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Background Because consumption of conventional yogurt has beneficial effects in a healthy population, and insulin resistance (IR) is the mutual pathogenesis in nonalcoholic fatty liver disease (NAFLD) and metabolic syndrome (MetS), we hypothesized that yogurt would ameliorate IR in patients with NAFLD and MetS. Objectives The aim of this study was to investigate the effects of yogurt on IR and secondary endpoints including liver fat, gut microbiota, and serum biomarkers of inflammation and oxidative stress in obese women with NAFLD and MetS. Methods One hundred obese women aged 36–66 y with both NAFLD and MetS were randomly assigned to consume 220 g/d of either conventional yogurt or milk for 24 wk. At baseline and week 24, we measured anthropometric indices, serum glucose, insulin, lipids, and cytokines in all participants, and liver fat and gut microbiota in 20 participants randomly selected from each group. Results Forty-eight participants from the yogurt group and 44 from the milk group completed the intervention. Compared with milk, yogurt significantly decreased the homeostasis model assessment of insulin resistance (−0.53; 95% CI: −1.03, −0.02), fasting insulin (−2.77 mU/L; 95% CI: −4.91, −0.63 mU/L), 2-h insulin (−25.5 mU/L; 95% CI: −33.0, −17.9 mU/L), 2-h area under the curve for insulin (−29.4 mU/L · h; 95% CI: −44.0, −14.8 mU/L · h), alanine aminotransferase (−4.65 U/L; 95% CI: −8.67, −0.64 U/L), intrahepatic lipid (−3.44%; 95% CI: −6.19%, −0.68%), and hepatic fat fraction (−3.48%; 95% CI: −6.34%, −0.63%). Yogurt also decreased serum LPS (−0.31 EU/mL; 95% CI: −0.48, −0.14 EU/mL), fibroblast growth factor 21 (−57.76 pg/mL; 95% CI: −86.32, −29.19 pg/mL), lipids, and biomarkers of inflammation and oxidative stress, and altered gut microbiota composition. Mediation analysis showed that yogurt may improve IR by reducing serum lipids, inflammation, oxidative stress, and LPS. Conclusions Yogurt was better than milk at ameliorating IR and liver fat in obese Chinese women with NAFLD and MetS, possibly by improving lipid metabolism, reducing inflammation, oxidative stress, and LPS, and changing the gut microbiota composition. This trial was registered at www.chictr.org.cn as ChiCTR-IPR-15006801.

BackgroundNon-alcoholic fatty liver disease (NAFLD) given its association with obesity and diabetes may perhaps exert distinct free fatty acids (FFA) pattern, but the understanding of this phenomenon is limited. To this effect, we evaluated FFA profiles among healthy subjects and NAFLD patients stratified by body weight, to identify FFA valuable for early diagnosis of NAFLD.MethodsSerum FFA profiles of healthy and NAFLD (lean, overweight and obese) subjects was determined using gas chromatography–mass spectrometry (GC–MS) and distinctions in FFA patterns were evaluated using one-way ANOVA while Receiver operating characteristics (ROC) and logistic regression models were used to explore FFA significant for diagnosing NAFLD.ResultsNAFLD patients presented significantly higher (P < 0.05) serum FFA profiles compared to healthy controls (HC). While total FFA profiles were insignificantly different between lean (2093.33 ± 558.11 μg/ml) and overweight (2420.81 ± 555.18 μg/ml) NAFLD patients, obese NAFLD (2739.01 ± 810.35 μg/ml) presented most significantly elevated (P < 0.05) total FFA profiles compared with HC. Of the four FFA; myristic acid (14:0), palmitoleic acid (16:1), γ-linolenic acid (γ-18:3) and cis-7,10,13,16,19-docosapentaenoic acid (22:5), selected in ROC analysis given their high Youden’s index and AUC, only 14:0; 5.58(1.37, 22.76) and 16:1; 4.36(1.34, 14.13) had statistical significant odd ratios.ConclusionOur findings suggest 14:0 and 16:1 are promising for early diagnosis of NAFLD.Electronic supplementary materialThe online version of this article (doi:10.1186/s12944-017-0551-1) contains supplementary material, which is available to authorized users.