94-100DOI: 10.17235/reed.2019.6031/2018
María Vanessa Bullón Vela, Itziar Abete, María de los Ángeles Zulet, Josep A. Tur, Xavier Pintó, Emili Corbella, Miguel Ángel Martínez González, Dolores Corella, Manuel Macías González, Francisco Tinahones, Montserrat Fitó, Ramón Estruch, Emilio Ros, Jordi Salas Salvadó, Lidia Daimiel, J. Alfredo Martínez,
Abstract
Background and aims: non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in western countries. This study aimed to investigate putative risk factors differentially related with NAFLD in obese males and females diagnosed with metabolic syndrome (MetS), stratified using the non-invasive hepatic steatosis index (HSI).
Methods and results: a cross-sectional analysis of the PREDIMED Plus study was performed of 278 participants with MetS (141 males and 137 females) of the Navarra-Nutrition node. Subjects were categorized by HSI tertiles and gender. Baseline clinical, biochemical variants and adherence to a Mediterranean diet and physical activity were evaluated.
Results: multivariate analyses showed that females had 4.54 more units of HSI (95% CI: 3.41 to 5.68) than males. Both sexes showed increased levels of triglycerides, TG/HDL cholesterol ratio and triglyceride glucose index across the HSI tertiles. Physical activity exhibited a negative statistical association with HSI (males: r = -0.19, p = 0.025; females: r = -0.18, p = 0.031). The amount of visceral fat showed a positive association with HSI in both sexes (males: r = 0.64, p < 0.001; females: r = 0.46, p < 0.001). Adherence to the Mediterranean diet was lower in those subjects with higher HSI values (males: r = -0.18, p = 0.032; females r= -0.19, p = 0.027).
Conclusion: females had a poor liver status, suggesting gender differences related to NAFLD. Adherence to a Mediterranean diet and physical activity were associated with beneficial effects on cardiovascular disease features. Thus, reducing the risk of hepatic steatosis in subjects with MetS and obesity.
New comment
Comments
21/04/2023 17:11:16
Recovery Masters Cypto/Btc Recovery Experts
Anyone looking for a Cryptocurrency Recovery Expert I would absolutely recommend RECOVERY MASTERS for their professionalism and efficient services. I was amazed after they were able to recover my Lost crypto which I had lost to an online theft Plartform.They are straight forward and reliable to communicate with and are very friendly as they offer their services,contact them through;
Whatsap; +1(204)819-5505. or through their email (Recoverymasters@email.cz }.This is the best I can do for them for their best hacking services.
21/04/2023 17:11:05
Recovery Masters Cypto/Btc Recovery Experts
Anyone looking for a Cryptocurrency Recovery Expert I would absolutely recommend RECOVERY MASTERS for their professionalism and efficient services. I was amazed after they were able to recover my Lost crypto which I had lost to an online theft Plartform.They are straight forward and reliable to communicate with and are very friendly as they offer their services,contact them through;
Whatsap; +1(204)819-5505. or through their email (Recoverymasters@email.cz }.This is the best I can do for them for their best hacking services.
18/04/2023 15:30:24
i want to quickly leave this review here, sometime last month i was convinced to invest in Bitcoin Binary, i didn't know how to do it so i met a firm online and i was happy i never knew that was the beginning of my destruction i trusted him and i invested with them, unluckyling for me i was scammed all of my coins, as if that was not enough i tried to recover them i was advised by a friend of mine we met online and have been very good to me though have never met her, i took her advice and she directed me to a bitcoin hacker who can help me recover my lost BTC i contacted him and he took away my $23,000 trying to recover my lost bitcoin, she was working with him at this point i had lost it all, then again something keep on telling me not to give up that i can get my money back, i decided to go spiritual this time i met a spell caster i read people commenting that he helped them win lottery with spell cast, i contacted him again though this was different and i explain my story to him he consoled me and promise me victory, i did all he ask of me and said my bitcoin with be restored to me in no time, i was actually waiting for a miracle, the next morning i got an email from the bitcoin scammer that he has been seeing me in his dream every night that i have be chasing him and for real he keep seeing me day and night, i thought it was all a joke till his parent and siblings also called that i should save their son he is not talking anymore just laying dead but alive, at this point i was feeling bad and scared i don't want to kill anyone, so i called Dr Dominion and told him the situation and he said he will remain like that till he return my BTC, to cut the whole story short, Dr Dominion restored him and immediately he returned my BTC, now he is working on the fake hacker who took my money i will come back to let you all know once he is done with him. meanwhile if there is any of your there looking for help to recover your BTC Dr Dominion is the best solution believe it or leave it. here is his contact you can reach out to him for help.
Email: dominionlottospelltemple@gmail.com
website: https://dominionlottospell.wixsite.com/dr-dominion
WhatsApp: +16574277820
Call: +12059642462
18/04/2023 15:30:09
i want to quickly leave this review here, sometime last month i was convinced to invest in Bitcoin Binary, i didn't know how to do it so i met a firm online and i was happy i never knew that was the beginning of my destruction i trusted him and i invested with them, unluckyling for me i was scammed all of my coins, as if that was not enough i tried to recover them i was advised by a friend of mine we met online and have been very good to me though have never met her, i took her advice and she directed me to a bitcoin hacker who can help me recover my lost BTC i contacted him and he took away my $23,000 trying to recover my lost bitcoin, she was working with him at this point i had lost it all, then again something keep on telling me not to give up that i can get my money back, i decided to go spiritual this time i met a spell caster i read people commenting that he helped them win lottery with spell cast, i contacted him again though this was different and i explain my story to him he consoled me and promise me victory, i did all he ask of me and said my bitcoin with be restored to me in no time, i was actually waiting for a miracle, the next morning i got an email from the bitcoin scammer that he has been seeing me in his dream every night that i have be chasing him and for real he keep seeing me day and night, i thought it was all a joke till his parent and siblings also called that i should save their son he is not talking anymore just laying dead but alive, at this point i was feeling bad and scared i don't want to kill anyone, so i called Dr Dominion and told him the situation and he said he will remain like that till he return my BTC, to cut the whole story short, Dr Dominion restored him and immediately he returned my BTC, now he is working on the fake hacker who took my money i will come back to let you all know once he is done with him. meanwhile if there is any of your there looking for help to recover your BTC Dr Dominion is the best solution believe it or leave it. here is his contact you can reach out to him for help.
Email: dominionlottospelltemple@gmail.com
website: https://dominionlottospell.wixsite.com/dr-dominion
WhatsApp: +16574277820
Call: +12059642462
18/04/2023 0:29:42
I was referred to Astraweb the moment scammers got away with my $408,000 worth of bitcoins and Ethereum. I was investing my money into cryptocurrency a few months back until I discovered this was all a scam and I had lost all my investments, it was a devastating experience but I’m truly grateful to the service of Astraweb who intervened and was able to recover everything thing that I lost. I was referred to Astraweb by my child's good friend who has been using the services of Astraweb for more than a year now. They are truly an amazing team of professional hackers. If you wish to recover your cryptocurrency or recover your lost wallet, you should consider reaching out to Astraweb via Email: Astraweb(@)cyberdude.com
18/04/2023 0:29:40
I was referred to Astraweb the moment scammers got away with my $408,000 worth of bitcoins and Ethereum. I was investing my money into cryptocurrency a few months back until I discovered this was all a scam and I had lost all my investments, it was a devastating experience but I’m truly grateful to the service of Astraweb who intervened and was able to recover everything thing that I lost. I was referred to Astraweb by my child's good friend who has been using the services of Astraweb for more than a year now. They are truly an amazing team of professional hackers. If you wish to recover your cryptocurrency or recover your lost wallet, you should consider reaching out to Astraweb via Email: Astraweb(@)cyberdude.com
17/04/2023 23:25:59
RECOVERY OF LOST FUNDS FROM SCAMMER.
Tracking Down Lost Bitcoins and Other Cryptos: Fast without wasting time Contact: Telegram: https://t.me/WizardWebRecovery / Email: wizardwebrecovery@gmail.com, Do you need support of recovery of your lost or stolen bitcoin, trying to obtain cryptocurrency transferred to the wrong wallet address, or believe your wallet has been compromised, get in touch with Wizard Web Recovery Group Hackers . I lost over 412,040 $ after participating in a SINCODE binary scam. The money I fraudulently lost has been recovered thanks to the super work of Wizard Web Recovery Group Hackers . They Working with the new digital software that recovers funds without a twinkle of eyes beep Wizard Web Recovery Group Hackers is trustworthy you can always contact them via
Telegram: https://t.me/WizardWebRecovery
Email: wizardwebrecovery@gmail.com
17/04/2023 23:22:04
RECOVERY OF LOST FUNDS FROM SCAMMER.
Tracking Down Lost Bitcoins and Other Cryptos: Fast without wasting time Contact: Telegram: https://t.me/WizardWebRecovery / Email: wizardwebrecovery@gmail.com, Do you need support of recovery of your lost or stolen bitcoin, trying to obtain cryptocurrency transferred to the wrong wallet address, or believe your wallet has been compromised, get in touch with Wizard Web Recovery Group Hackers . I lost over 412,040 $ after participating in a SINCODE binary scam. The money I fraudulently lost has been recovered thanks to the super work of Wizard Web Recovery Group Hackers . They Working with the new digital software that recovers funds without a twinkle of eyes beep Wizard Web Recovery Group Hackers is trustworthy you can always contact them via
Telegram: https://t.me/WizardWebRecovery
Email: wizardwebrecovery@gmail.com
10/04/2023 22:28:11
I want to share my story of how I became a victim of a cryptocurrency and romance scam that went on for several months, I was swindled of everything I have ever owned and went into depression. I thought all hope was lost until I came across an article about GHOST CHAMPION HACKING SERVICES and how they can help me recover all that I lost. GHOST CHAMPION HACKING SERVICES was able to recover everything that i have lost to the hands of scammers after hacking into their server they recover more that the amount i invested . You can contact them too if you've had a similar encounter in the past.
EMAIL ( ghostchampionwizard@gmail.com ) WhatsApp at+1(702)729 0770 and TELEGRAM ID:https://t.me/WizardGhosthacker
10/04/2023 22:27:26
I want to share my story of how I became a victim of a cryptocurrency and romance scam that went on for several months, I was swindled of everything I have ever owned and went into depression. I thought all hope was lost until I came across an article about GHOST CHAMPION HACKING SERVICES and how they can help me recover all that I lost. GHOST CHAMPION HACKING SERVICES was able to recover everything that i have lost to the hands of scammers after hacking into their server they recover more that the amount i invested . You can contact them too if you've had a similar encounter in the past.
EMAIL ( ghostchampionwizard@gmail.com ) WhatsApp at+1(702)729 0770 and TELEGRAM ID:https://t.me/WizardGhosthacker
References
1. Younossi ZM. Non-alcoholic fatty liver disease – A global public health perspective. J Hepatol. 2019;70(3):531–44.
2. Chalasani N, Younossi Z, Lavine JE, et al. The diagnosis and management of non‐alcoholic fatty liver disease: Practice Guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association. Hepatology. 2012;55(6):2005–23.
3. Li L, Liu DW, Yan HY, et al. Obesity is an independent risk factor for non-alcoholic fatty liver disease: evidence from a meta-analysis of 21 cohort studies. Obes Rev. 2016;17(6):510–9.
4. Lonardo A, Ballestri S, Marchesini G, et al. Nonalcoholic fatty liver disease: A precursor of the metabolic syndrome. Dig Liver Dis. 2015;47(3):181–90.
5. Pan J-J, Fallon MB. Gender and racial differences in nonalcoholic fatty liver disease. World J Hepatol. 2014;6(5):274–83.
6. Suzuki A, Abdelmalek MF. Nonalcoholic Fatty Liver Disease in Women. Women’s Heal. 2009;5(2):191–203.
7. Bedossa P, Patel K. Biopsy and Noninvasive Methods to Assess Progression of Nonalcoholic Fatty Liver Disease. Gastroenterology. 2016;150(8):1811–1822.e4.
8. Bugianesi E, Rosso C, Cortez-Pinto H. How to diagnose NAFLD in 2016. J Hepatol. 2016;65(3):643–4.
9. Lee J-H, Kim D, Kim HJ, et al. Hepatic steatosis index: A simple screening tool reflecting nonalcoholic fatty liver disease. Dig Liver Dis. 2010;42(7):503–8.
10. Martínez-González MA, Buil-Cosiales P, Corella D, et al. Cohort Profile: Design and methods of the PREDIMED-Plus randomized trial. Int J Epidemiol. 2018 Nov 22 [Epub ahead of print].
11. Alberti KGMM, Eckel RH, Grundy SM, et al. Harmonizing the Metabolic Syndrome. Circulation. 2009;120(16):1640–5.
12. Bairaktari ET, Seferiadis KI, Elisaf MS. Evaluation of Methods for the Measurement of Low-Density Lipoprotein Cholesterol. J Cardiovasc Pharmacol Ther. 2005;10(1):45–54.
13. Navarro-González D, Sánchez-Íñigo L, Pastrana-Delgado J, et al. Triglyceride–glucose index (TyG index) in comparison with fasting plasma glucose improved diabetes prediction in patients with normal fasting glucose: The Vascular-Metabolic CUN cohort. Prev Med (Baltim). 2016;86:99–105.
14. Angulo P, Hui JM, Marchesini G, et al. The NAFLD fibrosis score: A noninvasive system that identifies liver fibrosis in patients with NAFLD. Hepatology. 2007;45(4):846–54.
15. Fernández-Ballart JD, Piñol JL, Zazpe I, et al. Relative validity of a semi-quantitative food-frequency questionnaire in an elderly Mediterranean population of Spain. Br J Nutr. 2010;103(12):1808–16.
16. De La Fuente-Arrillaga C, Vzquez Ruiz Z, Bes-Rastrollo M, et al. Reproducibility of an FFQ validated in Spain. Public Health Nutr. 2010;13(9):1364–72.
17. Trichopoulou A, Costacou T, Bamia C, et al. Adherence to a Mediterranean diet and survival in a Greek population. N Engl J Med. 2003;348(26):2599–608.
18. Trichopoulou A, Orfanos P, Norat T, et al. Modified Mediterranean diet and survival: EPIC-elderly prospective cohort study. BMJ. 2005;330(7498):991.
19. Molina L, Sarmiento M, Peñafiel J, et al. Validation of the Regicor Short Physical Activity Questionnaire for the Adult Population. Lucía A, editor. PLoS One. 2017;12(1):e0168148.
20. Gómez-de-la-Cuesta S, Aller-de-la-Fuente R, Tafur-Sánchez C, et al. Analytical, anthropometric and dietary factors associated with the development of fibrosis in patients with nonalcoholic fatty liver disease. Rev Esp Enfermedades Dig. 2018;110(5):292–7.
21. Ballestri S, Nascimbeni F, Baldelli E, et al. NAFLD as a Sexual Dimorphic Disease: Role of Gender and Reproductive Status in the Development and Progression of Nonalcoholic Fatty Liver Disease and Inherent Cardiovascular Risk. Adv Ther. 2017;34(6):1291–326.
22. Bertolotti M, Lonardo A, Mussi C, et al. Nonalcoholic fatty liver disease and aging: epidemiology to management. World J Gastroenterol. 2014;20(39):14185–204.
23. Ryu S, Suh B-S, Chang Y, et al. Menopausal stages and non-alcoholic fatty liver disease in middle-aged women. Eur J Obstet Gynecol Reprod Biol. 2015;190:65–70.
24. Bullón-Vela MV, Abete I, Martínez JA, et al. Obesity and Nonalcoholic Fatty Liver Disease: Role of Oxidative Stress. In Obesity, Marti del Moral AM, García CMA, editors. Oxidative stress and Dietary Antioxidants. Elsevier: London, UK, 2018. p. 111-133.
25. Cazanave S, Sanyal A. Molecular Mechanisms of Lipotoxicity in Nonalcoholic Fatty Liver Disease. In Springer, James M. Ntambi, editor. Hepatic De Novo Lipogenesis and Regulation of Metabolism. Springer, Cham, Switzerland, 2016. p. 101-130.
26. Garjani A, Safaeiyan A, Khoshbaten M. Association between platelet count as a noninvasive marker and ultrasonographic grading in patients with nonalcoholic fatty liver disease. Hepat Mon. 2015;15(1):1–6.
27. Fang K, Cheng Y, Su C, et al. Higher platelet counts are associated with metabolic syndrome independent of fatty liver diagnosis. J Chin Med Assoc. 2017;80(3):125–32.
28. Suzuki A, Abdelmalek MF. Nonalcoholic Fatty Liver Disease in Women. Women’s Heal. 2009;5(2):191–203.
29. Nielsen S, Guo Z, Johnson CM, et al. Splanchnic lipolysis in human obesity. J Clin Invest. 2004;113(11):1582–8.
30. Wang Z, Xu M, Hu Z, et al. Prevalence of nonalcoholic fatty liver disease and its metabolic risk factors in women of different ages and body mass index. Menopause. 2015;22(6):667–73.
31. Karastergiou K, Smith SR, Greenberg AS, et al. Sex differences in human adipose tissues – the biology of pear shape. Biol Sex Differ. 2012;3(1):13.
32. Estruch R. Anti-inflammatory effects of the Mediterranean diet: the experience of the PREDIMED study. Proc Nutr Soc. 2010;69(3):333–40.
33. Cantero I, Abete I, Babio N, et al. Dietary Inflammatory Index and liver status in subjects with different adiposity levels within the PREDIMED trial. Clin Nutr. 2018;37(5):1736–43.
34. Ros E, Martínez-González MA, Estruch R, et al. Mediterranean diet and cardiovascular health: Teachings of the PREDIMED study. Adv Nutr. 2014;5(3):330S-6S.
35. Ryan MC, Itsiopoulos C, Thodis T, et al. The Mediterranean diet improves hepatic steatosis and insulin sensitivity in individuals with non-alcoholic fatty liver disease. J Hepatol. 2013;59(1):138–43.
36. Kontogianni MD, Tileli N, Margariti A, et al. Adherence to the Mediterranean diet is associated with the severity of non-alcoholic fatty liver disease. Clin Nutr. 2014;33(4):678–83.
37. Johnson NA, George J. Fitness versus fatness: moving beyond weight loss in nonalcoholic fatty liver disease. Hepatology. 2010;52(1):370–80.
38. Whitsett M, VanWagner LB. Physical activity as a treatment of non-alcoholic fatty liver disease: A systematic review. World J Hepatol. 2015;7(16):2041.