담낭 절제술을 시행한 환자에서 혈중 지방산 조성 및 식이패턴과 비알콜성 지방간 질환의 위험성과의 연관성

Abstract

식사패턴이 비 알코올성 지방간과 관련이 있는 것으로 보고되고 있지만, 비 알코올성 지방간의 위험이 높은 담석증환자에서 식이패턴과 비 알코올성 지방간 위험과 식이패턴과의 연관성은 연구된 바가 없다. 따라서 본 연구는 담낭절제술을 받은 환자에서 건강한 식사패턴이 비 알코올성 지방간 발병의 위험을 낮출 것이라는 가설을 검증하기 위해 시행되었다. 또한, 비 알코올성 지방간의 위험성과 적혈구 지방산 조성 사이의 관련성을 분석하였다. 본 연구에서는 139명의 환자에게 복강경 담낭절제술을 시행하기 전에 간 초음파 검사를 실시하여 지방간 유무를 검사하였으며, 비 알코올성 지방간 환자가 58명이었다. 반정량적 식품섭취빈도법으로 식이섭취를 조사하였고, 적혈구 내 지방산 조성은 가스 크로마토그래피로 측정하였다. 잡곡, 콩과 식물, 생선, 채소 및 과일을 섭취하는 건강한 식사패턴이 비 알코올성 지방간의 위험과 음의 상관성을 보였으며, 정제된 곡물, 육류, 가공된 고기 및 튀김류를 섭취하는 건강하지 않은 식사패턴은 비 알코올성 지방간의 위험과 양의 상관성을 보였다. 비 알코올성 지방간 환자는 총 지방, 동물성 지방과 육류의 섭취가 지방간이 없는 환자보다 유의하게 높았으나, 비타민 A, β-카로틴, 비타민 E, 생선 및 채소류의 섭취는 유의하게 낮았다. 총 지방, 동물성 지방과 육류의 섭취는 비 알코올성 지방간의 위험과 양의 상관관계가 있었으나, 비타민 A, β-카로틴, 비타민 E, 생선 및 채소류의 섭취는 지방간의 위험과 음의 상관관계가 있었다. 또한 비 알코올성 지방간 환자에서 적혈구 16:0, 총 18:2t, 포화 지방산 및 트랜스 지방산이 유의하게 높았으나, 오메가-3 불포화 지방산은 유의하게 낮았고, 이들 지방산은 비 알코올성 지방간의 위험과 각각 양의 상관관계와 음의 상관관계가 있었다. 본 연구에서 복강경 담낭절제술을 받은 환자에서 건강한 식사패턴이 비 알코올성 지방간의 위험성과 음의 상관성을 보여, 지방간의 위험이 높은 담석증 환자에서 비 알코올성 지방간을 예방하기 위해 잡곡, 콩과 식물, 생선, 채소 및 과일을 섭취가 중요하다는 것을 제안하였다.| Non-alcoholic fatty liver disease (NAFLD) has been shown to associate with healthy dietary pattern, but there was no study reporting the association between diet and the risk of NAFLD in patients with gallstone disease who have high risk patients of NAFLD. The present study was investigated the hypothesis that risk of NAFLD was associated with healthy dietary pattern in patients underwent cholecystectomy. Additionally, the association between the risk of NAFLD and erythrocyte fatty acid composition was determined as a marker for diet. In 139 patients, liver ultrasonography was performed to determine the presence of NAFLD before laparoscopic cholecystectomy, dietary intake was assessed by semi-quantitative food frequency questionnaire, and erythrocyte fatty acid composition was measured by GC. The risk of NAFLD was negatively associated with two healthy dietary pattern consuming whole grain, legumes or consuming fish, vegetable and fruit, while positively associated with unhealthy dietary pattern consuming refined grain, meat, processed meat and fried foods. Consistently, intake of lipid, animal fat and meat was positively, but intake of vitamin A, β-carotene, vitamin E, fish and vegetable was negatively associated with the risk of NAFLD. Additionally, the patients with NAFLD (n=58) had significantly higher levels of 16:0, total 18:2t, SFA and total trans-fat, while lower n-3 polyunsaturated fatty acids than those without NAFLD (n=81). In conclusion, the present study was the first report showing the negative association between risk of NAFLD and healthy dietary pattern in patients underwent cholecystectomy, suggesting the importance of diet on the risk of NAFLD in patient with gallstone disease.; Non-alcoholic fatty liver disease (NAFLD) has been shown to associate with healthy dietary pattern, but there was no study reporting the association between diet and the risk of NAFLD in patients with gallstone disease who have high risk patients of NAFLD. The present study was investigated the hypothesis that risk of NAFLD was associated with healthy dietary pattern in patients underwent cholecystectomy. Additionally, the association between the risk of NAFLD and erythrocyte fatty acid composition was determined as a marker for diet. In 139 patients, liver ultrasonography was performed to determine the presence of NAFLD before laparoscopic cholecystectomy, dietary intake was assessed by semi-quantitative food frequency questionnaire, and erythrocyte fatty acid composition was measured by GC. The risk of NAFLD was negatively associated with two healthy dietary pattern consuming whole grain, legumes or consuming fish, vegetable and fruit, while positively associated with unhealthy dietary pattern consuming refined grain, meat, processed meat and fried foods. Consistently, intake of lipid, animal fat and meat was positively, but intake of vitamin A, β-carotene, vitamin E, fish and vegetable was negatively associated with the risk of NAFLD. Additionally, the patients with NAFLD (n=58) had significantly higher levels of 16:0, total 18:2t, SFA and total trans-fat, while lower n-3 polyunsaturated fatty acids than those without NAFLD (n=81). In conclusion, the present study was the first report showing the negative association between risk of NAFLD and healthy dietary pattern in patients underwent cholecystectomy, suggesting the importance of diet on the risk of NAFLD in patient with gallstone disease.