Dataset Information

Mediterranean diet for patients with non-alcoholic fatty liver disease, a systematic review and meta-analysis of observational and clinical investigations.

ABSTRACT:

Aim

Mediterranean diet (MD) is a healthful dietary pattern with benefits for prevention of metabolic diseases including non-alcoholic fatty liver disease (NAFLD). In the current meta-analysis, we assessed the association between MD and liver steatosis and cardiometabolic risk factors in patients with NAFLD.

Methods

PubMed, Scopus, and Embase were searched to find observational and clinical studies on the issue. No restriction on date and language was made. Outcomes included body mass index (BMI), waist circumference, blood pressure, triglycerides (TG), cholesterol fractions, glucose, insulin, insulin resistance, and liver transaminases.

Results

Seven observational reports and 6 trials met our inclusion criteria and entered in the meta-analysis. In observational studies, there was an inverse association between MD and NAFLD (effect size (ES)?=?0.95; 95% CI: 0.90, 1.00; P?=?0.05). In trials, subgroup analysis based on the method of liver examination showed effectiveness of MD on steatosis examined by magnetic resonance spectroscopy (P?n?=?2) but not by ultrasound (P?=?0.08; n?=?2). MD also showed a significant decreasing effect on BMI (ES?=?-1.23 kg/m²; 95% CI: -2.38, -0.09), plasma triglycerides (ES?=?-33.01 mg/dL; 95% CI: -52.84, -13.18), and HOMA-IR (ES?=?-0.94; 95% CI: -1.29, -0.58) but no significant effect was observed in waist circumference, cholesterol fractions, glucose and insulin, and liver transferases.

Conclusion

Overall, available data from observational and clinical studies indicated a trend for the relationship between MD and hepatic steatosis. Improvement in the most important risk factors of NAFLD, i.e. BMI, serum triglycerides, and insulin resistance, may be involved in such relationship.

SUBMITTER: Akhlaghi M

PROVIDER: S-EPMC7271299 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature

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Publications

Mediterranean diet for patients with non-alcoholic fatty liver disease, a systematic review and meta-analysis of observational and clinical investigations.

Akhlaghi Masoumeh M Ghasemi-Nasab Maryam M Riasatian Maryamsadat M

Journal of diabetes and metabolic disorders 20200217 1

<h4>Aim</h4>Mediterranean diet (MD) is a healthful dietary pattern with benefits for prevention of metabolic diseases including non-alcoholic fatty liver disease (NAFLD). In the current meta-analysis, we assessed the association between MD and liver steatosis and cardiometabolic risk factors in patients with NAFLD.<h4>Methods</h4>PubMed, Scopus, and Embase were searched to find observational and clinical studies on the issue. No restriction on date and language was made. Outcomes included body m ...[more]

PMID: 32550210

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Project description:BACKGROUND:Non-alcoholic fatty liver disease (NAFLD) is a leading cause of chronic liver disease worldwide. Many individuals have risk factors associated with NAFLD, but the majority do not develop advanced liver disease: cirrhosis, hepatic decompensation, or hepatocellular carcinoma. Identifying people at high risk of experiencing these complications is important in order to prevent disease progression. This review synthesises the evidence on metabolic risk factors and their potential to predict liver disease outcomes in the general population at risk of NAFLD or with diagnosed NAFLD. METHODS AND FINDINGS:We conducted a systematic review and meta-analysis of population-based cohort studies. Databases (including MEDLINE, EMBASE, the Cochrane Library, and ClinicalTrials.gov) were searched up to 9 January 2020. Studies were included that reported severe liver disease outcomes (defined as liver cirrhosis, complications of cirrhosis, or liver-related death) or advanced fibrosis/non-alcoholic steatohepatitis (NASH) in adult individuals with metabolic risk factors, compared with individuals with no metabolic risk factors. Cohorts selected on the basis of a clinically indicated liver biopsy were excluded to better reflect general population risk. Risk of bias was assessed using the QUIPS tool. The results of similar studies were pooled, and overall estimates of hazard ratio (HR) were obtained using random-effects meta-analyses. Of 7,300 unique citations, 22 studies met the inclusion criteria and were of sufficient quality, with 18 studies contributing data suitable for pooling in 2 random-effects meta-analyses. Type 2 diabetes mellitus (T2DM) was associated with an increased risk of incident severe liver disease events (adjusted HR 2.25, 95% CI 1.83-2.76, p < 0.001, I2 99%). T2DM data were from 12 studies, with 22.8 million individuals followed up for a median of 10 years (IQR 6.4 to 16.9) experiencing 72,792 liver events. Fourteen studies were included in the meta-analysis of obesity (BMI > 30 kg/m2) as a prognostic factor, providing data on 19.3 million individuals followed up for a median of 13.8 years (IQR 9.0 to 19.8) experiencing 49,541 liver events. Obesity was associated with a modest increase in risk of incident severe liver disease outcomes (adjusted HR 1.20, 95% CI 1.12-1.28, p < 0.001, I2 87%). There was also evidence to suggest that lipid abnormalities (low high-density lipoprotein and high triglycerides) and hypertension were both independently associated with incident severe liver disease. Significant study heterogeneity observed in the meta-analyses and possible under-publishing of smaller negative studies are acknowledged to be limitations, as well as the potential effect of competing risks on outcome. CONCLUSIONS:In this review, we observed that T2DM is associated with a greater than 2-fold increase in the risk of developing severe liver disease. As the incidence of diabetes and obesity continue to rise, using these findings to improve case finding for people at high risk of liver disease will allow for effective management to help address the increasing morbidity and mortality from liver disease. TRIAL REGISTRATION:PROSPERO CRD42018115459.

Dataset Information

Mediterranean diet for patients with non-alcoholic fatty liver disease, a systematic review and meta-analysis of observational and clinical investigations.

Aim

Methods

Results

Conclusion

Publications

Mediterranean diet for patients with non-alcoholic fatty liver disease, a systematic review and meta-analysis of observational and clinical investigations.

Similar Datasets

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