首页|Effect of soy protein supplementation in patients with chronic hepatitis C: A randomized clinical trial

Effect of soy protein supplementation in patients with chronic hepatitis C: A randomized clinical trial

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AIM:To evaluate the effects of soy supplementation on insulin resistance,fatty liver and alanine aminotransferase (ALT) levels in non-diabetic patients with chronic hepatitis C (CHC).METHODS:In a prospective,randomized and singleblinded clinical trial,we compared patients with CHC who had casein as a supplement (n =80) (control group),with patients who consumed a soy supplement diet (n =80) [intervention group (IG)].Both groups received 32 g/d of protein for 12 wk.RESULTS:Patients' baseline features showed that 48.1％ were overweight,43.7％ had abdominal fat accumulation,34.7％ had hepatic steatosis and 36.3％ had an homeostasis model assessment index of insulin resistance (HOMA-IR) ≥ 3.0.Descriptive analysis showed that protein supplementation diet reduced hepatic steatosis in both groups; however,significant reductions in ALT levels occurred in the soy group.Multiple regression modeling indicated that in the presence of severe fibrosis (F3/F4),y glutamyl transferase elevation and high density lipoprotein (HDL) reduction,the intervention group had 75％ less chance of developing hepatic steatosis (OR=0.25; 95％ CI:0.06-0.82) and 55％ less chance of presenting with an ALT level ≥ 1.5× the upper limit of normal (ULN) (OR =0.45,95％CI:0.22-0.89).Soy treatment did not have any effect on insulin resistance (OR =1.92; 95％ CI:0.80-4.83),which might be attributed to the fact that the HOMAIR values at baseline in most of our patients were in the normal range.Advanced hepatic fibrosis,an ALT level ＞ 1.5 × ULN and visceral fat were predictors of an HOMA-IR ≥ 3.The IG group had a reduced risk of an ALT level ＞ 1.5 × ULN.An HOMA-IR ≥ 3.0 and HDL ＜35 mg/dL were also risk factors for increased ALT.CONCLUSION:Soy supplementation decreased ALT levels and thus may improve liver inflammation in hepatitis C virus (HCV) patients; it also reduced hepatic steatosis in a subgroup of patients but did not change insulin resistance.It should be considered in the nutritional care of HCV patients.

Chronic hepatitis CSoy supplementationInsulin resistanceHepatic steatosisHepatitis C virus

Lucivalda PM Oliveira、Rosangela P de Jesus、Ramona SSB Boulhosa、Carlos Mauricio C Mendes、Maria Cecilia Gnoatto、Denise C Lemaire、Maria Betania P Toralles

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Postgraduate Course in Medicine and Health and Nutrition Science Department, Federal University of Bahia, Bahia 40110-150, Brazil

Nutrition Science Department, Federal University of Bahia, Bahia 40110-150, Brazil

Lourianne N Cavalcante, Postgraduate Course in Medicine and Health, Federal University of Bahia, Bahia 40110-150, Brazil

the Medicine and Health Postgraduation program, Federal University of Bahia, Bahia 40110-150,Brazil

the Radiology Service, Prof.Edgard Santos University Hospital, Federal University of Bahia, Bahia 40110-150, Brazil

Laboratory of Immunology, Health Science Institute, Federal University of Bahia, Bahia 40110-150, Brazil

Pediatric Department, Federal University of Bahia, Bahia 40110-150, Brazil

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2012

10.3748/wjg.v18.i18.2203

世界胃肠病学杂志(英文版)
太原消化病研治中心

世界胃肠病学杂志(英文版)

SCI
影响因子：1.001
ISSN：1007-9327
年,卷(期)：2012.18(18)
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