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- Title
Gender Differences in Liver Steatosis and Fibrosis in Overweight and Obese Patients with Metabolic Dysfunction-Associated Steatotic Liver Disease before and after 8 Weeks of Very Low-Calorie Ketogenic Diet.
- Authors
Rinaldi, Roberta; De Nucci, Sara; Donghia, Rossella; Donvito, Rosanna; Cerabino, Nicole; Di Chito, Martina; Penza, Alice; Mongelli, Francesco Pio; Shahini, Endrit; Zappimbulso, Marianna; Pesole, Pasqua Letizia; Coletta, Sergio; Triggiani, Vincenzo; Cozzolongo, Raffaele; Giannelli, Gianluigi; De Pergola, Giovanni
- Abstract
Obesity and metabolic syndrome are linked to steatotic liver disease (SLD), the most common form of chronic liver disease. Lifestyle modifications and dieting are strategies that can prevent metabolic dysfunction-associated steatotic liver disease (MASLD). The very low-calorie ketogenic diet (VLCKD) is a helpful treatment for MASLD and has been recommended for people affected by obesity; we evaluated the effect of gender on steatosis and fibrosis in a cohort of 112 overweight or obese patients undergoing an eight-week treatment with a VLCKD. Differences between the genders in terms of anthropometric measures, body composition, and metabolic indicators were examined before, during, and after the nutritional intervention. At baseline, there were significant differences between men and women in terms of anthropometric parameters, blood pressure, Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), fasting insulin, hepatic markers, and lipid profile. Men had considerably higher levels of liver steatosis (measured by CAP) and liver stiffness (measured by E) under basal conditions than women. After the VLCKD, there were reductions in both genders of controlled attenuation parameter (CAP), body weight, body mass index (BMI), waist circumference, systolic and diastolic blood pressure, insulin resistance, fat mass (FM), free fat mass (FFM), and fasting blood glucose, insulin, glycated hemoglobin (HbA1c), triglycerides, total cholesterol, low-density lipoprotein (LDL) cholesterol, alanine transaminase (ALT), gamma-glutamyl transferase (γGT), and uric acid levels. Only in men, liver stiffness, aspartate aminotransferase (AST), creatinine, and C-reactive protein (CRP) levels significantly decreased. Moreover, men had significantly greater levels of liver steatosis: the male gender featured an increase of 23.96 points of the Fibroscan CAP. Men exhibited higher levels of steatosis and fibrosis than women, and these differences persist despite VLCKD. These gender-specific variations in steatosis and fibrosis levels could be caused by hormonal and metabolic factors, suggesting that different therapeutic strategies might be required depending on the gender.
- Subjects
ITALY; METABOLIC disorders; FATTY liver; KETOGENIC diet; BODY mass index; RESEARCH funding; GLYCOSYLATED hemoglobin; SEX distribution; QUESTIONNAIRES; BODY composition; BODY weight; DESCRIPTIVE statistics; FIBROSIS; LIVER diseases; INSULIN resistance; WAIST circumference; BLOOD sugar; ANTHROPOMETRY; BLOOD pressure; TRIGLYCERIDES; OBESITY; REDUCING diets; FASTING
- Publication
Nutrients, 2024, Vol 16, Issue 10, p1408
- ISSN
2072-6643
- Publication type
Article
- DOI
10.3390/nu16101408