Low Physical Activity and Energy Dense Malaysian Foods are Associated with Non-alcoholic Fatty Liver Disease in Centrally Obese But Not in Non-centrally Obese Patients with Diabetes Mellitus

低体力活动和高能量马来西亚食物与糖尿病患者中向心性肥胖者的非酒精性脂肪肝病有关，而与非向心性肥胖者无关

Wah-Kheong Chan ； Alexander Tong-Boon Tan ； Shireene Ratna Vethakkan ； Pei-Chien Tah ； Anushya Vijayananthan ； Khean-Lee Goh

《Asia Pacific Journal of Clinical Nutrition》 24卷2期 (2015/06) Pp. 289-298

https://doi.org/10.6133/apjcn.2015.24.2.15

摘要

目的：研究糖尿病患者的膳食摄入和体力活动水平以及与非酒精性脂肪肝病（NAFLD）的关系。方法：连续到我院糖尿病门诊就诊的成年2型糖尿病患者报名参加课题。分别用国际体力活动问卷和半定量食物频率问卷评估体力活动和膳食摄入。NAFLD的诊断是基于超声并排除酒精摄入和其它原因引起的严重慢性肝病。结果：299名患者的数据被纳入分析，平均年龄为63.3±10.5岁，其中41.1%为男性。NAFLD的患病率为49.2%。低体力活动的患者更容易患NAFLD（OR=1.75，95%CI=1.03-2.99，p=0.029）。2型糖尿病患者患NAFLD与否在能量摄入，宏量营养素的摄入及其能量百分比，高糖食物、高胆固醇食物和高饱和脂肪酸食物的摄入之间没有显著差异。低体力活动并处于脂肪来源能量百分比的最高四分之一（OR=4.03,95%CI=1.12-15.0,p=0.015）、摄入高胆固醇食物（OR=3.61,95%CI=1.37-9.72,p=0.004）和高饱和脂肪酸食物（OR=2.67,95%CI=1.08-6.67,p=0.019）的向心性肥胖患者更容易发生NAFLD。在没有向心性肥胖的患者中，体力活动和能量百分比来自脂肪、高胆固醇食物和高饱和脂肪酸食物均与NAFLD无关。结论：低体力活动和能量百分比来自高脂肪、高胆固醇食物和高饱和脂肪酸食物均与糖尿病患者中向心性肥胖者的非酒精性脂肪肝病有关，而与非向心性肥胖者无关。

關鍵字

膳食 ； 体力活动 ； 非酒精性脂肪肝 ； 糖尿病 ； 肥胖

並列摘要

Objective: To study the dietary intake and level of physical activity (PA) of patients with diabetes mellitus and the association with non-alcoholic fatty liver disease (NAFLD). Methods: Consecutive adult patients with type 2 diabetes mellitus seen in our hospital diabetes clinic were enrolled. The Global Physical Activity Questionnaire and a semi-quantitative food-frequency questionnaire were used to assess PA and dietary intake, respectively. Diagnosis of NAFLD was ultrasound-based and following exclusion of significant alcohol intake and other causes of chronic liver disease. Results: Data for 299 patients were analyzed (mean age 63.3±10.5 years old, 41.1% male). Prevalence of NAFLD was 49.2%. Patients with low PA were more likely to have NAFLD (OR=1.75, 95% CI=1.03-2.99, p=0.029). There was no significant difference in energy intake, intake of macronutrients and percentage energy intake from each macronutrient, high sugar food, high cholesterol food and high SFA food between patients with and without NAFLD. Among centrally obese patients, patients with low PA and in the highest quartile of percentage energy intake from fat (OR=4.03, 95% CI=1.12-15.0, p=0.015), high cholesterol food (OR=3.61, 95% CI=1.37-9.72, p=0.004) and high SFA food (OR=2.67, 95% CI=1.08-6.67, p=0.019) were most likely to have NAFLD. Among those who were not centrally obese, PA and percentage energy intake from fat, high cholesterol food and high SFA food was not associated with NAFLD. Conclusion: Low PA and high percentage energy intake from fat, high cholesterol food and high SFA food is associated with NAFLD in centrally obese but not in non-centrally obese patients with diabetes mellitus.

並列關鍵字

diet ； physical activity ； non-alcoholic fatty liver disease ； diabetes mellitus ； obesity