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Randomized Controlled Trial
. 2021 Feb 15;13(2):629.
doi: 10.3390/nu13020629.

Energy Expenditure Improved Risk Factors Associated with Renal Function Loss in NAFLD and MetS Patients

Manuela Abbate  1   2 , Catalina M Mascaró  1   2 , Sofía Montemayor  1   2 , María Barbería-Latasa  3 , Miguel Casares  4 , Cristina Gómez  5 , Escarlata Angullo-Martinez  1   2   6 , Silvia Tejada  1   2   7 , Itziar Abete  7   8 , Maria Angeles Zulet  7   8 , Antoni Sureda  1   2   7 , J Alfredo Martínez  7   8   9 , Josep A Tur  1   2   7
Affiliations
Randomized Controlled Trial

Energy Expenditure Improved Risk Factors Associated with Renal Function Loss in NAFLD and MetS Patients

Manuela Abbate et al. Nutrients. .

Abstract

To assess the efficacy of three lifestyle interventions on the reduction of liver fat content and metabolic syndrome (MetS), and whether such reductions would influence renal outcomes, we conducted a randomized controlled trial on 128 participants with MetS and non-alcoholic fatty liver disease (NAFLD), as well as available data on estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatine ratio (UACR). Patients were randomized in 1:1:1 ratio to either Conventional Diet, Mediterranean diet (MD)-high meal frequency, and MD-physical activity groups. Each intervention aimed at reducing caloric intake by 25%-30% of baseline intake and increase energy expenditure by 400 kcal/70 kg. Patients attended regular visits and were followed-up for 6 months. Increased albuminuria was present in 13.3% of patients, while 32.8% showed hyperfiltration. UACR reduction was associated with higher levels of UACR at baseline but not with changes in liver fat. eGFR decreased in patients presenting hyperfiltration at baseline and was associated with reduction in liver fat and insulin resistance, as well as with increase in energy expenditure (R2 = 0.248, p = 0.006). No significant differences were observed between the three treatment groups. In patients with NAFLD and MetS, energy expenditure significantly reduced hepatic fat accumulation and insulin resistance, which reduced glomerular hyperfiltration. Increased albuminuria was reduced, but it was not associated with reduced liver fat.

Keywords: albumin-to-creatinine ratio; caloric restriction; glomerular hyperfiltration; increased energy expenditure; non-alcoholic fatty liver disease.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(A): Changes in urinary albumin-to-creatine ratio (UACR) between baseline and 6 months according to UACR baseline status. (B): Changes in estimated glomerular filtration rate (eGFR) between baseline and 6 months according to eGFR baseline status.
Figure 2
Figure 2
(A): Number or patients with increased albuminuria at baseline and 6 months. (B): Number of patients with hyperfiltration at baseline and 6 months.
See this image and copyright information in PMC

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