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Weight loss is the cornerstone in the treatment of NAFLD and was found associated with a histological improvement proportional to its extent. However, it is a difficult goal to achieve and maintain. Moreover, the precise link between weight changes and NAFLD is not fully understood. To describe the possible positive influences of a nutritionist-guided low-glycemic index diet on anthropometric parameters, Transient Elastography (TE), Controlled Attenuation Parameter (CAP, with the SmartExam software), and blood chemistry in overweight or obese NAFLD patients. The genetic correlation with TE/CAP measurements was also taken into account. 69/106 patients who were attending our Hepatology Unit, with NAFLD, aged ≥ 18, and with a BMI ≥ 25 accepted to start the nutritionist-guided diet. Baseline anthropometric data, TE/CAP, and blood test results were recorded. Single nucleotide polymorphisms in NAFLD risk genes were analyzed and genetic risk score (GRS) was calculated. Control visits were scheduled after 1 and 3 months. TE/CAP was performed during each visit, and after 3 months blood tests were repeated. 57/69 patients (82.61%) attended at least one of the control visits. A significant difference from baseline was observed at both 1-month and 3-month visit in weight (-4.26 kg [-4.78%] p <0.0001, and -7.67 kg [-8.43%] p <0.0001), BMI (-1.55 Kg/m2, p <0.0001, and -2.75 Kg/m2, p <0.0001), and CAP (-27.67 dB/m, p =0.0062, and -42 dB/m, p =0.0182). Changes in CAP were proportional to the extent of weight loss, whereas mean liver stiffness remained almost unchanged. Baseline CAP was proportional to GRS; high GRS patients presented a higher decrease in TE/CAP values after 3 months of diet. After 3 months of diet, significant differences in glycemia and triglycerides were observed; AST, ALT, total cholesterol and HDL cholesterol also improved. In our NAFLD population, after diet-induced weight loss, an improvement in metabolic parameters was observed. The early reduction of CAP could increase patient awareness of the ongoing improvements. Genetics could influence the reduction of steatosis during weight loss. [ABSTRACT FROM AUTHOR]

Abstract: In the lactating rat there is a dramatic increase in food intake that peaks at around day 15 postpartum, a time when pups are near weaning age, yet still fully dependant on maternal nourishment. We examined whether the orexigenic hormone ghrelin plays a role in increasing food intake during lactation. To do this, we compared plasma levels ghrelin, as well as brain and pituitary expression of the growth hormone secretagogue receptor (GHS-R 1a) rats in one of three groups: (1) dams whose litters were removed the day after giving birth (non-lactating); (2) dams whose litters were removed on day 13 postpartum (litter removed), and dams allowed keeping their litters (lactating). On day 15 postpartum, all dams were decapitated and trunk blood collected for plasma analysis of active ghrelin levels. Also, brain and pituitaries were collected and snap frozen using liquid nitrogen and stored at −80°C before mRNA extraction and RT-PCR analysis. Results show no differences in ghrelin concentrations between lactating and non-lactating rats. Hypothalamic and pituitary expression of GHS-R 1a, however, was significantly increased in lactating animals compared to non-lactating animals. Interestingly, litter removed dams had higher levels of plasma ghrelin concentrations than either lactating or non-lactating females. Furthermore, GHS-R mRNA expression in these animals remained elevated in the pituitary but not the hypothalamus. These data suggest that the hypothalamus and pituitary of lactating rats are more sensitive to the effects of ghrelin, and that hypothalamic sensitivity to ghrelin depends on the presence of a suckling litter. [Copyright &y& Elsevier]