Journal of Nutrition,Fasting and Health

Journal of Nutrition,Fasting and Health

Effect of Ramadan Fasting on Alanine Transferase (ALT) in Nonalcoholic Fatty Liver Disease (NAFLD)

Document Type : Research Paper

Authors
Hojjatolah Rahimi
Mohammad Emad Habibi
Ali Gharavinia
Mohammad hasan Emami
Abdolmahdi Baghaei
Najmeh Tavakol
Gastrointestinal and Hepatobiliary Diseases Research Center, Poursina Hakim Research Institute for Health Care Development, Isfahan, Iran.
10.22038/jfh.2017.24588.1089
Abstract
Introduction: The effects of Ramadan fasting on NAFLD are unknown and there are very limited studies have done in this area. Some nutritional and behavioral changes of fasting people in Ramadan can affect NAFLD. These include nutrition with high fat and calories, altering in weight and sleep and low physical activity. We decided to evaluate the effects of these changes on one of the important indicators of deterioration of NAFLD, ALT. Methods: Sixty patients with fatty liver disease performed two consecutive ALT exams before and after Ramadan month of whom finally 34 were fasting and 26 nonfasting. After collecting data they were divided in two groups of fasting and nonfasting and compared using SPSS software. Results: Mean ALT change from before to after Ramadan was higher and positive in fasting (+7.38±8.47 IU/L) compared to nonfastng patients that was negative (-0.12±10.15 IU/L) (P=0.002) and this change was mainly in patients who had fasted 21-30 days. Conclusion: Ramadan fasting may increase ALT. It is needed to perform more studies in patients with NAFLD during Ramadan fasting with larger sample size and in various conditions especially weight loss with patients’ education for observing dietary regimen.
Keywords
ALT
Fasting
Ramadan
  1. Bajaj S, Khan A, Fathima FN, Jaleel MA, Sheikh A, Azad K, et al. South Asian consensus statement on women's health and Ramadan. Indian J Endocrinol Metab. 2012; 16(4):508-11.
  2. Oztec Z, Bagci T. Effects of fasting Ramadan on compliance with medical treatment. Ann Saudi Med. 1998; 18(5):479-81.
  3. Sheth SG, Gordon FD, Chopra S. Nonalcoholic steatohepatitis. Ann Intern Med. 1997; 126(2):
    137-45.
  4. Vernon G, Baranova A, Younossi ZM. Systematic review: the epidemiology and natural history of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in adults. Aliment Pharmacol Ther. 2011; 34(3):274-85.
  5. Younossi ZM, Koenig AB, Abdelatif D, Fazel Y, Henry L, Wymer M. Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology. 2016; 64(1):73-84.
  6. Younossi ZM, Stepanova M, Afendy M, Fang Y, Younossi Y, Mir H, et al. Changes in the prevalence of the most common causes of chronic liver diseases in the United States from 1988 to 2008. Clin Gastroenterol Hepatol. 2011; 9(6):524-30.
  7. Moghaddasifar I, Lankarani KB, Moosazadeh M, Afshari M, Ghaemi A, Aliramezany M, et al. Prevalence of non-alcoholic fatty liver disease and its related factors in Iran. Int J Organ Transplant Med. 2016; 7(3):149-60.
  8. Williams CD, Stengel J, Asike MI, Torres DM, Shaw J, Contreras M, et al. Prevalence of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis among a largely middle-aged population utilizing ultrasound and liver biopsy: a prospective study. Gastroenterology. 2011; 140(1):124-31.
  9. Rogha M, Najafi N, Azari A, Kaji M, Pourmoghaddas Z, Rajabi F, et al. Non-alcoholic steatohepatitis in a sample of Iranian adult population: age is a risk factor. Int J Prev Med. 2011; 2(1):24-7.
  10. Adams LA, Feldstein AE. Nonalcoholic steatohepatitis: risk factors and diagnosis. Expert Rev Gastroenterol Hepatol. 2010; 4(5):623-35.
  11. Farooq N, Priyamvada S, Arivarasu NA, Salim S, Khan F, Yusufi AN. Influence of Ramadan-type fasting on enzymes of carbohydrate metabolism and brush border membrane in small intestine and liver of rat used as a model. Br J Nutr. 2006; 96(6):1087-94.
  12. Chalasani N, Younossi Z, Lavine JE, Diehl AM, Brunt EM, Cusi K, et al. The diagnosis and management of non-alcoholic fatty liver disease: practice Guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association. Hepatology. 2012; 55(6):2005-23.
  13. Kwo PY, Cohen SM, Lim JK. ACG clinical guideline: evaluation of abnormal liver chemistries. Am J Gastroenterol. 2017; 112(1):18-35.
  14. Mosek A, Korczyn AD. Fasting headache, weight loss, and dehydration. Headache. 1999; 39(3):225-7.
  15. Roy AS, Bandyopadhyay A. Effect of Ramadan intermittent fasting on selective fitness profile parameters in young untrained Muslim men. BMJ Open Sport Exerc Med. 2015; 1(1):20.
  16. Meo SA, Hassan A. Physiological changes during fasting in Ramadan. J Pak Med Assoc. 2015; 65(5 Suppl 1):S6-14.
  17. Trabelsi K, El Abed K, Trepanowski JF, Stannard SR, Ghlissi Z, Ghozzi H, et al. Effects of Ramadan fasting on biochemical and anthropometric parameters in physically active men. Asian J Sports Med. 2011; 2(3):134-44.
  18. Farshidfar G, Yousfi H, Vakili M, Asadi Noughabi F. The effect of Ramadan fasting on hemoglobin, hematocrit and blood biochemical parameters. J Res Health Sci. 2006; 6(2):21-7.
  19. Ajabnoor GM, Bahijri S, Borai A, Abdulkhaliq AA, Al-Aama JY, Chrousos GP. Health impact of fasting in Saudi Arabia during Ramadan: association with disturbed circadian rhythm and metabolic and sleeping patterns. PLoS One. 2014; 9(5):e96500.
  20. Gnanou JV, Caszo BA, Khalil KM, Abdullah SL, Knight VF, Bidin MZ. Effects of Ramadan fasting on glucose homeostasis and adiponectin levels in healthy adult males. J Diabetes Metab Disord. 2015; 14:55.
  21. Turin TC, Ahmed S, Shommu NS, Afzal AR, Al Mamun M, Qasqas M, et al. Ramadan fasting is not usually associated with the risk of cardiovascular events: A systematic review and meta-analysis. J Family Community Med. 2016; 23(2):73-81.
  22. Perk G, Ghanem J, Aamar S, Ben-Ishay D, Bursztyn M. The effect of the fast of Ramadan on ambulatory blood pressure in treated hypertensives. J Hum Hypertens. 2001; 15(10):723-5.
  23. Chamsi-Pasha H, Ahmed WH. The effect of fasting in Ramadan on patients with heart disease. Saudi Med J. 2004; 25(1):47-51.
  24. Elnadry MH, Nigm IA, Abdel Aziz IM, Elshafee AM, Elazhary SS, Abdel Hafeez MA, et al. Effect of Ramadan fasting on Muslim patients with chronic liver diseases. J Egypt Soc Parasitol. 2011; 41(2):337-46.
Journal of Nutrition,Fasting and Health
Volume 5, Issue 3
Summer 2017
Pages 107-112

  • Receive Date 27 June 2017
  • Revise Date 28 July 2017
  • Accept Date 08 August 2017