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      Is dietary glycemic load associated with liver fibrosis in hepatitis C? Translated title: ¿Está asociada la carga glucémica en la dieta con la fibrosis hepática en la hepatitis C?

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          Abstract

          Abstract Introduction: Occidental diet and metabolic profile seems to increase hepatic fibrosis (HF) in patients with chronic hepatitis C virus (HCV) infection, but there is scarce information about the diet components and their role in this setting. Objectives: This study aims to evaluate the dietary intake, metabolic profile, presence of metabolic syndrome (MetS) and cardiovascular risk in patients with chronic HCV infection according to the presence of fibrosis. Methods: Cross-sectional study which 58 patients with HCV infection without active antiviral therapy and non-cirrhotic were assessed. All patients were subjected to clinical, laboratorial and dietary evaluation, and classified according to the METAVIR score. Patients were divided as the presence of hepatic fibrosis. Results: In this sample, fifty-five percent of patients were females, the average age was 51.6 ± 9.7 years, and 79.3% were carriers of HCV genotype 1. Patients with HF presented higher energy, and fat intake as well as higher glycemic load of meals in comparison to those without HF. Patients with HF presented higher systolic and diastolic arterial pressure and higher levels of insulin. Conclusions: In conclusion, patients with HF had higher total daily energy and total fat intakes, and worse metabolic profile, characterized by a higher insulin resistance and blood pressure.

          Translated abstract

          Resumen Introducción: en pacientes infectados crónicamente por el virus de la hepatitis C (VHC), la dieta occidental y el perfil metabólico parecen aumentar la fibrosis hepática (FH), sin embargo existe poca información sobre los componentes de la dieta y su papel en este contexto. Objetivos: evaluar la ingesta dietética, el perfil metabólico, la presencia de síndrome metabólico (SAT) y el riesgo cardiovascular en pacientes con VHC crónico según la presencia de fibrosis. Métodos: estudio transversal en el que se evaluaron 58 pacientes con VHC sin terapia antiviral activa ni cirrótica. Todos los pacientes fueron sometidos a evaluación clínica, de laboratorio y dietética, y fueron clasificados según la puntuación METAVIR. Los pacientes se dividieron según la presencia de FH. Resultados: en esta muestra el 55% de los pacientes eran mujeres, con edad promedio de 51,6 ± 9,7 años, siendo el 79,3% portadores del genotipo 1 del VHC. Los alimentos de los pacientes con FH presentaron una mayor proporción de energía y grasa, así como mayor carga glucémica en comparación con las personas sin FH. Los pacientes con circunferencia de la cintura presentaron mayor presión arterial sistólica y diastólica y mayores niveles de insulina. Conclusión: en conclusión, los pacientes con FH presentaron un consumo mayor de energía y grasas diario total, y peor perfil metabólico, caracterizado por mayor resistencia a la insulina y presión arterial.

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          Most cited references40

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          An algorithm for the grading of activity in chronic hepatitis C. The METAVIR Cooperative Study Group.

          Histological activity reflects the global assessment of basic necroinflammatory lesions and is a criterion of major importance in chronic hepatitis C. The aim of this study was to propose and test the accuracy of a simple algorithm that generates a single activity score based on basic pathological features. A panel of 10 pathologists reviewed 363 chronic hepatitis C liver biopsies and graded the activity of hepatitis according to their own experience (reference activity). Then, a consensual algorithm on the grading of activity was established by the 10 experts in a panel discussion. Finally, stepwise discriminant analysis was performed to define which basic features had been intuitively used in the reference activity (statistical activity). To test the accuracy of the algorithm, concordance between the activity defined by the algorithm and the reference activity was assessed. It was compared with concordance between the activity defined by the statistical model and the reference activity. The algorithm proposed by the panel for the grading of activity included piecemeal necrosis and lobular necrosis. Concordance between reference activity and activity defined by the algorithm was substantial (305 cases, 84%, kappa = .75). Discriminant analysis showed that piecemeal necrosis, lobular necrosis, and portal inflammation were independently used to grade the activity. Concordance between reference activity and activity defined by the statistical model was substantial (300 cases, 83%, kappa = .73), virtually identical to the concordance between reference activity and activity defined by algorithm. This study proposes a simple algorithm for the grading of activity in chronic hepatitis. Its accuracy is as high as that obtained using a statistical approach.
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            International Tables of Glycemic Index and Glycemic Load Values: 2008

            OBJECTIVE—To systematically tabulate published and unpublished sources of reliable glycemic index (GI) values. RESEARCH DESIGN AND METHODS—A literature search identified 205 articles published between 1981 and 2007. Unpublished data were also included where the data quality could be verified. The data were separated into two lists: the first representing more precise data derived from testing healthy subjects and the second primarily from individuals with impaired glucose metabolism. RESULTS—The tables, which are available in the online-only appendix, list the GI of over 2,480 individual food items. Dairy products, legumes, and fruits were found to have a low GI. Breads, breakfast cereals, and rice, including whole grain, were available in both high and low GI versions. The correlation coefficient for 20 staple foods tested in both healthy and diabetic subjects was r = 0.94 (P < 0.001). CONCLUSIONS—These tables improve the quality and quantity of GI data available for research and clinical practice.
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              Causes and metabolic consequences of Fatty liver.

              Type 2 diabetes and cardiovascular disease represent a serious threat to the health of the population worldwide. Although overall adiposity and particularly visceral adiposity are established risk factors for these diseases, in the recent years fatty liver emerged as an additional and independent factor. However, the pathophysiology of fat accumulation in the liver and the cross-talk of fatty liver with other tissues involved in metabolism in humans are not fully understood. Here we discuss the mechanisms involved in the pathogenesis of hepatic fat accumulation, particularly the roles of body fat distribution, nutrition, exercise, genetics, and gene-environment interaction. Furthermore, the effects of fatty liver on glucose and lipid metabolism, specifically via induction of subclinical inflammation and secretion of humoral factors, are highlighted. Finally, new aspects regarding the dissociation of fatty liver and insulin resistance are addressed.
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                Author and article information

                Journal
                nh
                Nutrición Hospitalaria
                Nutr. Hosp.
                Grupo Arán (Madrid, Madrid, Spain )
                0212-1611
                1699-5198
                February 2018
                : 35
                : 1
                : 140-147
                Affiliations
                [2] orgnameHospital de Clínicas de Porto Alegre, UFRGS orgdiv1Centre for Studies in Food and Nutrition (CESAN) Brazil
                [4] orgnameHospital de Clínicas de Porto Alegre, UFRGS orgdiv1Gastroenterology Division Brazil
                [1] Rio Grande do Sul orgnameUniversidade Federal do Rio Grande do Sul orgdiv1School of Medicine Brazil
                [3] orgnameSchool of Medicine, UFRGS orgdiv1Department of Internal Medicine Brazil
                [6] Porto Alegre orgnameHospital de Clínicas de Porto Alegre, UFRGS orgdiv1Nutrition Division Brazil
                [5] orgnameSchool of Medicine, UFRGS orgdiv1Department of Nutrition Brazil
                Article
                S0212-16112018000100140 S0212-1611(18)03500100140
                10.20960/nh.1172
                48ee8bce-8c3e-44ed-a00e-f43aa78d177e

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 04 April 2017
                : 18 September 2017
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 41, Pages: 8
                Product

                SciELO Spain

                Categories
                Original Papers

                Chronic hepatitis C,Nutrition,Liver fibrosis,Glycemic load,Fibrosis hepática,Diet,Dieta,Nutrición,Hepatitis C crónica,Carga glicémica

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