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Received Dec 25, 2017; Revised Feb 15, 2018; Accepted Feb 25, 2018
This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
1. Introduction
At present, nonalcoholic fatty liver disease (NAFLD) is the most common cause of elevated serum aminotransferase [1]. In fact, elevated serum alanine aminotransferase (ALT) not only is a consequence of the NAFLD but also predicts the progression of the disease [2]. Recent findings point out that NAFLD may be linked to an increased risk of cardiovascular disease (CVD), which is the most common cause of overall mortality [3, 4]. Many long-term follow-up studies of NAFLD found a strong link between mortality related to the coronary artery disease and NAFLD. Another common reason for mortality in the NAFLD patients is hepatic failure, especially in those with nonalcoholic steatohepatitis (NASH) [5–7]. The increased levels of the liver enzymes including ALT, aspartate aminotransferase (AST), and γ-glutamyl transferase (GGT) are the markers of NAFLD and the occurrence of CVD events in both nondiabetic subjects and the patients with type 2 diabetes [8]. Studies have also shown that ALT predicts cardiovascular events, early carotid atherosclerosis [9, 10]. This suggests that NAFLD is associated with coronary heart disease (CHD), independent of the other features of the metabolic syndrome. The studies showed that the prevalence of NAFLD in Iran was relatively high and the people with NAFLD had a higher risk of 10-year CVD events than the individuals without NAFLD [4, 11].
Animal models and human studies suggest that the dietary factors play a key role in the progression of NAFLD. In particular, the amount and type of dietary fat can affect fatty infiltration and lipid peroxidation in NAFLD [12, 13]. There is little research on the effects of the type of dietary fat in NAFLD [14]. Recently, the Mediterranean diet has received attention as a diet that prevents NAFLD and cardiovascular disease. It is known that olive oil, which is rich in the monounsaturated fatty acids (MUFAs), is responsible for the major part of the beneficial effects of the Mediterranean diet [15–17].
Animal studies indicated that olive oil consumption leads to an increase in the release...
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