Association between dietary total antioxidant capacity and hepatocellular ballooning in nonalcoholic steatohepatitis: a cross-sectional study

• Published in: European journal of nutrition Vol. 58; no. 6; pp. 2263 - 2270
• Main Authors: de Oliveira, Daiane Gonçalves, de Faria Ghetti, Fabiana, Moreira, Ana Paula Boroni, Hermsdorff, Helen Hermana Miranda, de Oliveira, Juliano Machado, de Castro Ferreira, Lincoln Eduardo Villela Vieira
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-09-2019; Springer Nature B.V
• Subjects: Anthropometry; Antioxidants; Antioxidants - administration & dosage; Antioxidants - pharmacology; Balloon treatment; Biopsy; Body composition; Chemistry; Chemistry and Materials Science; Cirrhosis; Cross-Sectional Studies; Diet; Diet - methods; Dietary intake; Female; Fibrosis; Food intake; Hepatocytes; Hepatocytes - drug effects; Hepatocytes - pathology; Humans; Liver; Liver - pathology; Liver cirrhosis; Liver diseases; Male; Middle Aged; Non-alcoholic Fatty Liver Disease - diet therapy; Non-alcoholic Fatty Liver Disease - pathology; Nutrition; Original Contribution; Oxidative stress; Oxidative Stress - drug effects; Severity of Illness Index; Steatosis; Surveys and Questionnaires; Oxidative stress; Dietary antioxidants; Total antioxidant capacity; Nonalcoholic steatohepatitis; Hepatocellular ballooning
• ISSN: 1436-6207; 1436-6215
• DOI: 10.1007/s00394-018-1776-0

Purpose
Nonalcoholic steatohepatitis (NASH) is characterized by steatosis, lobular inflammation, ballooning, and in some cases, fibrosis, which can progress to cirrhosis and carcinoma. The progression of NASH is closely related to oxidative stress. Dietary intake of antioxidants has been suggested in protection against oxidative damage and related clinical complications. Thus, we evaluated the potential association of dietary total antioxidant capacity (TAC) with disease severity in NASH patients, as well as with anthropometric and body composition markers and biochemical parameters.
Methods
Thirty-three outpatients with a mean age of 48.4 ± 1.9 years were evaluated. Dietary TAC was estimated from a quantitative food frequency questionnaire. NASH severity, determined by liver biopsy, lifestyle characteristics, occurrence of comorbidities, anthropometry, body composition, and biochemical parameters were assessed.
Results
NASH patients who had a higher dietary TAC had fewer ballooned hepatocytes compared to those with a lower TAC (
p
 = 0.024). The patients with the highest dietary TAC had a reduction of approximately 20% in the risk of having many ballooned hepatocytes (OR 0.791; 95% CI 0.643–0.974;
p
 = 0.027). There was no association of steatosis, lobular inflammation, and fibrosis with dietary TAC. The same occurred for lifestyle characteristics, occurrence of comorbidities, anthropometry, body composition, and biochemical parameters.
Conclusion
Dietary TAC is higher in patients with lower hepatic injury (ballooning), suggesting a possible role of food intake naturally high in its antioxidant capacity in reducing free radical production and, consequently, oxidative stress.