RT info:eu-repo/semantics/doctoralThesis
T1 Ensayo clínico comparativo de dos dietas hipocalóricas: dieta con patrón Mediterráneo, frente a dieta hipograsa en pacientes con esteatosis hepática metabólica (EHMET). Papel del polimorfismo PNPLA3 en la respuesta a la dieta.
A1 Laserna Del Gallego, Cristina
A2 Universidad de Valladolid. Escuela de Doctorado
K1 Nutrición
K1 Mediterranean diet
K1 Esteatosis hepática
K1 32 Ciencias Médicas
AB Fatty metabolic liver disease (FMD) encompasses a broad spectrum ranging from simple steatosis to non-alcoholic steatohepatitis, leading to an increased risk of cirrhosis and hepatocarcinoma. With the increasing incidence of obesity worldwide, sedentary lifestyles and unhealthy diets, an increase in the prevalence of GHD is being observed in Europe to between 20-30%.  It is a major public health problem. Dietary habits and nutrients are the most important contributors to the development, progression and treatment of non-alcoholic fatty liver disease and associated metabolic comorbidities. In general, a hypercaloric diet, especially rich in trans fats, saturated fats and cholesterol, and fructose-sweetened beverages appear to increase visceral adiposity and stimulate hepatic lipid accumulation and the progression of non-alcoholic steatohepatitis. However, reduced calorie intake and monounsaturated fatty acid supplementation have preventive and therapeutic effects. In addition, fibre, coffee, green tea and olive oil may be protective factors for MGHD. Based on the available data, at least 3-5% weight loss, achieved by the low-calorie diet alone or in combination with exercise and lifestyle modification, generally reduces hepatic steatosis; but a weight loss of up to 10% is necessary to improve hepatic necroinflammation according to the 2012 AESLD (European Association for the Study of Liver Diseases) guidelines. Promrat K et al. conducted one of the most relevant studies which showed that a loss of at least 7% of body weight through diet and lifestyle changes improved all histological parameters in patients with MGUS. Adherence to the diet over time is an important factor in achieving this goal. Moreover, a healthy diet has benefits beyond weight reduction in patients with NAFLD whether obese or normal weight. Therefore, nutrition serves as an important axis of prevention and treatment of NAFLD, and patients with NAFLD should receive individualised dietary recommendations. Our aim is to compare the effects of a hypocaloric diet with a Mediterranean pattern rich in EVOO and nuts versus a low-fat hypocaloric diet for 3 months on the improvement of the liver and anthropometric profile of patients with EHMET. Other objectives are: to analyse the dynamic changes in some panels of serum biomarkers or non-invasive clinical-analytical indices of steatosis (FLI, HSI, LAP), and liver fibrosis (NAFLD-FS, FIB-4, HEPAMET fibrosis score) after the two dietary interventions. To assess the improvement in liver fibrosis assessed by transitional elastography after the dietary intervention and its relationship with the weight loss achieved. To analyse the effect of the dietary intervention on cardiovascular risk factors classically associated with EHMET (glycaemic profile, lipid profile, MS). And finally, to analyse the role of the I148M genetic polymorphism of PNPLA3 in the response to dietary intervention as assessed by NASH resolution.
YR 2024
FD 2024
LK https://uvadoc.uva.es/handle/10324/66294
UL https://uvadoc.uva.es/handle/10324/66294
LA spa
NO Escuela de Doctorado
DS UVaDOC
RD 17-jul-2024