Dietary Habits, Biochemistry And LTB4 In Patients With Non-alcoholic Fatty Liver Disease

BackgroundNonalcoholic fatty liver disease(NAFLD)is a clinical pathological syndrome characterized by fat deposition and steatosis in liver,excluding alcoholic or other factors.With an increasing prevalence,NAFLD has surpassed the viral hepatitis to become the first chronic liver disease in China.In the United States,studies have shown that the rate of hepatic cellular cancer(HCC)caused by NAFLD is much higher than 10 years before,thus more attention should be paid to NAFLD.With the improvement of living standards,the citizens’ diet and lifestyle have changed tremendously.The intake of lipids and calories has increased significantly,exceeding the metabolic requirements of the body,and lipids accumulated in the body,then the metabolic environment changed,which led to a chronic low-grade inflammation following by multiple metabolic diseases and finally caused the occurrence of NAFLD.A large sample(including 1950 cases)of epidemiology of TCM syndromes in patients with NAFLD showed that there were 5 types of syndromes,and in this 5 types,patients with damp heat syndrome are the most common(31.5%-50.0%).Therefore,this study uses patients with the syndrome as the main research object.Therefore,this study focus on patients with this syndrome,aiming to explore the relationship between diet and NAFLD disease,to find the factors that may be related to the onset of this type of disease.In the early stages of NAFLD treatment,diet and exercise adjustment is one of the most important treatment methods.However,there is no specific dietary adjustment guidance so far.This study focuses on the investigation and analysis of dietary habits and provides basis for dietary guidance for this type of patients.PurposeInvestigate the clinical features and dietary habits of dampness heat accumulation syndrome of NAFLD patients.Analyze the biochemical indicators and inflammation factors to find the relationship between the diseases.And explore the factors that may be related to the onset of this type of dampness heat accumulation syndrome NAFLD,and provide evidence of the dietary guidance for this kind of patients.MethodWe recruited patients and healthy volunteers from September 2017 to February 2018 in the health examination center of the China-Japan Friendship Hospital.Patients diagnosed as NAFLD who also conformed to the TCM dampness heat accumulation syndrome were recruited.Questionnaire surveys were conducted on the participants.Patients’ clinical data and eating habit were collected.Biochemical indicators and inflammation factors were tested.SPSS 17.0 software was used for statistical analysis of data.Measured data which obey the normal distribution use mean ± standard deviation(X±S).While measured data which does not meet the normal distribution using the median(Q1,Q3).Count data using frequency representation.Chi-square test,Fisher’s exact test,two independent sample t-tests,non-parametric test were used.And take P<0.05 for statistical differences,P<0.01 for significant statistical differences.Result1.General InformationA total of 88 cases of effective data were collected.There were 59 cases in the NAFLD group and 29 cases in the healthy group.In the NAFLD group,38(64.4%)were males and 21(35.6%)were females,with a gender ratio of 1.81:1.The NAFLD group had a minimum age of 24 and a maximum age of 60 with an average of 34(29,43).In terms of age structure,theage of NAFLD group is mostly distributed in 30-39,accounting for 33.9%.Among them,women aged 30-39 were the most,accounting for 33.3%of the female patients,males were 30-39 years old and accounting for 34.2%.There was a significant difference in gender and age between the NAFLD group and the healthy group.2.Body Mass Index(BMI)As for the BMI of NAFLD group,8 cases were in the normal range,and 51 cases were higher than the normal range,of which 19 were overweight and 32 were obesity.There was a significant difference in BMI between the NAFLD group and the healthy group(P<0.01).The BMI in the NAFLD group was higher than that in the healthy group.3.Waist circumference and waist to hip ratioWe collected 57 cases.Male’s waist circumference included 3 cases of normal,3 cases of central pre-obesity,31 cases of central obesity.While female’s waist circumference had 1 case of normal,1 case of central pre-obesity,and 18 cases of central obesity.There was a significant difference in waist circumference between the NAFLD group and the healthy control group(P<0.01),and the level of NAFLD group was significantly higher than the healthy group.The waist-to-hip ratio(WHR)was calculated.In the NAFLD group,there were 57 cases.In the males,18 cases were in the normal range,while 19 cases were abdominal obesity.In the females,5 cases were normal,and 15 cases were abdominal obesity.There was a significant difference in WHR between the NAFLD group and the healthy group both in the two gender(P<0.01).The NAFLD group was significantly higher than the healthy group.4.Biochemical indicatorsThere were differences in the levels of aspartate aminotransferase(AST),alanine aminotransferase(ALT),urea,creatinine(CR),uric acid(UA),blood glucose(GLU),cholesterol(CHO),and triglyceride(TG)between the NAFLD group and the healthy group(P<0.05).The indexes of NAFLD group were higher than the healthy group.5.Inflammation factorsIn terms of leukotriene B4(LTB4),there was a significant difference between the NAFLD group and the healthy group(P<0.01).The LTB4 level in the NAFLD group was higher than that in the healthy group.There was no significant difference in serum levels of Interleukin-8(IL-8),Interleukin-10(IL-10)and Cyclo-oxygen-ase-2(COX-2)between the two groups(P>0.05).6.Eating habitsCompared with the healthy group,the patients in NAFLD group had a significant difference in dietary taste preference and dietary collocation(P<0.01).The NAFLD group was significantly higher than the healthy group in the consumption of fried foods and meat(P<0.01).In terms of vegetables and fruits,the NAFLD group was significantly lower than the healthy group(P<0.05).There was no significant difference in regular diet,dried fired food,pepper,spicy food,eggs,and grains(P>0.05).Conclusion1.Most patients with dampness heat accumulation syndrome patients are obesity or abdominal obesity.2.Excessive intake of fried and meat foods may be one of the causes of damp heat accumulation syndrome NAFLD,but it needs further confirmation in case-control studies.3.The level of serum LTB4 was elevated in patients with damp-heat accumulation syndrome NAFLD.More than 30%of patients had elevated serum lipids and uric acid levels and abnormal liver function.