Effect of an isocaloric high-protein low-carbohydrate diet on serum lipid profile in nonalcoholic fatty liver disease

Abstract

Abstract: Objective To study the effects of an isocaloric low-carbohydrate high-protein diet (CRD)[2] on patients with nonalcoholic fatty liver disease (NAFLD) and its impact on lipid metabolism. Methods Twenty-five patients diagnosed with NAFLD and 25 healthy volunteers from the physical examination center were recruited for the study. The NAFLD patients underwent a CRD intervention. Basic information about the subjects was collected, and biochemical indices,including liver function and blood lipids, were tested. Serum lipid analysis was performed using UPLC-Q-Orbitrap/MS technology. Principal component analysis and orthogonal partial least squares-discriminant analysis were utilized to construct differential serum lipid metabolic profiles and identify lipid biomarkers. Results After 4 weeks of dietary intervention, the patients' weight decreased from 77.88±10.76 kg to 76.62±10.78 kg, (P<0.001), and BMI decreased from 25.63 (24.40-26.80) kg/m² to 24.88 (24.5-26.34) kg/m², (P<0.01), while waist circumference showed no significant change (P>0.05). The AKP level significantly decreased from 93.36±30.41U/L to 3.12±23.90 U/L after CRD intervention (P<0.01). GGT and ALT levels were reduced from 43.84±27.78 U/L and 35.0 (25.0-76.5) U/L to 35.16±17.51 U/L and 28.0 (14.5-45.5) U/L respectively( P<0.05 for both). Serum TC levels decreased significantly from 4.56 (3.82-6.31) mmol/L to 3.15 (1.79-4.32) mmol/L (P<0.001). There were no significant changes in the levels of CHE, AST, TG, HDL, and LDL (P>0.05). Lipidomic studies revealed significant changes in serum levels of OAFHA, LPC, MG, LPG, PI, PS, PG, PA, and SM after CRD intervention (P<0.05). Conclusion The CRD intervention effectively reduce body mass, lower BMI and waist circumference, and improve liver function and dyslipidemia in patients with NAFLD. Lipidomic analysis indicated that a CRD diet could mitigate the development of NAFLD by alleviating fatty liver lipotoxicity and regulating sphingolipid metabolism. The 53 lipid biomarkers identified through this screening can serve as potential targets for NAFLD intervention.

Key words: Isocaloric low-carbohydrate high-protein diet, Lifestyle intervention, NAFLD, Lipidomics

QIAN Xiao-jing, CHEN Ying, LIU Wang zhen-zu, ZHANG Jia-qi, JIANG Yuan-ye, HU Cheng. Effect of an isocaloric high-protein low-carbohydrate diet on serum lipid profile in nonalcoholic fatty liver disease[J]. Chinese Hepatolgy, 2024, 29(6): 706-713.

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