378:metabolism* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D009765:Obesity / Q000150:complications* / Q000378:metabolism / Q000473:pathology; D012307:Risk Factors
D002791:Cholesterol, Dietary; D002784:Cholesterol