Nonalcoholic fatty liver disease (NAFLD) is a common chronic condition associated with genetic and environmental factors in which fat abnormally accumulates in the liver. NAFLD is epidemiologically associated with obesity, type 2 diabetes, and dyslipidemia. Environmental factors, such as physical inactivity and an unbalanced diet, interact with genetic factors, such as epigenetic mechanisms and polymorphisms for the genesis and development of the condition. Different genetic polymorphisms seem to be involved in this context, including variants in PNPLA3, TM6SF2, PEMT, and CHDH genes, playing a role in the disease’s susceptibility, development, and severity. From carbohydrate intake and weight loss to omega-3 supplementation and caloric restriction, different dietary and nutritional factors appear to be involved in controlling the onset and progression of NAFLD conditions influencing metabolism, gene, and protein expression. The polygenic risk score represents a sum of trait-associated alleles carried by an individual and seems to be associated with NAFLD outcomes depending on the dietary context. Understanding the exact extent to which lifestyle interventions and genetic predispositions can play a role in the prevention and management of NAFLD can be crucial for the establishment of a personalized and integrative approach to patients.
Objective: Adverse changes in body composition are increasingly being recognized in patients with rheumatoid arthritis (RA). This study aimed to explore the relationship between RA disease activity, disease impact, and functional disability with bioelectrical phase angle (PhA) and appendicular skeletal muscle mass index (ASMI). Methods: Patients with RA were recruited at a tertiary hospital in Portugal. The Disease Activity Score in 28 joints based on erythrocyte sedimentation rate and C-reactive protein (DAS28-ESR and DAS28-CRP, respectively) were used to assess disease activity. The impact of disease and functional status were evaluated using the Rheumatoid Arthritis Impact of Disease (RAID) questionnaire and the Health Assessment Questionnaire (HAQ), respectively. Body composition was measured by bioelectrical impedance analysis (BIA). PhA was stratified into tertiles, and ASMI was classified according to the European Working Group on Sarcopenia in Older People 2 criteria. Results: A total of 104 patients with RA were included (74% female; mean age 60.9 [SD 9.6] years). RAID scores were significantly lower in patients in the highest PhA tertile (PhA-T3) than in those in the lower PhA tertiles (PhA-T2 and PhA-T1, P = 0.001 and P < 0.001, respectively). HAQ scores were significantly lower in patients in the highest PhA tertile (PhA-T3) than in those in the lowest PhA tertile (PhA-T1, P < 0.001). Median DAS28-ESR and DAS28-CRP were lower among patients with higher PhA, but the difference did not reach statistical significance ( P = 0.07 and P = 0.16, respectively). No differences were found among the ASMI groups in DAS28-ESR ( P = 0.62), DAS28-CRP ( P = 0.97), RAID ( P = 0.30), or HAQ ( P = 0.51) scores. Conclusion: A lower PhA was associated with greater disease impact and greater significant functional disability in patients with RA.