title: Adenovirus-36 seropositivity enhances effects of nutritional intervention on obesity, bright liver, and insulin resistance.
abstract: BACKGROUND
  Obesity and liver steatosis are both currently attributed to inappropriate lifestyle and nutrition. Higher prevalence of human adenovirus Ad36 seropositivity (Ad36+) is reported only in obesity.
  
  
  OBJECTIVE
  To investigate whether a lifestyle-nutritional intervention achieves different outcomes in NAFLD patients, i.e., if is blunted or enhanced according to Ad36 seropositivity status.
  
  
  METHODS
  One-year nutritional intervention was planned and accomplished for 62 non-alcoholic fatty liver disease overweight-obese patients, studied by liver ultrasound, evaluating Bright Liver Score (BLS), by Homeostatic Model assessment of Insulin Resistance (HOMA), by body composition and Ad36+ assay. Lower salt/lower calories Mediterranean diet, physical activity increase, smoking withdrawal and lifestyle counseling, provided by a health psychologist, were given.
  
  
  RESULTS
  Ad36 seropositive patients have baseline greater BMI with the same level of BLS. Different prevalence of post-interventional response, significantly greater among Ad36+ patients, is observed: greater decrease of obesity, assessed by BMI, greater reduction of insulin resistance, assessed by HOMA and higher prevalence of bright liver disappearance. A BMI-adjusted multiple linear regression model explains significantly 23.8% (p < 0.04) of the variance; significant predictive variables are Ad36 seropositivity (p < 0.012) and fat mass loss (p < 0.011) accounting for the variance of the occurrence of bright liver disappearance.
  
  
  CONCLUSIONS
  Ad36 previous infection is significantly associated with enhanced weight loss, bright liver disappearance, and recovery of insulin sensitivity through the chosen tailored nutritional interventional treatment. Nonetheless, Ad36 seronegative NAFLD patients' fatty liver pattern improves, at a lower extent, also without significant weight loss: an effect of dietary changes profile, Mediterranean diet, not only of lowered food caloric intake, is conceivably operating.
authors.affiliation: Department of Internal Medicine, Clinica di Medicina Interna e Terapia Medica, Facoltà di Medicina e Chirurgia, Università di Catania, Via Sant'Orsola 30, 95131, Catania, Italy. guglielmotrovato@unict.it
authors.forename: Guglielmo M
authors.initials: GM
authors.lastname: Trovato
authors.forename: Giuseppe Fabio
authors.initials: GF
authors.lastname: Martines
authors.forename: Francesca M
authors.initials: FM
authors.lastname: Trovato
authors.forename: Clara
authors.initials: C
authors.lastname: Pirri
authors.forename: Patrizia
authors.initials: P
authors.lastname: Pace
authors.forename: Adriana
authors.initials: A
authors.lastname: Garozzo
authors.forename: Angelo
authors.initials: A
authors.lastname: Castro
authors.forename: Daniela
authors.initials: D
authors.lastname: Catalano
mesh_terms: D000258:Adenovirus Infections, Human / Q000453:epidemiology / Q000276:immunology*; D000260:Adenoviruses, Human / Q000276:immunology* / Q000472:pathogenicity; D000328:Adult; D015992:Body Mass Index; D015897:Comorbidity; D038441:Diet, Mediterranean; D005234:Fatty Liver / Q000453:epidemiology / Q000276:immunology* / Q000821:virology; D005260:Female; D015438:Health Behavior; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology; D008019:Life Style; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D015596:Nutrition Assessment; D009765:Obesity / Q000453:epidemiology / Q000517:prevention & control / Q000821:virology*; D016036:Seroepidemiologic Studies