Capacidade antioxidante total da dieta e sua relação com esteato-hepatite não alcoólica

Abstract

Nonalcoholic steatohepatitis (NASH) is a manifestation of the metabolic syndrome and hepatic disorders, characterized by steatosis, lobular inflammation, edema and rarefied cytoplasm (balonization) and, in some cases, fibrosis, which can progress to cirrhosis and carcinoma. The progression of NASH is also closely related to insulin resistance in relation to oxidative stress. Dietary intake of antioxidants has been suggested in protection against oxidative damage and related clinical complications. The total antioxidant capacity of the diet (CATd) is considered a useful tool to evaluate the antioxidant potential of the diet, and there is currently no study examining the relationship of CATd with NASH. The objective of this study was to evaluate the potential association of total antioxidant capacity of the diet with severity in patients with NASH, as well as with anthropometric composition and body markers and biochemical parameters. Thirty-three patients with a mean age of 48.4 ± 11.0 years were evaluated. EHNA severity, lifestyle characteristics, occurrence of comorbidities, dietary intake, anthropometry, body composition and biochemical parameters were evaluated. It was observed that 24.2% (n = 25) were diabetic type 2, 48.5% (n = 17) had systemic arterial hypertension and 84.8% (n = 28) were dyslipidemic. Regarding obesity, 81.8% (n = 27) had central obesity at risk and 84.8% were overweight according to the body mass index. The presence of metabolic syndrome was noted in 54.5% (n = 18) of the participants. Patients with NASH who had a higher dietary CAT had fewer hepatocyte (balloon) lesions compared to those with lower CATd (p = 0.034). Patients with higher dietary CAT had an approximately 20% reduction in the risk of having many balloonized hepatocytes (odds ratio [OR]: 0.791; 95% confidence interval [CI]: 0.643-0.974, p = 0.027). There was no association between steatosis, lobular inflammation and fibrosis with dietary CAT. The same occurred with characteristics of life style, occurrence of comorbidities, anthropometry, body composition and biochemical parameters. It is concluded that dietary CAT is greater in patients with lower hepatic injury (balloonism), suggesting a possible role of naturally high food intake in its antioxidant capacity in reducing the production of free radicals and, consequently, oxidative stress.