非常低能量的类饮食与地中海饮食对MASLD:在随机试点研究中降低高级肥胖症
Ann M Farrell1, Tonya Paris2, Evelyn B Parr3
1University of Melbourne, Melbourne, Australia; St Vincent's Hospital Melbourne, Department of Gastroenterology, Melbourne, Australia.
JHEP reports : innovation in hepatology
|March 14, 2026
概括
与地中海饮食相比,一个非常低能量的性饮食 (VLED) 显著降低了与代谢功能障碍相关的性肝病 (MASLD) 患者的肝硬化和体重减轻. VLED是MASLD患者超重或肥胖的可访问的第一线治疗方法.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 代谢疾病 代谢疾病
- 饮食干预 饮食干预
背景情况:
- 与代谢功能障碍相关的脂肪性肝病 (MASLD) 在超重或肥胖的人群中越来越普遍.
- 减肥是MASLD的主要治疗策略.
- 对比不同的饮食干预措施对于优化MASLD管理至关重要.
研究的目的:
- 为了比较非常低能量的性饮食 (VLED) 与地中海饮食 (MD) 在治疗MASLD的疗效.
- 评估VLED和MD对肝肥胖症,减肥和肝脏组织学的影响.
- 评估VLED作为MASLD治疗的安全性和可访问性.
主要方法:
- 一项试点随机对照试验,涉及组织学证实MASLD和超重/肥胖 (BMI 27-35 kg/m2) 的成年人.
- 参与者被分配到一个为期12周的VLED (3151 kJ/天) 或MD (8950 kJ/天) 计划,并被监测了24周.
- 从第13周开始,VLED组接受了semaglutide (0.5毫克/周) 来维持体重;主要结局是12周后通过MRI-LFF改变肝硬化症.
主要成果:
- 与MD组相比,VLED组在12周内显示出肝硬化症 (MRI-LFF: -77% vs -14%,p<0.01) 和总体体重减轻 (TBWL: -13% vs -4%,p<0.01) 的显著减少.
- 在24周后,VLED/半黄胺组维持了TBWL (-14%对MD组的-3%).
- 肝脏组织学在两组都得到改善,在VLED组观察到的改善更大 (NAFLD活动得分减少: -2 vs -1,p<0.01).
结论:
- 非常低能量的性饮食在减少肝硬化和促进MASLD患者减肥方面比地中海饮食有效得多.
- 该VLED是可访问的,有效的,应该强烈考虑作为一线治疗超重或肥胖的个人与MASLD.
- 这项研究提供了VLED和MD对MASLD的首次直接比较,突出了VLED的优异结果和临床适用性.
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