High protein intake is associated with histological disease activity in patients with NAFLD

  • Overconsumption of carbohydrates and lipids are well known to cause nonalcoholic fatty liver disease (NAFLD), while the role of nutritional protein intake is less clear. In Western diet, meat and other animal products are the main protein source, with varying concentrations of specific amino acids. Whether the amount or composition of protein intake is associated with a higher risk for disease severity has not yet been examined. In this study, we investigated associations of dietary components with histological disease activity by analyzing detailed 14‐day food records in a cohort of 61 patients with biopsy‐proven NAFLD. Furthermore, we used 16S ribosomal RNA gene sequencing to detect associations with different abundances of the gut microbiota with dietary patterns. Patients with definite nonalcoholic steatohepatitis (NAFLD activity score of 5‐8 on liver biopsy) had a significantly higher daily relative intake of protein compared with patients with a NAFLD activity score of 0‐4 (18.0% vs. 15.8% of daily protein‐based calories, P = 0.018). After adjustment for several potentially confounding factors, a higher protein intake (≥17.3% of daily protein‐based calories) remained associated with definite nonalcoholic steatohepatitis, with an odds ratio of 5.09 (95% confidence interval 1.22‐21.25, P = 0.026). This association was driven primarily by serine, glycine, arginine, proline, phenylalanine, and methionine. A higher protein intake correlated with a lower Bacteroides abundance and an altered abundance of several other bacterial taxa. Conclusion: A high protein intake was independently associated with more active and severe histological disease activity in patients with NAFLD. Further studies are needed to investigate the potential harmful role of dietary amino acids on NAFLD, with special attention to meat as their major source.

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Author:Sonja Lang, Anna Martin, Fedja FarowskiORCiDGND, Hilmar WisplinghoffGND, Maria J. G. T. VehreschildORCiDGND, Jinyuan Liu, Marcin KrawczykORCiDGND, Angela NowagORCiDGND, Anne Kretzschmar, Jens Herweg, Bernd Schnabl, Xin M. Tu, Frank LammertORCiDGND, Tobias GoeserGND, Frank TackeORCiDGND, Kathrin Heinzer, Philipp Kasper, Hans‐Michael Steffen, Münevver DemirORCiDGND
Parent Title (English):Hepatology communications
Place of publication:Hoboken, NJ
Document Type:Article
Date of Publication (online):2020/03/26
Date of first Publication:2020/03/26
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2020/12/08
Page Number:15
First Page:681
Last Page:695
Institutes:Medizin / Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung-Nicht kommerziell - Keine Bearbeitung 4.0