دوره 31، شماره 252: هفته دوم آبان ماه 1392:1461-1480

سندرم متابولیک و کبد چرب غیر الکلی: رویکرد تغذیه‌ای در پیشگیری

زمزم پاک نهاد, هادی زراعی بیدگلی

چکیده


مقدمه: سندرم متابولیک مجموعه‌ای از عوامل خطرزای متابولیک است که در یک فرد وجود دارند. این عوامل خطرزا شامل مقاومت به انسولین، فشار خون، اختلالات چربی خون و افزایش خطر انعقاد می‌باشند. اغلب بیماران دچار اضافه وزن یا چاقی می‌باشند و برخی از آن‌ها از کبد چرب رنج می‌برند. این نکته ارتباط قوی کبد چرب را با سندرم متابولیک نشان می‌دهد. هدف مطالعه‌ی حاضر، خلاصه کردن شواهد موجود در زمینه‌ی اپیدمیولوژی، پاتوفیزیولوژی کبد چرب غیر الکلی و سندرم متابولیک و یافته‌های مبنی بر اثرات مقدار ماده‌ی مغذی یا اجزای خاص غذایی (مانند اسید چرب امگا 3) بود.

روش‌ها: به این منظور واژگان کلیدی “Metabolic syndrome”، “Nonalcoholic Fatty Liver”،  “Metabolic syndrome and diet”، “Metabolic syndrome and Nonalcoholic Fatty Liver”، “Nonalcoholic Fatty Liver and diet”، “Nonalcoholic Fatty Liver and nutrition” و “Metabolic syndrome and nutrition” در PubMed و EMBASE بین سال‌های 1998 تا 2013 جستجو کردیم.

یافته‌ها: افزایش جهانی شیوع چاقی با افزایش شیوع کبد چرب غیر الکلی و همچنین افزایش خطر دیابت نوع 2 همراه است. اگر چه راهکار خاصی برای درمان کبد چرب غیر الکلی وجود ندارد، ولی اصلاح رژیم غذایی نقش خاصی در درمان آن دارد. الگوهای غذایی سرشار از میوه و سبزیجات همراه با شیوع کمتری از سندرم متابولیک بودند. دریافت زیاد گوشت با اجزای سندرم متابولیک به ویژه اختلال در تحمل گلوکز همراه بود. دریافت اسیدهای چرب ترانس از روغن‌های هیدروژنه با افزایش مارکرهای التهابی همراه بوده است. به نظر می‌رسد یک رژیم غذایی حاوی مقادیر کم کربوهیدرات و اسید چرب اشباع و مقدار بیشتر فیبر و اسیدهای چرب امگا 3 برای کنترل سندرم متابولیک مفید باشد. پیشنهاد می‌شود در مبتلایان کبد چرب غیر الکلی، دریافت غذاها و نوشیدنی‌های سرشار از فروکتوز محدود شود. یافته‌ها ارتباط معکوس بین مصرف قهوه و سندرم متابولیک را به دلیل شیوع کمتر هیپر تری‌گلیسریدمی نشان داد و پیشنهاد شده است که دریافت قهوه می‌تواند خطر کبد چرب غیر الکلی را کاهش دهد.

نتیجه‌گیری: برنامه‌ای مبنی بر کاهش وزن تدریجی و فعالیت فیزیکی، هنوز یک استاندارد طلایی درمان کبد چرب غیر الکلی می‌شود. مصرف منظم میوه و سیبزیجات برای کاهش خطر ایجاد سندرم متابولیک پیشنهاد می‌شود.


واژگان کلیدی


سندرم متابولیک؛ کبد چرب غیر الکلی؛ رژیم غذایی؛ تغذیه

تمام متن:

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