Perfil nutricional e metabólico de mulheres obesas com doença hepática gordurosa não alcoólica após intervenção no estilo de vida

Abstract

Introduction: Nonalcoholic fatty liver disease (NAFLD) has a higher prevalence in obesity and lifestyle management is the primary treatment. Method: We assessed 61 obese women by anthropometric, biochemical, clinical and image measurements at baseline and after 6 months of treatment who received instructions to change their lifestyle. Food intake was assessed by a qualitative food frequency questionnaire. According to liver steatosis they were divided in NAFLD and Control groups. Results: No differences were found for food intake, but both groups had a tendency to lower intake of fats, sugar and sweets after 6 months and high consume of cereals, vegetables and fruits. NAFLD group reduced body weight, waist circumference and liver steatosis. In both groups occurred an improvement in visceral and subcutaneous adiposity (VA, SA) and in TNF-α and IL-6 cytokines, whereas leptin was high and adiponectin was low during the study. In Control group SA associated with body weight and VA with TNF-α whereas in NAFLD group a strong correlation ocurred between VA with body weight and BMI, and between SA with systolic and diastolic blood pressure and among IL-6 with leptin levels. Serum CRP was greater and, similar to GGT liver enzyme, was associated with body weight in NAFLD group. High insulin resistance and low insulin sensitivity occurred in both groups during the study, being more pronounced in the NAFLD. Conclusion: These results suggested the important role of a comprehensive lifestyle management in nutritional and metabolic profile of obese women with NAFLD.