بررسی تأثیر مکمل اسفرزه (Psyllium) همراه با رژیم کاهش وزن بر شاخص‌های آنتروپومتریک و آنزیم‌های کبدی در بزرگ‌سالان چاق یا دارای اضافه وزن

نوع مقاله : مقاله های پژوهشی

نویسندگان

1 دانشجوی ‌کارشناسی ‌ارشد، ‌گروه ‌تغذیه‌ی ‌جامعه، ‌دانشکده‌ی ‌تغذیه ‌و علوم ‌غذایی و مرکز تحقیقات دانشجویی، ‌دانشگاه ‌علوم ‌پزشکی ‌اصفهان، ‌اصفهان، ‌ایران

2 استادیار، ‌گروه ‌تغذیه‌ی‌ ‌جامعه، ‌دانشکده‌ی ‌تغذیه ‌و علوم ‌غذایی، ‌دانشگاه ‌علوم ‌پزشکی ‌اصفهان، ‌اصفهان، ‌ایران

3 دانشیار، گروه اپیدمیولوژی، دانشکده‌ی بهداشت، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

4 استادیار، گروه داخلی، دانشکده‌ی پزشکی، دانشگاه آزاد اسلامی، واحد نجف‌آباد و بیمارستان دکتر علی شریعتی، اصفهان، ایران

چکیده

مقدمه: اضافه وزن و چاقی عوامل خطر مهم مرتبط با NAFLD (Non-alcoholic fatty liver disease) هستند. اولین خط درمان NAFLD، کاهش وزن از طریق رژیم غذایی و فعالیت فیزیکی است. فیبر خوراکی اسفرزه (Psyllium)، در جلوگیری و درمان چاقی و پیامدهای آن مؤثر است.روش‌ها: این مطالعه‌‌ی مورد- شاهدی،‌ یک کارآزمایی بالینی تصادفی دو سو کور موازی بود. 80 بیمار NAFLD با محدوده‌ی سنی 77-18 سال دارای اضافه وزن (BMI ≥ 25) (شاخص توده‌ی بدنی یا Body mass index) که بیماریشان به روش الاستوگرافی تأیید شده بود، به روش متوالی انتخاب و توسط بلوک‌های تصادفی دوتایی به دو گروه مورد و شاهد تقسیم شدند. این دو گروه، به ترتیب روزانه 10 گرم Psyllium و 10 گرم تراشه‌ی‌ گندم بدون سبوس مصرف کردند. هر دو گروه، رژیم غذایی کاهش وزن و توصیه‌های افزایش فعالیت بدنی (PA یا Physical activity) دریافت و به مدت 5/2 ماه مورد مطالعه قرار گرفتند. دریافت‌های غذایی (با استفاده از پرسش‌نامه‌ی ثبت غذایی سه روزه)، میزان فعالیت بدنی (از طریق پرسش‌نامه‌ی فعالیت فیزیکی)، شاخص‌های آنتروپومتریک و آنزیم‌های کبدی آلانین آمینو ترانسفراز (ALT یا Alanine transaminase) و آسپارتات آمینو ترانسفراز (AST یا Aspartate transaminase) به روش فتومتریک آنزیماتیک در ابتدا و انتهای مطالعه اندازه‌گیری شد.یافته‌ها: 13 مرد و 25 زن در گروه مورد و 22 مرد و 15 زن در گروه شاهد قرار گرفتند. میانگین سنی افراد 9/44 بود. پیش از مداخله، شاخص توده‌ی بدنی در گروه‌های مورد و شاهد به ترتیب 4/29 و1/31 کیلوگرم بر مترمربع و انرژی دریافتی به ترتیب، 8/2044 و 7/2449 کیلوکالری بود. با کنترل اثر متغیرهای مخدوشگر، مشاهده شد که کالری دریافتی (020/0 = P)، کربوهیدرات دریافتی (010/0 = P)، ALT (006/0 = P)، دور کمر (006/0 = P)، شاخص توده‌ی بدنی (006/0 = P) و وزن (030/0 = P) در گروه مورد در مقایسه با گروه شاهد کاهش معنی‌دار یافت و کاهش نسبت دور کمر به دور باسن، در مرز معنی‌دار شدن بود (050/0 = P). میزان AST سرمی کاهش معنی‌داری نداشت (980/0 = P).نتیجه‌گیری: مصرف Psyllium همراه بارژیم کاهش وزن و فعالیت فیزیکی، می‌تواند در کاهش عوامل خطر بیماری کبد چرب غیر الکلی و کاهش آنزیم‌های کبدی مفید واقع شود.

کلیدواژه‌ها

عنوان مقاله [English]

The Effect of Psyllium on Anthropometric Measurements and Liver Enzymes in Overweight or Obese Adults with Nonalcoholic Fatty Liver Disease (NAFLD)

نویسندگان [English]

  • Zahra Akbarzadeh 1
  • Mojgan Nourian 2
  • Gholamreza Askari 2
  • Mohammad Reza Maracy 3
  • Rahmatollah Rafiei 4
1 MSc Student, Department of Community Nutrition, School of Food Science and Nutrition AND Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
2 Assistant Professor, Department of Community Nutrition, School of Food Science and Nutrition, Isfahan University of Medical Sciences, Isfahan, Iran
3 Associate Professor, Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
4 Assistant Professor, Department of Internal Medicine, School of Medicine, Najafabad Branch, Islamic Azad University AND Shariati Hospital, Isfahan, Iran
چکیده [English]

Background: Overweight and obesity are two important risk factors for nonalcoholic fatty liver disease (NAFLD). Controling the weight via using dietary fiber may help to manage patients with NAFLD by diet and physical activity. Psyllium as a fiber can reduce obesity and its consequences.Methods:This was a placebo-controlled, double-blind, randomized clinical trial study. 80 overweight or obese patients with NAFLD (age: 18-77 years) diagnosis via elastography were enrolled. Participants assigned to intervention and placebo groups using randomized block design; which were supplemented with 10 g psyllium or 10 g ground wheat, respectively. Both groups followed weight-loss diet and physical activity (PA) recommendations for 10 weeks. Serum liver enzymes (using enzymatic photometric method), dietary intake (via 3-day food record) physical activity (using physical activity questionnaire) and anthropometric measurements were assessed at baseline and the end of the study.Findings: 75 participants (mean age: 44.9 years) met the inclusion criteria, 13 men and 25 women in intervention group and 22 men and 15 women in placebo group. At the beginning, the mean body mass index (BMI) was 29.4 and 31.1 kg/m2 and the mean calorie intake was 2044.8 and 2449.7 kcal in intervention and placebo groups, respectively. Controling the confounding variables, calorie intake (P = 0.020), carbohydrate intake (P = 0.010), serum alanine aminotransferase (ALT) (P = 0.006), waist circumference (P = 0.006), body mass index (P = 0.006) and weight (P = 0.030) were reduced in intervention group as compared with placebo group. Waist to hip ratio reduced at a boarderline significancy (P = 0.050); and serum aspartate aminotransferase (AST) reduced unsignificantly (P = 0.980).Conclusion: Weight-loss diet program supplemented with psyllium, in parallel with increasing the physical activity, can be useful in reducing NAFLD outcomes.

کلیدواژه‌ها [English]

  • Psyllium
  • Non-alcoholic fatty liver disease (NAFLD)
  • Obesity
  • Waist to Hip Ratio
  • Dietary Intake

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مجله دانشکده پزشکی اصفهان
دوره 33، شماره 355 - شماره پیاپی 355
آذر و دی 1394
صفحه 1771-1783

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سابقه مقاله

  • تاریخ دریافت: 28 مرداد 1394
  • تاریخ بازنگری: 07 اردیبهشت 1403
  • تاریخ پذیرش: 17 فروردین 1401

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