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High-protein diet more effectively reduces hepatic fat than low-protein diet despite lower autophagy and FGF21 levels.

Liver international : official journal of the International Association for the Study of the Liver
December 1, 2020
Chenchen Xu et al. (20 authors)
Journal ArticleRandomized Controlled TrialResearch Support, Non-U.S. Gov'tHuman StudyClinical
Study Details

Study Goal

The researchers aimed to compare the effectiveness of low-protein (10E%) and high-protein (30E%) hypocaloric diets in reducing liver fat and reversing NAFLD, and to explore the underlying mechanisms.

Results Summary

The high-protein diet reduced intrahepatic lipid levels by 42.6%, suppressed fat uptake and lipid biosynthesis genes, and lowered inflammatory pathway activity, while the low-protein diet increased autophagy flux and serum FGF21 without significant liver fat reduction.

Population

19 participants with morbid obesity undergoing bariatric surgery.

Effective Dosage

30E% protein (high-protein group), 10E% protein (low-protein group), within a 1500-1600 kcal/day diet.

Duration

3 weeks

Interactions

None mentioned

Extracted Claims (9)
InterventionDirectionEndpointPopulationDosageImpactClaim #
high-protein (HP) diet
decrease
Intrahepatic lipid levels (IHL)
participants with morbid obesity undergoing bariatric surgery
42.6%
decreased
#1
low-protein (LP) diet
no change
Intrahepatic lipid levels (IHL)
participants with morbid obesity undergoing bariatric surgery
no significant change
were not significantly changed
#2
low-protein (LP) diet
increase
Hepatic autophagy flux
participants with morbid obesity undergoing bariatric surgery
66.7%
increased
#3
low-protein (LP) diet
increase
serum fibroblast growth factor 21 (FGF21)
participants with morbid obesity undergoing bariatric surgery
42.2%
increased
#4
high-protein (HP) diet
decrease
Expression levels of fat uptake and lipid biosynthesis genes
-
-
were lower
#5
high-protein (HP) diet
decrease
inflammatory pathways
-
-
revealed lower activity
#6
high-protein (HP) diet
no change
Hepatic mitochondrial activity
-
-
did not increase
#7
high-protein (HP) diet
no change
expression of β-oxidation genes
-
-
did not increase
#8
HP diet
decrease
hepatic fat
-
-
more effectively reduces
#9
Abstract

BACKGROUND AND AIMS: Non-alcoholic fatty liver disease (NAFLD) is becoming increasingly prevalent and nutrition intervention remains the most important therapeutic approach for NAFLD. Our aim was to investigate whether low- (LP) or high-protein (HP) diets are more effective in reducing liver fat and reversing NAFLD and which mechanisms are involved. METHODS: 19 participants with morbid obesity undergoing bariatric surgery were randomized into two hypocaloric (1500-1600 kcal/day) diet groups, a low protein (10E% protein) and a high protein (30E% protein), for three weeks prior to surgery. Intrahepatic lipid levels (IHL) and serum fibroblast growth factor 21 (FGF21) were measured before and after the dietary intervention. Autophagy flux, histology, mitochondrial activity and gene expression analyses were performed in liver samples collected during surgery. RESULTS: IHL levels decreased by 42.6% in the HP group, but were not significantly changed in the LP group despite similar weight loss. Hepatic autophagy flux and serum FGF21 increased by 66.7% and 42.2%, respectively, after 3 weeks in the LP group only. Expression levels of fat uptake and lipid biosynthesis genes were lower in the HP group compared with those in the LP group. RNA-seq analysis revealed lower activity of inflammatory pathways upon HP diet. Hepatic mitochondrial activity and expression of β-oxidation genes did not increase in the HP group. CONCLUSIONS: HP diet more effectively reduces hepatic fat than LP diet despite of lower autophagy and FGF21. Our data suggest that liver fat reduction upon HP diets result primarily from suppression of fat uptake and lipid biosynthesis.

Medical Subject Headings (MeSH)
AutophagyDietDiet, High-FatDiet, High-ProteinDiet, Protein-RestrictedDietary ProteinsFibroblast Growth FactorsHumansLiver
Study Links
Quality Scores
SafetyNot Assessed
Efficacy85/10
Quality75/10
Citation Metrics
Total Citations48
Citations/Year9.6
Relative Citation Ratio3.18
NIH Percentile86.2%
Research Impact Scores
APT Score0.75
Weight Score2.49
Normalized Score0.69
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