Influence of dietary fat intake on acute changes in postprandial lipid and lipoprotein expression in children and adolescents with nonalcoholic fatty liver disease (NAFLD)

• Author / Creator

  Rodriguez Dimitrescu, Carla

• Nonalcoholic fatty liver disease (NAFLD) is a chronic liver disease that typically occurs in obese children and adolescents with hyperinsulinemia/insulin resistance and dyslipidemia. While treatment is aimed at lifestyle modification (diet and physical activity), very little is known regarding the contribution of diet to underlying metabolic processes leading to hepatic damage and how modification of meal patterning might contribute to improved patient outcomes. We hypothesized that children and adolescents with biopsy proven NAFLD will be characterized by different body fat distribution, prolonged postprandial hyperinsulinemia, lipemia and altered lipoprotein and inflammatory marker expression when compared to obese and lean healthy children and adolescents after consumption of two different high saturated fat meal challenges (with varying long chain polyunsaturated fat: 0% LCPUFA vs 1.5% LCPUFA). Children and adolescents with NAFLD had higher fat localized to the visceral region compared to the other groups. Higher (p>0.05) trunk to extremity ratio and waist to hip ratio was observed in children with NAFLD. Fasting and postprandial insulin were higher (p<0.05) in the NAFLD when compared to lean and obese controls. NEFA postprandial clearance in NAFLD population was significantly lower when compared to obese and lean controls. NAFLD subjects were characterized by higher (p<0.05) fasting Apo B-100 and C-III as well as higher postprandial Apo B-48; all suggestive of differences in fat balance across the liver following a meal. Acute changes in LCPUFA intake in a high saturated fat meal resulted in significant lowering of iAUC for NEFA in the NAFLD group and significant increased postprandial changes in Apo C-III, but did not evoke any other major postprandial changes in lipoprotein expression. In conclusion our study suggests that children and adolescents with NAFLD exhibit delayed postprandial lipid and lipoprotein expression in comparison to lean controls. Acute changes in LCPUFA content in a high saturated meal, reflective of the typical amounts present in a fast food meal, evoke small postprandial changes in children and adolescents with NAFLD. Whether an improvement in postprandial lipid clearance can be obtained through a higher LCPUFA dose or whether responses are mainly determined by the chronic intake should be further investigated

• Subjects / Keywords

  • Insulin resistance
  • NAFLD
  • Body composition

• Graduation date

  Fall 2012

• Type of Item

  Thesis

• Degree

  Doctor of Philosophy

• DOI

  https://doi.org/10.7939/R3V913

• License

  This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.