Abbate, ManuelaMascaro, Catalina MMontemayor, SofiaBarberia-Latasa, MariaCasares, MiguelGómez Bellvert, CristinaAngullo-Martinez, EscarlataTejada Gavela, SilviaAbete, ItziarZulet, Maria AngelesSureda Gomila, AntoniAlfredo Martinez, JTur, Josep A2024-09-182024-09-182021-02Abbate M, Mascaro CM, Montemayor S, Barberia-Latasa M, Casares M, Gomez C, et al. Energy Expenditure Improved Risk Factors Associated with Renal Function Loss in NAFLD and MetS Patients. Nutrients. 2021 Feb;13(2):629.https://hdl.handle.net/20.500.13003/19573https://hdl.handle.net/20.500.12105/23262To assess the efficacy of three lifestyle interventions on the reduction of liver fat content and metabolic syndrome (MetS), and whether such reductions would influence renal outcomes, we conducted a randomized controlled trial on 128 participants with MetS and non-alcoholic fatty liver disease (NAFLD), as well as available data on estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatine ratio (UACR). Patients were randomized in 1:1:1 ratio to either Conventional Diet, Mediterranean diet (MD)-high meal frequency, and MD-physical activity groups. Each intervention aimed at reducing caloric intake by 25%-30% of baseline intake and increase energy expenditure by 400 kcal/70 kg. Patients attended regular visits and were followed-up for 6 months. Increased albuminuria was present in 13.3% of patients, while 32.8% showed hyperfiltration. UACR reduction was associated with higher levels of UACR at baseline but not with changes in liver fat. eGFR decreased in patients presenting hyperfiltration at baseline and was associated with reduction in liver fat and insulin resistance, as well as with increase in energy expenditure (R-2 = 0.248, p = 0.006). No significant differences were observed between the three treatment groups. In patients with NAFLD and MetS, energy expenditure significantly reduced hepatic fat accumulation and insulin resistance, which reduced glomerular hyperfiltration. Increased albuminuria was reduced, but it was not associated with reduced liver fat.enghttp://creativecommons.org/licenses/by/4.0/Glomerular hyperfiltrationAlbumin-to-creatinine rationon-alcoholic fatty liver diseaseCaloric restrictionIncreased energy expenditureMetabolic SyndromeCreatinineEnergy MetabolismAdultHumansLife StyleKidneyKidney Function TestsMiddle AgedNon-alcoholic Fatty Liver DiseaseInsulin ResistanceLiverMaleFemaleRisk FactorsDiet, MediterraneanAlbuminuriaGlomerular Filtration RateExerciseresearch articleAttribution 4.0 International3367207313262910.3390/nu130206292072-6643Nutrientsopen accessDieta MediterráneaEjercicio FísicoSíndrome MetabólicoFemeninoEnfermedad del Hígado Graso no AlcohólicoResistencia a la InsulinaHígadoMasculinoRiñónFactores de RiesgoMetabolismo EnergéticoHumanosPersona de Mediana EdadPruebas de Función RenalEstilo de VidaCreatininaAdultoTasa de Filtración GlomerularAlbuminuria2-s2.0-85100753283622948900001L2006018965