Effect of a high monounsaturated vs high polyunsaturated fat hypocaloric diets in nonalcoholic fatty liver disease

OBJECTIVE: Hyperaminotransferase is an important problem in obese patients. We decide to examine the changes in hyperaminotransferasemia after weight reduction in obese patients with and without NAFLD secondary to a high monounsaturated fat vs. a high polyunsaturated fat hypocaloric diets. PATIENTS AND METHODS: A population of 306 obese patients was randomly allocated to two groups: Diet M (high monounsaturated fat hypocaloric diet) and Diet P (high polyunsaturated fat hypocaloric diet). Patients were classified as group I (obese subjects; n=262) when serum ALT activity was normal or group II (NAFLD patients; n=44) when serum ALT activity was (>= 43 UI/L). RESULTS: In NAFLD group with diet M, BMI, weight, fat mass, waist circumference, systolic blood pressure, total cholesterol, LDL cholesterol), insulin and HOMA-R decreased. In NAFLD group with diet P, BMI, weight, fat mass, waist circumference, systolic blood pressure, total cholesterol, LDL cholesterol), insulin and HOMA-R decreased, too. In NAFLD group, alanine aminotransferase [(diet M) -20.3 +/- 19.2 UI/L vs. (diet P) 14.2 +/- 20.1 UI/L], aspartate aminotransferase [(diet M) -11.3 +/- 12.2 UI/L vs. (diet P) -11.1 +/- 10.1 UI/L], and gammaglutamyl transferase [(diet M) 18.1 +/- 12.2 UI/L vs. (diet P) -10.9 +/- 20.1 UI/L] improved with both diets. CONCLUSIONS: We showed that weight reduction secondary to two hypocaloric diets was associated with improvement in hypertransaminasemia and insulin resistance in NAFLD patients.