Yanchuan Li

Lean-non-alcoholic fatty liver disease increases risk for metabolic disorders in a normal weight Chinese population

AIM To study the prevalence and clinical biochemical, blood cell and metabolic features of lean-non-alcoholic fatty liver disease (lean-NAFLD) and its association with other diseases. METHODS Demographic, biochemical and blood examinations were conducted in all the subjects in this study. We classified the subjects into four groups according to their weight and NAFLD status: lean-control, lean-NAFLD [body mass index (BMI) < 24 kg/m(2)], overweight-obese control and overweight-obese NAFLD. One-way analysis of variance (ANOVA) was used to compare the means of continuous variables (age, BMI, blood pressure, glucose, lipid, insulin, liver enzymes and blood cell counts) and the χ (2) test was used to compare the differences in frequency of categorical variables (sex, education, physical activity, smoking, alcohol consumption and prevalence of hypertension, hyperlipidemia, diabetes, metabolic syndrome central obesity and obesity). Both univariate and multivariate logistic regression models were adopted to calculate odds ratios (ORs) and predict hyperlipidemia, hypertension, diabetes and metabolic syndrome when we respectively set all controls, lean-control and overweight-obese-control as references. In multivariate logistic regression models, we adjusted potential confounding factors, including age, sex, smoking, alcohol consumption and physical activity. RESULTS The prevalence of NAFLD was very high in China. NAFLD patients were older, had a higher BMI, waist circumference, blood pressure, fasting blood glucose, insulin, blood lipid, liver enzymes and uric acid than the controls. Although lean-NAFLD patients had lower BMI and waist circumstance, they had significantly higher visceral adiposity index than overweight-obese controls. Lean-NAFLD patients had comparable triglyceride, cholesterin and low-density lipoprotein cholesterin to overweight-obese NAFLD patients. In blood cell examination, both lean and overweight-obese NAFLD was companied by higher white blood cell count, red blood cell count, hemoglobin and hematocrit value. All NAFLD patients were at risk of hyperlipidemia, hypertension, diabetes and metabolic syndrome (MetS). Lean-NAFLD was more strongly associated with diabetes (OR = 2.47, 95%CI: 1.14-5.35), hypertension (OR = 1.72, 95%CI: 1.00-2.96) and MetS (OR = 3.19, 95%CI: 1.17-4.05) than overweight-obese-NAFLD (only OR for MetS was meaningful: OR = 1.89, 95%CI: 1.29-2.77). NAFLD patients were more likely to have central obesity (OR = 1.97, 95%CI: 1.38-2.80), especially in lean groups (OR = 2.17, 95%CI: 1.17-4.05). CONCLUSION Lean-NAFLD has unique results in demographic, biochemical and blood examinations, and adds significant risk for diabetes, hypertension and MetS in lean individuals.

Effects of tea or tea extract on metabolic profiles in patients with type 2 diabetes mellitus: a meta‐analysis of ten randomized controlled trials

As consumption of tea has been confirmed as a protective factor for type 2 diabetes mellitus (T2DM), it would be interesting to know if T2DM patients could benefit from tea. Because of small sample sizes and inconsistent results of previous studies, we performed this meta‐analysis to reevaluate the effects of tea or tea extract on all available outcomes in patients with T2DM. We systematically searched electronic databases of PubMed, Cochrane Library and EMBASE to identify randomized controlled trials of tea in T2DM patients up to January 2015. Weight mean differences for the changes in all outcomes were pooled by Review Manager 5.2 (Cochrane Collaboration, Oxford, England). A total of ten trials including 608 subjects were identified. The meta‐analysis found that tea could alleviate the decrease of fasting blood insulin [1.30 U/L, 95% CI (0.36, 2.24)], and reduced waist circumference only in more than 8‐week intervention [−2.70 cm, 95% CI (−4.72, −0.69)], whereas there were no statistically significant differences with regard to homeostasis model of insulin resistance 0.38 (−0.18, 0.95), fasting blood glucose −0.05 mmol/L (−0.51, 0.40), low density lipoprotein‐cholesterol 0.07 mmol/L (−0.15, 0.29), high density lipoprotein‐cholesterol 0.01 mmol/L (−0.08, 0.09), body mass index −0.15 kg/m2 (−0.50, 0.21), SBP 0.35 mmHg (−3.54, 4.24), DBP −1.02 mmHg (−3.53, 1.48), triglycerides −0.11 mmol/L (−0.28, 0.05) and fasting cholesterol −0.05 mmol/L (−0.20, 0.11) in patients with T2DM, and leptin, ADPN, CRE and UA were also non‐significant. The intervention of tea or tea extraction could maintain a stable fasting blood insulin and reduce waist circumference in the T2DM patients; however, the effects on other outcomes were not significant. Copyright

Histidine supplementation alleviates inflammation in the adipose tissue of high-fat diet-induced obese rats via the NF-κB- and PPARγ-involved pathways.

Obesity is considered to be accompanied by a chronic low-grade inflammatory state that contributes to the occurrence of many chronic diseases. Our previous study has demonstrated that histidine supplementation significantly ameliorates inflammation and oxidative stress in obese women. However, the in vivo potential mechanisms are not known. The present study was conducted to investigate the mechanisms underlying the effects of histidine on inflammation in a high-fat diet (HFD)-induced female obese rat model. An obese model was established in female Sprague-Dawley rats by HFD feeding for 8 weeks and followed by histidine supplementation for another 4 weeks. The results revealed that HFD-increased body weight and HFD-lowered serum histidine concentrations were significantly reversed by histidine supplementation (P< 0·05). In addition, the serum concentrations of TNF-α, IL-6, C-reactive protein (CRP) and malondialdehyde were significantly reduced and those of superoxide dismutase (SOD) were significantly increased by histidine supplementation when compared with those in obese rats (P< 0·05). Correspondingly, the mRNA expressions of TNF-α, IL-6 and CRP in the adipose tissue were significantly down-regulated and that of CuZnSOD was significantly up-regulated by histidine supplementation (P< 0·05). Histidine supplementation significantly reduced the HFD-induced translocation of NF-κB p65 into the nucleus (P= 0·032) by reducing the phosphorylation of the inhibitor of κBα in the adipose tissue. The results also revealed that the expression of adiponectin was markedly increased both in the serum and in the adipose tissue after histidine supplementation, accompanied by the activation of PPARγ (P= 0·021). These findings indicate that histidine is an effective candidate for ameliorating inflammation and oxidative stress in obese individuals via the NF-κB- and PPARγ-involved pathways.

The Ratio of Dietary Branched-Chain Amino Acids is Associated with a Lower Prevalence of Obesity in Young Northern Chinese Adults: An Internet-Based Cross-Sectional Study

This study aims to examine the association between the ratio of dietary branched chain amino acids (BCAA) and risk of obesity among young northern Chinese adults. A total of 948 randomly recruited participants were asked to finish our internet-based dietary questionnaire for the Chinese (IDQC). Associations between dietary BCAA ratio and prevalence of overweight/obesity and abdominal obesity were analyzed. Furthermore, 90 subjects were randomly selected to explore the possible mechanism. Dietary BCAA ratio in obese participants was significantly lower than non-obese participants. We found negative correlations between the ratio of dietary BCAA and body mass index (BMI) (r = −0.197, p < 0.001) or waist circumference (r = −0.187, p < 0.001). Compared with those in the first quartile, the multivariable-adjusted OR (95% CI) of the 3rd and 4th quartiles of dietary BCAA ratio for overweight/obesity were 0.508 (0.265–0.972) and 0.389 (0.193–0.783), respectively (all p < 0.05). After stratification by gender, the significance still existed in the 3rd and 4th quartile in males and the 4th quartile in females. For abdominal obesity, the multivariable-adjusted OR (95% CI) of the 3rd and 4th quartile of dietary BCAA ratio were 0.351 (0.145–0.845) and 0.376 (0.161–0.876), respectively (all p < 0.05). This significance was stronger in males. Further studies indicated that dietary BCAA ratio was inversely associated with 2-h postprandial glucose (2 h-PG) and status of inflammation. In conclusion, a higher ratio of dietary BCAA is inversely associated with prevalence of obesity, postprandial glucose and status of inflammation in young northern Chinese adults.

Abnormal circulating amino acid profiles in multiple metabolic disorders

AIM To evaluate circulating amino acids (AA) profiles in obesity, type 2 diabetes (T2D) and metabolic syndrome (MetS). METHODS Serum AA were profiled among 200; healthy, obese, T2D and MetS subjects matched by sex, age and BMI using ultra-high performance liquid chromatography tandem quadruple mass spectrometry (UPLC-TQ-MS). A meta-analysis, including 47 case-control studies (including the current study) on serum AA in obesity, T2D and MetS searched through October 2016 was conducted to explore the AA differences in obesity, T2D and MetS. RESULTS In comparison with healthy controls, 14 AA (10 increased and 4 decreased) were significantly altered (P<0.05) in all non-healthy subjects. Also, mean differences of valine (obese: 34.13 [27.70, 40.56]µmol/L, P<0.001, T2D: 19.49 [3.31, 35.68]µmol/L, P<0.05, MetS: 29.18 [16.04, 42.33]µmol/L, P<0.001), glutamic acid (obese: 18.62 [11.64, 25.61]µmol/L, P<0.001, T2D: 19.94 [0.28, 39.61]µmol/L, P<0.05, MetS: 12.45 [3.98, 20.91]µmol/L, P<0.001), proline (obese: 16.72 [6.20, 27.24]µmol/L, P<0.001, T2D: 20.72 [15.82, 25.61]µmol/L, P<0.001, MetS: 29.95 [25.18, 34.71]µmol/L, P<0.001) and isoleucine (obese: 11.39 [8.54, 14.24]µmol/L, P<0.001, T2D: 7.37 [1.52, 13.22]µmol/L, P<0.05, MetS: 10.40 [4.90, 15.89]µmol/L, P<0.001) were significantly higher compared to healthy controls. Similarly, mean differences of glycine (obese: -30.99 [-39.69, -22.29]µmol/L, P<0.001, T2D: -30.37 [-41.80, -18.94]µmol/L, P<0.001 and MetS: -35.24 [-39.28, -31.21]µmol/L, P<0.001) were significantly lower compared to healthy controls. CONCLUSION In both the case-control study and meta-analysis, obesity was related to the most circulating AA changes, followed by MetS and T2D. Valine, isoleucine, glutamic acid and proline increased, while Glycine decreased in all metabolic disorders.

The impact of body weight gain on nonalcoholic fatty liver disease and metabolic syndrome during earlier and later adulthood.

AIM Body weight gain adds risk for metabolic disorders and there are different metabolic changes in earlier and later adulthood. However, its impact on non-alcoholic fatty liver disease (NAFLD) was indeterminate. The aim of current study was to evaluate the impact of body weight gain on NAFLD and metabolic syndrome (MetS) during overall, earlier (25-40y) and later (over 40y) adulthood. METHODS 1119 subjects were selected to calculate changes in body weight (ΔBW), body mass index (BMI) (ΔBMI) and bodyweight per year (ΔBW/y) to analysis their impact on NAFLD and MetS in multi-variable regression models, and explored the potential mediators that associated ΔBMI with NAFLD by mediation analysis. RESULTS ΔBMI, ΔBW and ΔBW/y in whole adulthood were all positively associated with NAFLD and MetS. Body weight gain during earlier adulthood was more strongly associated with NAFLD than those during later adulthood. In NAFLD, the ORs of ΔBMI (third trisection), ΔBW and ΔBW/y were 3.86 (2.25, 6.57), 1.05 (1.02, 1.09) and 2.05 (1.29, 3.24) during earlier adulthood, and 1.47 (1.09, 2.02), 1.02 (1.00, 1.06), and 1.04 (.99, 1.13) over 40y. Insulin and HOMA-IR were important intermediates that associated ΔBMI with NAFLD. ΔBMI in earlier adulthood increased higher insulin and insulin resistance (IR) than later adulthood. CONCLUSIONS Body weight gain in adulthood was positively associated with NAFLD and MetS, and the association was stronger in earlier than later adulthood. Insulin and IR were important mediators that contributed to the association.

Relationships of Dietary Histidine and Obesity in Northern Chinese Adults, an Internet-Based Cross-Sectional Study

Our previous studies have demonstrated that histidine supplementation significantly ameliorates inflammation and oxidative stress in obese women and high-fat diet-induced obese rats. However, the effects of dietary histidine on general population are not known. The objective of this Internet-based cross-sectional study was to evaluate the associations between dietary histidine and prevalence of overweight/obesity and abdominal obesity in northern Chinese population. A total of 2376 participants were randomly recruited and asked to finish our Internet-based dietary questionnaire for the Chinese (IDQC). Afterwards, 88 overweight/obese participants were randomly selected to explore the possible mechanism. Compared with healthy controls, dietary histidine was significantly lower in overweight (p < 0.05) and obese (p < 0.01) participants of both sexes. Dietary histidine was inversely associated with body mass index (BMI), waist circumference (WC) and blood pressure in overall population and stronger associations were observed in women and overweight/obese participants. Higher dietary histidine was associated with lower prevalence of overweight/obesity and abdominal obesity, especially in women. Further studies indicated that higher dietary histidine was associated with lower fasting blood glucose (FBG), homeostasis model assessment of insulin resistance (HOMA-IR), 2-h postprandial glucose (2 h-PG), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), interleukin-6 (IL-6), C-reactive protein (CRP), malonaldehyde (MDA) and vaspin and higher glutathione peroxidase (GSH-Px), superoxide dismutase (SOD) and adiponectin of overweight/obese individuals of both sexes. In conclusion, higher dietary histidine is inversely associated with energy intake, status of insulin resistance, inflammation and oxidative stress in overweight/obese participants and lower prevalence of overweight/obesity in northern Chinese adults.

Associations between Dietary Nutrient Intakes and Hepatic Lipid Contents in NAFLD Patients Quantified by 1H-MRS and Dual-Echo MRI

Dietary habits are crucial in the progression of hepatic lipid accumulation and nonalcoholic fatty liver disease (NAFLD). However, there are limited studies using 1H-magnetic resonance spectroscopy (1H-MRS) and dual-echo in-phase and out-phase magnetic resonance spectroscopy imaging (dual-echo MRI) to assess the effects of dietary nutrient intakes on hepatic lipid contents. In the present study, we recruited 36 female adults (NAFLD:control = 19:17) to receive questionnaires and medical examinations, including dietary intakes, anthropometric and biochemical measurements, and 1H-MRS and dual-echo MRI examinations. NAFLD patients were found to consume diets higher in energy, protein, fat, saturated fatty acid (SFA), and polyunsaturated fatty acid (PUFA). Total energy intake was positively associated with hepatic fat fraction (HFF) and intrahepatic lipid (IHL) after adjustment for age and body-mass index (BMI) (HFF: β = 0.24, p = 0.02; IHL: β = 0.38, p = 0.02). Total fat intake was positively associated with HFF and IHL after adjustment for age, BMI and total energy intake (HFF: β = 0.36, p = 0.03; IHL: β = 0.42, p = 0.01). SFA intake was positively associated with HFF and IHL after adjustments (HFF: β = 0.45, p = 0.003; IHL: β = 1.16, p = 0.03). In conclusion, hepatic fat content was associated with high energy, high fat and high SFA intakes, quantified by 1H-MRS and dual-echo MRI in our population. Our findings are useful to provide dietary targets to prevent the hepatic lipid accumulation and NAFLD.

Dietary Sulfur-Containing Amino Acids Are Associated with Higher Prevalence of Overweight/Obesity in Northern Chinese Adults, an Internet-Based Cross-Sectional Study.

Background/aims: Elevation of plasma sulfur-containing amino acids (SAAs) is generally associated with higher body mass index (BMI) and unfavorable lipid profiles. It is not known how dietary SAAs relate to these associations in humans. Methods: A convenient tool named internet-based dietary questionnaire for Chinese (IDQC) was used to estimate dietary SAAs intake. A total of 936 participants were randomly recruited and asked to complete the IDQC. Furthermore, 90 subjects were randomly selected to perform a subgroup study. The associations between dietary SAAs and prevalence of obesity, lipid profiles, and status of insulin resistance (IR), inflammation and oxidative stress were assessed. Results: Dietary total SAAs and cysteine of overweight/obese participants were significantly higher. Dietary total SAAs and cysteine were positively associated with BMI and waist circumference. Higher dietary total SAAs were associated with higher prevalence of overweight/obesity. Higher dietary total SAAs and cysteine also associated with higher serum triglyceride (total cholesterol), low density lipoprotein, fasting blood glucose, 2 h-postprandial glucose, and homeostasis model assessment of IR. In the subgroup study, positive associations between dietary SAAs and inflammation biomarkers were also observed. Conclusions: Dietary SAAs are associated with higher prevalence of overweight/obesity, unfavorable lipid profiles and status of IR, and inflammation.