Publication: Estrategias terapéuticas frente a la esteatosis hepática no alcohólica: tratamiento dietético
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2017-06
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Abstract
El HGNA es una patología multifactorial, pues el SM causado por RI, obesidad, DM2 e hiperlipemia, favorece la progresión a EHNA, fibrosis y HCC. La incidencia creciente de la enfermedad se debe a los malos hábitos de vida que se han adquirido en las últimas décadas. Por tanto, el tratamiento no farmacológico se centrará en un aumento de la actividad física junto con la ingesta de una dieta saludable que favorezca la pérdida de peso. Se optará por dietas bajas en carbohidratos, en lípidos y con una notable presencia de proteínas y fibra. Consiguiendo reducir así la RI, la lipogénesis de novo, la inflamación hepática y se mejora el perfil y metabolismo lipídico al incidir sobre la PPARα, SREBP-1, ChREBP y LRX. La deficiencia de micronutrientes como el zinc, ácido fólico, y vitamina D pueden favorecer el HGNA; por lo que será importante la ingesta de una dieta saludable y completa. La dieta mediterránea será ideal por sus buenos resultados frente al desarrollo de esta y otras patologías. En esta se pueden incluir algunos alimentos como el café, los frutos secos, el aguacate y el aceite de oliva, cuyos efectos antioxidantes, antifibróticos y antiinflamatorios, les confiere de propiedades hepatoprotectoras. Se precisan de más estudios que confirmen de su acción en el HGNA para indicarlos como tratamiento principal.
NAFLD is a multifactorial pathology; since the metabolic syndrome (MS), caused by insulin resistance (IR), obesity, Diabetes Mellitus 2 (DM2) and hyperlipidemia, favours its progression to NASH, fibrosis and HCC. The increasing prevalence of this disease is due to unhealthy lifestyles acquired over the last decades. The non pharmacological treatment will therefore focus on increasing physical activity together with a healthy diet that will lead to weight loss. Low carbohydrate and lipid diets with high proteins and fiber content will be chosen. Thereby lowering IR, de novo lipogenesis, hepatic inflammation as well as improving the lipid profile and metabolism as a result of its influence over PPARα, SREBP-1, ChREBP and LRX. Micronutrient deficiency of zinc, folic acid and vitamin D could favour NAFLD; hence the importance of the ingestion of a complete and healthy diet. The Mediterranean Diet is ideal as it provides good results against NAFLD and other pathologies. Foods such as coffee, nuts, avocado and olive oil can be included, seeing that their antioxidant, anti-fibrotic and anti-inflammatory effects provide them with protective hepatic properties. More studies are needed to prove their beneficial effects on NALFD so they can be used as the main treatment.
NAFLD is a multifactorial pathology; since the metabolic syndrome (MS), caused by insulin resistance (IR), obesity, Diabetes Mellitus 2 (DM2) and hyperlipidemia, favours its progression to NASH, fibrosis and HCC. The increasing prevalence of this disease is due to unhealthy lifestyles acquired over the last decades. The non pharmacological treatment will therefore focus on increasing physical activity together with a healthy diet that will lead to weight loss. Low carbohydrate and lipid diets with high proteins and fiber content will be chosen. Thereby lowering IR, de novo lipogenesis, hepatic inflammation as well as improving the lipid profile and metabolism as a result of its influence over PPARα, SREBP-1, ChREBP and LRX. Micronutrient deficiency of zinc, folic acid and vitamin D could favour NAFLD; hence the importance of the ingestion of a complete and healthy diet. The Mediterranean Diet is ideal as it provides good results against NAFLD and other pathologies. Foods such as coffee, nuts, avocado and olive oil can be included, seeing that their antioxidant, anti-fibrotic and anti-inflammatory effects provide them with protective hepatic properties. More studies are needed to prove their beneficial effects on NALFD so they can be used as the main treatment.