Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jun 21;13(7):754.
doi: 10.3390/antiox13070754.

Effects of a Two-Year Lifestyle Intervention on Intrahepatic Fat Reduction and Renal Health: Mitigation of Inflammation and Oxidative Stress, a Randomized Trial

Maria Magdalena Quetglas-Llabrés  1   2   3 , Margalida Monserrat-Mesquida  1   2   3 , Cristina Bouzas  1   2   3 , Silvia García  1   2   3 , David Mateos  1   2   3 , Miguel Casares  4 , Cristina Gómez  2   3   5 , Lucía Ugarriza  1   2   3   6 , Josep A Tur  1   2   3 , Antoni Sureda  1   2   3
Affiliations

Effects of a Two-Year Lifestyle Intervention on Intrahepatic Fat Reduction and Renal Health: Mitigation of Inflammation and Oxidative Stress, a Randomized Trial

Maria Magdalena Quetglas-Llabrés et al. Antioxidants (Basel). .

Abstract

Metabolic-associated fatty liver disease (MAFLD) is the most common chronic liver disease observed in clinical practice worldwide. This disorder has been independently associated with an increased risk of developing chronic kidney disease (CKD). The aim of this study was to evaluate whether a 2-year intervention based on a Mediterranean diet (MedDiet) and physical activity focussed on reducing intrahepatic fat contents (IFC) was associated with a decreased risk of CKD. Forty adults (50% women) residing in Mallorca, aged 48 to 60 years, diagnosed with MAFLD were recruited. Participants were divided into two groups based on whether they improved IFC measured by nuclear magnetic resonance. Anthropometric and clinical parameters improved in responders, including reduced weight, body mass index (BMI), and waist circumference. Only responders showed improvements in lipid profile and liver enzymes. Haematological parameters showed favourable changes in both groups. Oxidative stress and inflammatory biomarkers differed between groups. Responders had lower plasma interleukine-18 (IL-18) levels, but higher erythrocyte malonaldehyde (MDA) levels. Non-responders showed increased erythrocyte catalase and superoxide dismutase activity. After 2 years, non-responders had higher serum creatinine, Modification of Diet in Renal Disease (MDRD), and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) levels, while responders showed reductions in these parameters together with uric acid and urine albumin-to-creatinine ratio (UACR). Positive correlations were found between changes in IFC and kidney injury biomarkers, including MDRD and serum creatinine levels. In conclusion, a healthy diet based on the Mediterranean dietary pattern and lifestyle promotes significant improvements in parameters related to cardiovascular, hepatic, and renal health.

Keywords: MAFLD; fatty liver; inflammation; intervention; intrahepatic fat content; lifestyle change; oxidative state; renal dysfunction.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flow diagram of the study.
Figure 2
Figure 2
(A) Intrahepatic fat contents (IFCs) expressed as percentage of fat in the liver and (B) liver stiffness expressed as kPa at baseline and 2 years stratified by improvement of IFC group. Results are presented as mean ± SD. Two-way analysis of co-variance (ANCOVA) after adjustments by age and sex. * Difference in means between participants over time (baseline and 2 years). # Difference in means between groups (IFC responders and IFC non-responders). Data points are significant when p < 0.05.
Figure 3
Figure 3
(A) IL-18 levels in plasma and (B) NGAL/Cr, (C) CysC/Cr, and (D) α1m/Cr levels in urine classified according to improvement of IFC group after 2-year intervention. Results are presented as mean ± SD. Two-way analysis of co-variance (ANCOVA) after adjustments by age and sex. * Difference in means between participants over time (baseline and 2 years). # Difference in means between groups (IFC responders and IFC non-responders). Data points are significant when p < 0.05.
See this image and copyright information in PMC

References

    1. Han S.K., Baik S.K., Kim M.Y. Non-alcoholic fatty liver disease: Definition and subtypes. Clin. Mol. Hepatol. 2023;29:S5–S16. doi: 10.3350/cmh.2022.0424. - DOI - PMC - PubMed
    1. Eslam M., Newsome P.N., Sarin S.K., Anstee Q.M., Targher G., Romero-Gomez M., Zelber-Sagi S., Wai-Sun Wong V., Dufour J.-F., Schattenberg J.M., et al. A new definition for metabolic dysfunction-associated fatty liver disease: An international expert consensus statement. J. Hepatol. 2020;73:202–209. doi: 10.1016/j.jhep.2020.03.039. - DOI - PubMed
    1. Wong V.W.S., Ekstedt M., Wong G.L.H., Hagström H. Changing epidemiology, global trends and implications for outcomes of NAFLD. J. Hepatol. 2023;79:842–852. doi: 10.1016/j.jhep.2023.04.036. - DOI - PubMed
    1. Monserrat-Mesquida M., Quetglas-Llabrés M., Abbate M., Montemayor S., Mascaró C.M., Casares M., Tejada S., Abete I., Zulet M.A., Tur J.A., et al. Oxidative stress and pro-inflammatory status in patients with non-alcoholic fatty liver disease. Antioxidants. 2020;9:759. doi: 10.3390/antiox9080759. - DOI - PMC - PubMed
    1. Masarone M., Rosato V., Dallio M., Gravina A.G., Aglitti A., Loguercio C., Federico A., Persico M. Role of Oxidative Stress in Pathophysiology of Nonalcoholic Fatty Liver Disease. Oxidative Med. Cell. Longev. 2018;2018:9547613. doi: 10.1155/2018/9547613. - DOI - PMC - PubMed

LinkOut - more resources