Diabetologie und Stoffwechsel 2016; 11 - FV26
DOI: 10.1055/s-0036-1580773

Fatty liver reduction and diminished lipolysis by high-protein intake without caloric restriction: a randomized controlled trial in type 2 diabetes

M Markova 1, S Hornemann 1, 2, S Sucher 1, KJ Petzke 1, J Machann 3, O Pivovarova 1, 2, A Pfeiffer 1, 2
  • 1Deutsches Institut für Ernährungsforschung Potsdam-Rehbrücke (DIfE), Nuthetal, Germany
  • 2Charité Universitätsmedizin Berlin, Berlin, Germany
  • 3Institut für Diabetesforschung und metabolische Erkrankungen (IDM) des Helmholtz Zentrums München an der Universität Tübingen, Tübingen, Germany

Background and aims: There is lacking data on influence of high-protein diets and protein origin on liver fat content. In our clinical study we compared two different isocaloric high-protein diets of animal (AP) and plant (PP) origin and evaluated changes of body composition and intrahepatic lipid content (IHL) in diabetic subjects.

Study design: 37 individuals with type 2 diabetes (age 64 ± 6 years, BMI 30.2 ± 3.6 kg/m2, HbA1c 7.0 ± 0.6%) were randomized to either high-animal protein or high-plant protein diet (30% protein, 40% carbohydrates, 30% fat) for 6 weeks. Before and after diet intervention magnetic resonance spectroscopy imaging was performed. Gene expression was measured in subcutaneous adipose tissue samples using real-time PCR.

Results: Fat-free mass increased after intervention (AP: p < 0.05; PP: n.s.), while visceral and subcutaneous fat mass decreased (AP: p < 0.001; PP: n.s.). IHL was significantly reduced in all subjects (AP: -48.0%, p < 0.001; PP: -35.7%, p < 0.001). Fasting free fatty acids (AP: n.s.; PP: p < 0.01) and expression of lipolytic genes (HSL) in adipose tissue decreased as well, indicating enhanced insulin-mediated suppression of lipolysis. Moreover, elongase activity (C18:0/C16:0) and lipogenic index (C16:0/C18:2n6) were reduced in both groups, which correlated positively with IHL reduction. Expression of genes involved in lipogenesis and lipid storage in adipose tissue were diminished (ACC1, PPARG, PGC1a, SCD1) without differences between groups.

Conclusion: Isocaloric high-protein diet induced great decrease of IHL accompanied by diminished lipolysis in adipose tissue independently of protein origin which may be explained by improved adipose tissue insulin sensitivity.