低升糖指数饮食有助改善非酒精性脂肪肝病情Low-glycemic-CUHK.ppt

低升糖指數飲食有助改善非酒精性脂肪肝病情 Low-glycemic Dietary Intervention Program Improves the Nonalcoholic Fatty Liver Effectively Centre for Nutritional Studies Department of Medicine of Therapeutics 營養研究中心 內科及藥物治療學系 香港中文大學醫學院 Faculty of Medicine, The Chinese University of Hong Kong 脂肪肝在亞洲的普遍程度Prevalence of Fatty Liver among Asia Hong Kong China Taiwan Japan Korea Malaysia 非酒精性脂肪肝(Non-alcoholic Fatty Liver Disease)(簡稱脂肪肝 Simplified: Fatty Liver) 脂肪化 Fatty liver 脂肪性肝炎 Steatosis 纖維化 Fibrosis 肝硬化 Cirrhosis 人數 Prevalence 肝硬化 Cirrhosis 併發症的死亡率 Mortality 輕微脂肪化 Mild steatosis 59 3.3% 1.7% 脂肪性肝炎 Fatty liver disease 73 24.6% 10.9% 脂肪性肝炎 = 脂肪累積 + 細胞汽球化退化 ± 馬洛透明 或 肝纖維化 Fatty Liver = Fat cells accumulation + Ballooning degeneration + Mallorys hyaline or Fibrosis Matteoni, et al. Gastroenterology 1999 代謝症候群 Metabolic Syndrome “胰島素抗阻症候群” Insulin Resistance 空腹血糖值上升 High Blood Sugar 三酸甘油酯上升 High Triglyceride 高密度酯蛋白膽固醇過低 Low HDL 中央肥胖 Central Obesity 血壓上升 High Blood Pressure 脂肪肝 Fatty Liver 六成半脂肪肝患者同時患有非酒精性脂肪性肝炎65% NAFLD patients also have NASH (Non-alcoholic Steatophepatitis)  80 名曾進行肝活檢患者証實患有脂肪肝 80 patients were diagnosed with fatty liver after liver biopsy Wong VWS, et al., Clinical Gastroenterol Hepatol 2006 Mild fatty liver Non-alcoholic Steatophepatitis 脂肪肝治療 Treatment 未有針對性的藥物治療。No specific treatment “三低一高”的飲食原則: “3 low 1 high”Healthy Eating Principle 減少脂肪、鹽份及糖類的攝取，多吃高纖維的食物。Reduce fat, salt and sugar intake. Increase fibre intake 多運動，維持標準體重。Increase exercise, maintain healthy body weight 同時患有糖尿病的病人，須加強血糖控制。Well control blood sugar level for diabetic patients 研究目的Aim of Study 測試低升糖指數飲食配合生活模式輔導對患有非酒精性脂肪肝病人的影響 To test the efficacy of a low-glycemic index dietary intervention programme in NAFLD patients 研究構思 Study Design 使用超聲波診斷脂肪肝 Fatty liver on ultrasound 復審驗血報告並 括出其他肝臟問題 Review lab results and rule out other liver diseases 簡單健康生活模式指導(對照組)(100人) Simple lifestyle advice (control) (n=100) 低升糖指數飲