工业，不是水果的果糖摄入量与​​肝纤维化的患者G1 CHC队

StephenW

www.natap.org

industrial fructose included any amount of fructose derived from food sources containing high fructose corn syrup (beverages like soft drink and fruit juices, processed foods like fast-food especially when enriched by industrial sauce), while fruit fructose entailed only whole fruit sources.

In conclusion, we showed that industrial, not fruit fructose intake is associated with the severity of liver fibrosis in a cohort of patients with G1 CHC. These data provide a new target for the management of patients with chronic liver disease in the course of HCV infection.

…...industrial fructose intake (OR 1.147, 95% CI 1.047–1.257, p=0.003) were independently linked to severe fibrosis. No association was found between fructose intake and liver necroinflammatory activity, steatosis, and the features of NASH.

The association of industrial fructose intake with severe liver fibrosis was confirmed at multivariate analysis also in the subgroup of non-diabetic G1 CHC patients (OR 1.153, 95% CI 1.049–1.267, p=0.003), together with older age (OR 1.054, 95% CI 1.008–1.103, p=0.02) and severe necroinflammatory activity (OR 2.713, 95% CI 1.033–7.125, p=0.04), as well as in the subgroup of non-diabetic normal-weight patients, even if this last association was not confirmed at multivariate analysis (OR 1.480, 95% CI 0.946–2.316, p=0.08).
Fibrosis

Older age, high WC, high ALT levels, severe necroinflammatory activity, moderate-severe steatosis, histological features of NASH, and both total and industrial fructose intake (not fruit fructose) were linked to severe fibrosis at univariate analysis (p<0.10). By multivariate logistic regression analysis, only older age (OR 1.048, 95% CI 1.004–1.094, p=0.03), severe necroinflammatory grading (OR 3.325, 95% CI 1.347–8.209, p=0.009), moderate-severe steatosis (OR 2.421, 95% CI 1.017–6.415, p=0.04), and industrial fructose intake (OR 1.147, 95% CI 1.047–1.257, p=0.003) remained associated with severe fibrosis (Table 3). Similarly, when industrial fructose as continuous variable was replaced in the model by industrial fructose as categorical variable, at the cut-off of 8g/day, 14/25 pts with industrial fructose intake 8g/day had F3-F4 fibrosis vs. 18/89 in the group with lower intake (p=0.01); again, fructose remained independently associated with severe fibrosis (OR 4.453, 95% CI 1.618–12.256, p=0.004). Similar data were obtained when total fructose intake was entered in the model instead of industrial fructose intake; the association with severe fibrosis remained statistically significant (OR 1.053, 95% CI 1.002–1.106, p=0.04). The association between industrial fructose intake and severe liver fibrosis did not change when the presence of hypercaloric diet was forced into the model as independent variable (OR 1.158, 95%CI 1.045–1.283, p=0.005). Fig. 2 shows total (A), industrial (B), and fruit (C) fructose intake according to presence/absence of severe fibrosis.

StephenW

www.natap.org

工业果糖果糖包括从含高果糖玉米糖浆（饮料，如汽水和果汁，加工食品，如快餐尤其是当工业酱浓）食物来源的任何金额，而水果的果糖entailed只有整个水果的来源。

总之，我们发现，工业，不是水果的果糖摄入量与​​肝纤维化的患者G1 CHC队列的严重程度相关。这些数据提供了用于治疗慢性肝病患者中的HCV感染的过程中，管理一个新的目标。

工业......果糖摄入量（ OR 1.147 ， 95％CI为1.047-1.257 ， P = 0.003）分别独立地连接到重度纤维化。没有相关性果糖摄入量与肝脏炎症活动，脂肪变性和NASH的特征之间找到。

工业果糖的摄入量严重肝纤维化的关联在多因素分析也证实在非糖尿病G1 CHC患者（ OR 1.153 ， 95％CI为1.049-1.267 ， P = 0.003）的亚组，与年龄（OR 1.054在一起， 95％CI： 1.008-1.103 ，p值= 0.02 ）和严重炎症活动（OR 2.713 ， 95％CI： 1.033-7.125 ，p值= 0.04） ，以及在非糖尿病正常体重的患者的亚组中，即使这最后协会是不是在多变量分析（或1.480 ， 95％CI为0.946-2.316 ， P = 0.08 ）证实。
纤维化

年龄大，高WC ，高ALT水平，严重的坏死性炎症，重度脂肪肝， NASH的组织学特征，以及总的和工业摄取果糖（水果没有的果糖）被链接到重度纤维化在单因素分析（ P < 0.10） 。通过多因素Logistic回归分析显示，只有年龄大（ OR 1.048 ， 95％CI为1.004-1.094 ， P = 0.03） ，重度坏死性炎症分级（ OR 3.325 ， 95％CI为1.347-8.209 ， P = 0.009 ） ，中重度脂肪变性（或2.421 ， 95 ％ CI为1.017-6.415 ， P = 0.04） ，以及工业果糖的摄入量（ OR 1.147 ， 95％CI为1.047-1.257 ， P = 0.003）仍然有严重纤维化（表3） 。同样，当工业果糖作为连续变量被替换模型中的工业果糖作为分类变量，在截止8g/day的， 14/25点，与工业果糖的摄入量8g/day有F3 -F4纤维化与18 / 89组摄入量较低（P = 0.01） ;再次，果糖独立仍然有严重纤维化（ OR 4.453 ， 95％CI为1.618-12.256 ， P = 0.004）相关。也可以得到同样的数据时输入的模型，而不是工业果糖摄入的总摄取果糖;重度纤维化的关联仍有统计学显著（ OR 1.053 ， 95％CI为1.002-1.106 ， P = 0.04） 。工业果糖的摄入量和重度肝纤维化之间的关联时hypercaloric饮食的存在被强制纳入模型作为独立变量（或1.158 ， 95％CI为1.045-1.283 ， P = 0.005）并没有改变。图。 2显示总（ A） ，工业（B ） ，并根据存在/不存在严重纤维化的水果（ C）果糖的摄入量。