Abstract
We aimed to evaluate the relationship between food intake of lipids with nonalcoholic fatty liver disease (NAFLD) and/or liver fibrosis in people living with HIV/AIDS (PLWHA). In this cross-sectional study, transient elastography was used to detect the presence of NAFLD and/or liver fibrosis. The dietary intake of fats and fatty acids (FA) were assessed by two 24 h dietary recalls (24-HDR) (n = 451). Multivariate logistic regression models were performed. Participants with higher intake of total fat were associated with higher odds for NAFLD compared to those with lower consumption [adjusted odds ratio (aOR) = 1.91 (95% confidence interval (95% CI) 1.06–3.44)]. Furthermore, participants with intermediate intake of n6-PUFA (n6-poly-unsaturated FA) and lauric FA had lower odds for NAFLD, respectively aOR = 0.54 (95% CI 0.3–0.98) and aOR = 0.42 (95% CI 0.22–0.78). Additionally, a higher intake of myristoleic FA (fourth quartile) was a significant protective factor for NAFLD [aOR = 0.56 (95% CI 0.32–0.99)]. Participants with higher intake of lauric FA [0.38 (95% CI 0.18–0.80)], myristic FA [0.38 (0.17–0.89)], palmitoleic FA [0.40 (0.19–0.82)] and oleic FA [0.35 (0.16–0.79)] had positively less odds of having liver fibrosis. On the other hand, higher intake of n-6 PUFA was significantly associated with fibrosis [aOR = 2.45 (95% CI 1.12–5.32)]. Dietary assessment of total fat and FA should be incorporated into HIV care as a tool for preventing NAFLD and fibrosis in PLWHA.
Highlights
38 million people have been living with the human immunodeficiency virus (HIV) [1]
To the best of our knowledge, this is the one of the first studies that has demonstrated the role of fatty acids (FA) intake, and that high ingestion of total fat can increase the odds of nonalcoholic fatty liver disease (NAFLD) in people living with HIV/AIDS (PLWHA), independently of energy intake, age, sex and duration of c-antiretroviral therapy (ART)
The present study reinforces this concept since we demonstrated that a moderate consumption of myristoleic FA, an monounsaturated fatty acid (MUFA), was a protective nutrient for NAFLD associated with lower odds of NAFLD
Summary
38 million people have been living with the human immunodeficiency virus (HIV) [1]. The use of early combined antiretroviral therapy (c-ART) has been decreasing the incidence of opportunistic diseases and increased the life expectancy in people living with HIV/AIDS (PLWHA) [2]. The prevalence of non-communicable diseases has been dramatically increasing in PLWHA in the last decade [3]. Non-alcoholic fatty liver disease (NAFLD) is characterized by abnormal accumulation of fat in the liver in the absence of abusive alcohol intake. The presence of advanced liver fibrosis is the main predictor of mortality in individuals with NAFLD [4]. Several studies have been reporting the burden of NAFLD and/or liver fibrosis in PLWHA [5,6,7]
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