热量限制的低碳水化合物饮食和膳食纤维对非酒精性脂肪肝影响的研究进展

近年来热量限制的低碳水化合物饮食和膳食纤维干预对肝脏功能的影响被广泛关注,研究发现热量限制的低碳水化合物饮食和高膳食纤维干预在预防和治疗非酒精性脂肪肝方面表现出积极的作用。热量限制的低碳水化合物饮食可以有效降低非酒精性脂肪肝患者体重、BMI和肝脏脂肪病变程度,有效降低AST水平,但是对ALT和脂质代谢相关指标TC、TG、HDL和LDL的影响存在争议。高膳食纤维干预可有效降低AST和ALT水平,改善肝脏功能。热量限制的低碳水化合物饮食改善肝脏功能的机制是减少能量的摄入,降低胰岛素拮抗,防止脂肪的堆积。膳食纤维改善肝脏功能的机制是除降低胰岛素拮抗之外,还可延缓胃排空的时间,改变肠道的渗透性和增加增强肝脏对胰岛素敏感性的短链脂肪酸,从而调节脂质代谢,改善肝脏功能。本文主要综述了热量限制的低碳水化合物饮食、膳食纤维干预对非酒精性脂肪肝患者体重、BMI、肝脏功能的影响,以及改善肝脏功能的机制。

Research Progress of Effects of Calorie-restricted Low-carbohydrate Diet and Dietary Fiber on Nonalcoholic Fatty Liver Disease

The effects of calorie-restricted low-carbohydrate diets and dietary fiber interventions on liver function have been widely observed in recent years. Studies have found that calorie-restricted low-carbohydrate diets and high dietary fiber interventions have been shown to prevent and treat nonalcoholic fatty liver disease with positive effect. A calorie-restricted low-carbohydrate diet can effectively reduce the body weight,BMI,and hepatic fat lesions in patients with nonalcoholic fatty liver disease,effectively reducing AST levels,while there are controversy over TC,TG,HDL,and LDL findings for ALT and lipid metabolism-related indicators. High dietary fiber intervention can effectively reduce AST and ALT levels and improve liver function. The mechanism of calorie-restricted low-carbohydrate diets that improve liver function is to reduce energy intake,reduce insulin antagonism,and prevent fat accumulation. The mechanism by which dietary fiber improves liver function is to reduce the time of gastric emptying,reduce the permeability of the intestine,and increase the short-chain fatty acids that enhance the sensitivity of the liver to insulin,in order to regulate lipid metabolism and improve lipid metabolism and liver function. The paper reviewed the effects of calorie-restricted low-carbohydrate diets,dietary fiber interventions on body weight,BMI,liver function in patients with nonalcoholic fatty liver disease,and the mechanisms of improvement on liver function.