Publication: Non-alkolik yağlı karaciğer hastalığında PNPLA3 rs738409 gen polimorfizminin, diyet müdahalesi ile etkileşiminin incelenmesi
Abstract
Non-alkolik yağlı karaciğer hastalığında PNPLA3 rs738409 gen polimorfizminin, diyet müdahalesi ile etkileşiminin incelenmesi Amaç: Tıbbi beslenme tedavisi, non-alkolik yağlı karaciğer hastalığı (NAFLD) yönetiminin temel taşıdır ve patatin benzeri fosfolipaz alanı içeren protein 3 (PNPLA3), NAFLD'nin en önemli genetik belirleyicilerinden biridir. Bu çalışmanın amacı PNPLA3 gen polimorfizminin NAFLD hastalarında beslenme müdahalesine verilen yanıtlar üzerindeki etkisini araştırmaktır. Gereç ve Yöntem: Bu çalışma NAFLD hastalarında12 haftalık beslenme müdahalesi üzerine yapılan randomize kontrollü bir çalışmanın post-hoc analizidir. Hastalar diyet ve kontrol gruplarına eşit olarak randomize edilmiştir ve 65 katılımcı ile çalışma tamamlanmıştır. PNPLA3 rs738409 gen polimorfizmi (C>G), konvansiyonel ultrasonografi ile ölçülen karaciğer yağlanma derecesi, biyokimyasal parametreler ve antropometrik ölçümlerdeki değişikliklerle ilişkilendirilmiştir. Bulgular: Genotipe göre diyet müdahalesine verilen yanıtlar istatiksel olarak anlamlı farklılık göstermiştir ve müdahale ile karaciğer yağlanma derecesine en belirgin etkinin, CG/ GG-diyet grubunda olduğu saptanmıştır (p<0,001). Diyet müdahalesi G alel taşıyıcılığı AST ve GGT değerlerinde iyileşme sağlarken (p=0,011; p=0,030), genel olarak tüm diyet alt gruplarında TG ve ALT değerlerinde anlamlı düzelmeler gözlemlenmiştir (p<0,05). Müdahale öncesi-sonrası antropometrik ölçümler karşılaştırıldığında beden kütle indeksi (BKİ), vücut ağırlığı, vücut yağ kütlesi ve yüzdesi, bel ve kalça çevresi, bel/ kalça ve bel/ boy oranı tüm diyet alt gruplarında anlamlı olarak azalmıştır (p<0,05). CC-diyet grubunda vücut kas kütlesi anlamlı olarak düşüş gösterirken (p=0,005) CG/ GG-diyet grubunda bu düşüş anlamlı bulunmamıştır (p>0,05). Sonuç: PNPLA3 G alel taşıyıcılığı, NAFLD’li hastalarda yapılan 12 haftalık beslenme müdahalesine verilen klinik yanıtı olumlu etkilemiştir.
Investigation of the interaction between PNPLA3 rs738409 gene polymorphism and dietary intervention in non‐alcoholic fatty liver disease Objective: Medical nutrition therapy is the cornerstone of managing non‐alcoholic fatty liver disease (NAFLD), and Patatin-like phospholipase domain-containing protein 3 (PNPLA3) represents one of the most significant genetic determinants of NAFLD. This study aimed to investigate the effect of PNPLA3 gene polymorphism on responses to dietary intervention in patients with NAFLD. Materials and Methods: This investigation constitutes a post‐hoc analysis of a 12‐week randomized, controlled dietary intervention trial conducted in NAFLD patients. Sixty‐five participants were equally randomized into intervention and control groups. The PNPLA3 rs738409 genotype (C>G) was correlated with changes in hepatic steatosis degree (assessed by ultrasonography), biochemical and anthropometric parameters. Results: Responses to dietary intervention according to genotype showed statistically significant differences, and the most significant effect of intervention on the degree of liver steatosis was found in the CG/ GG-diet group (p<0.001). Dietary intervention improved AST and GGT values in G allele carriers (p=0.011; p=0.030), while significant improvements were observed in TG and ALT values in all diet subgroups in general (p<0.05). When anthropometric measurements were compared before and after the intervention, body mass index (BMI), body weight, body fat mass and percentage, waist and hip circumference, waist/ hip and waist/ height ratio decreased significantly in all diet subgroups (p<0.05). While body muscle mass decreased significantly in the CC-diet group (p=0.005), this decrease was not found significant in the CG/ GG-diet group (p>0.05). Conclusion: PNPLA3 G allele carriers positively affected the clinical response to the 12-week nutritional intervention in patients with NAFLD.
Investigation of the interaction between PNPLA3 rs738409 gene polymorphism and dietary intervention in non‐alcoholic fatty liver disease Objective: Medical nutrition therapy is the cornerstone of managing non‐alcoholic fatty liver disease (NAFLD), and Patatin-like phospholipase domain-containing protein 3 (PNPLA3) represents one of the most significant genetic determinants of NAFLD. This study aimed to investigate the effect of PNPLA3 gene polymorphism on responses to dietary intervention in patients with NAFLD. Materials and Methods: This investigation constitutes a post‐hoc analysis of a 12‐week randomized, controlled dietary intervention trial conducted in NAFLD patients. Sixty‐five participants were equally randomized into intervention and control groups. The PNPLA3 rs738409 genotype (C>G) was correlated with changes in hepatic steatosis degree (assessed by ultrasonography), biochemical and anthropometric parameters. Results: Responses to dietary intervention according to genotype showed statistically significant differences, and the most significant effect of intervention on the degree of liver steatosis was found in the CG/ GG-diet group (p<0.001). Dietary intervention improved AST and GGT values in G allele carriers (p=0.011; p=0.030), while significant improvements were observed in TG and ALT values in all diet subgroups in general (p<0.05). When anthropometric measurements were compared before and after the intervention, body mass index (BMI), body weight, body fat mass and percentage, waist and hip circumference, waist/ hip and waist/ height ratio decreased significantly in all diet subgroups (p<0.05). While body muscle mass decreased significantly in the CC-diet group (p=0.005), this decrease was not found significant in the CG/ GG-diet group (p>0.05). Conclusion: PNPLA3 G allele carriers positively affected the clinical response to the 12-week nutritional intervention in patients with NAFLD.