Effect Of Glycine-rich Diet On MAFLD/NAFLD Patients

Objective:With the prevention and treatment of infectious liver diseases in recent years,metabolic dysfunction-associated fatty liver disease(MAFLD)/ nonalcoholic fatty liver disease(NAFLD)has gradually shown a trend of globalization and younger age,and has become the most common chronic liver disease.Studies have shown that supplementary intake of glycine has therapeutic effect on MAFLD patients.In this paper,high performance cation exchange chromatography(HPCEC)was used to detect the serum glycine level in patients with MAFLD.Fibro Scan was used for transient elastography to measure liver stiffness(LS)and control attenuation parameters(CAP).The liver fat content before and after glycine diet was compared,and the correlation between glycine diet and human glycine level and the correlation between glycine diet and MAFLD were explored,in order to provide a new direction for the treatment and early diagnosis and prevention of nonalcoholic fatty liver disease.Methods :A total of 500 patients diagnosed with MAFLD in the physical examination center and inpatient department of the First Hospital of Shanxi Medical University from November 2018 to September 2019 were selected,and 75 cases were selected as the study group according to the exclusion criteria.By enzyme-linked immunoassay,the levels of serum leptin and adiponectin in patients with MAFLD were detected,and by biochemical method,the levels of reduced glutathione and malondialdehyde were detected,and the correlation between the changes of leptin,adiponectin,oxidative stress with MAFLD was explored,so as to provide a new direction for early non-invasive diagnosis of non-alcoholic fatty liver disease.According to the results of liver transient elastography,they were divided into mild,moderate and severe groups.At the same time,25 healthy non-MAFLD volunteers with gender and age matching were included as the control group.The general data of subjects including age,gender,height,weight,waist circumference and hip circumference were collected,and the BMI and WHR were calculated.The elbow venous blood of the subjects after 12 hours of fasting was collected to determine the content of glycine in the plasma,as well as the serum transaminase,triglyceride,serum uric acid,free fatty acid,fasting blood glucose,fasting insulin and other related indicators.After giving advice on glycine diet,the relevant data were collected by telephone follow-up.Three months later,the relevant laboratory indicators,plasma glycine content and liver transient elastography were reviewed.SPSS 26.0 statistical software was used for data analysis.Results:(1)Compared with the control group,the body weight,BMI,waist circumference,WHR,fasting blood glucose,insulin level,ALT,γ-GT and triglyceride in the MAFLD group were significantly increased,and the HDL-C level was decreased;there was no significant difference in age,gender,height,UA and other indicators between the MAFLD group and the control group.After glycine diet guidance,WHR,fasting blood glucose,insulin,ALT and triglyceride levels in MAFLD group were significantly decreased compared with those before guidance,while BMI,γ-GT and HDL-C did not change significantly compared with those before guidance.After guidance,insulin,ALT,triglyceride and HDL-C in the control group decreased significantly compared with those before guidance,while BMW,WHR,fasting blood glucose and γ-GT did not change significantly compared with those before guidance.(2)The plasma glycine level of MAFLD group was significantly lower than that of the control group,and the CAP value of MAFLD group was significantly higher than that of the control group.After glycine diet guidance,the glycine level of MAFLD group and control group increased significantly compared with that before guidance.The CAP value of liver transient elastography in MAFLD group decreased significantly compared with that before guidance,while the CAP value of liver transient elastography in control group did not change significantly.(3)After controlling factors such as gender,age,height,weight,BMI and WHR,plasma glycine level was negatively correlated with the severity of fatty liver.(4)The plasma glycine level was used as a covariate,and the occurrence of MAFLD was used as the dependent variable for binary Logistic regression analysis.The plasma glycine content was statistically significant with the occurrence of MAFLD.After correcting the related influencing factors of MAFLD,the plasma glycine level was still statistically significant with MAFLD.The plasma glycine level was an independent risk factor for MAFLD.The risk of MAFLD increased 1.373 times when the plasma glycine level decreased by 1mg/d L.BMI,WHR,fasting blood glucose,triglyceride and ALT were also independent risk factors for MAFLD.Conclusion :BMI,WHR,fasting blood glucose,triglyceride and ALT are independent risk factors for MAFLD.Glycerine diet guidance can improve the plasma glycine level of patients,so as to prevent or improve the severity of fatty liver in patients with MAFLD.Plasma glycine level was negatively correlated with MAFLD,and plasma glycine level was an independent We Chat factor for MAFLD.The CAP value of liver transient elastography can be used as a noninvasive diagnostic indicator of MAFLD,and it is expected to be the basis for evaluating the efficacy of MAFLD treatment.