TGF-β1, which plays a critical role in the pathogenesis of liver fibrosis and hepatocellular carcinoma,35 was reduced 2-fold after reduced carbohydrate diet compared to reduced fat diet, which could indicate a potential advantage of carbohydrate-restricted

diets on fibrogenesis. In our subjects, cytokeratin-18 fragments, which are markers of hepatocyte apoptosis,36 were in the normal range and did not change with either diet. The observation suggests that in most subjects obesity-associated IHL accumulation was not yet associated with ongoing hepatocyte apoptosis. Our results cannot be simply Selleck Alvelestat extrapolated to patients with more advanced liver disease. The main limitation of our study is that a 6-month weight loss period may not be sufficiently long to observe influences of macronutrient content on IHL. An influence of macronutrient composition could be unmasked during weight stabilization or regain. Furthermore, our study does not exclude that more extreme changes in dietary fat and/or carbohydrate affect IHL in a weight-independent fashion. However, we suggest that the changes in macronutrient content in our study reflect typical Western

dietary patterns. We controlled for fatty acid composition, which may affect IHL deposition. For example, transgenic restoration Dorsomorphin of omega-3 fatty acid tissue levels improved hepatic insulin sensitivity in mice fed a high-fat diet.37 We observed no changes for n-3 fatty acids during either diet. A reduction in n-6 fatty acid and more so saturated fatty acid ingestion in

the reduced fat diet 上海皓元 was unavoidable. Because we did not measure physical activity throughout the study, we cannot completely rule out an influence of an unrecognized change in physical activity on our outcomes. We conclude that over a 6-month period, caloric restriction through reductions in dietary fat or carbohydrates achieved similar reduction in IHL content in nondiabetic overweight or obese subjects. Patients with elevated intrahepatic fat content showed a particularly large response. The improvement in IHL content was associated with a reduction in ALT. Thus, both types of diets are similarly useful in the prevention of obesity-associated hepatic fat accumulation, which is a major risk factor for metabolic disease, such as insulin resistance and type 2 diabetes, and nonalcoholic steatohepatitis. We thank Gritt Stoffels, Anke Strauss, and Elke Nickel-Sczcech for technical help with patient recruitment and study procedures. We also thank Andreas Busjahn for statistical advice. Additional Supporting Information may be found in the online version of this article. “
“Background and Aim:  The present study was undertaken to examine whether there is an association between parity and age at first birth and risk of liver cancer.