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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" article-type="research-article" dtd-version="1.1" specific-use="sps-1.9" xml:lang="en">
  <front>
    <journal-meta>
      <journal-id journal-id-type="nlm-ta">Arq Bras Cardiol</journal-id>
      <journal-id journal-id-type="publisher-id">abc</journal-id>
      <journal-title-group>
        <journal-title>Arquivos Brasileiros de Cardiologia</journal-title>
        <abbrev-journal-title abbrev-type="publisher">Arq. Bras. Cardiol.</abbrev-journal-title>
      </journal-title-group>
      <issn pub-type="ppub">0066-782X</issn>
      <issn pub-type="epub">1678-4170</issn>
      <publisher>
        <publisher-name>Sociedade Brasileira de Cardiologia - SBC</publisher-name>
      </publisher>
    </journal-meta>
    <article-meta>
      <article-id pub-id-type="publisher-id" specific-use="scielo-v3">JkVFyx4kJxcTTYZVthvn3hk</article-id>
      <article-id pub-id-type="publisher-id" specific-use="scielo-v2">S0066-782X2019001100896</article-id>
      <article-id pub-id-type="publisher-id" specific-use="previous-pid">S0066-782X2019005015101</article-id>
      <article-id pub-id-type="doi">10.5935/abc.20190149</article-id>
      <article-categories>
        <subj-group subj-group-type="heading">
          <subject>Original Article</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title>High-Lard and High-Cholesterol Diet, but not High-Lard Diet, Leads to Metabolic Disorders in a Modified Dyslipidemia Model</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <name>
            <surname>Muniz</surname>
            <given-names>Lidiane B.</given-names>
          </name>
          <xref ref-type="aff" rid="aff1"/>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Alves-Santos</surname>
            <given-names>Aline M.</given-names>
          </name>
          <xref ref-type="aff" rid="aff1"/>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Camargo</surname>
            <given-names>Fabricio</given-names>
          </name>
          <xref ref-type="aff" rid="aff1"/>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Martins</surname>
            <given-names>Danieli Brolo</given-names>
          </name>
          <xref ref-type="aff" rid="aff1"/>
        </contrib>
        <contrib contrib-type="author">
          <contrib-id contrib-id-type="orcid">0000-0002-4733-007X</contrib-id>
          <name>
            <surname>Celes</surname>
            <given-names>Mara Rubia N.</given-names>
          </name>
          <xref ref-type="aff" rid="aff1"/>
        </contrib>
        <contrib contrib-type="author">
          <contrib-id contrib-id-type="orcid">0000-0003-4332-6206</contrib-id>
          <name>
            <surname>Naves</surname>
            <given-names>Maria Margareth V.</given-names>
          </name>
          <xref ref-type="aff" rid="aff1"/>
          <xref ref-type="corresp" rid="c1"/>
        </contrib>
        <aff id="aff1">
          <institution content-type="orgname">Universidade Federal de Goi&#225;s</institution>
          <addr-line>
            <city>Goiania</city>
            <state>GO</state>
          </addr-line>
          <country country="BR">Brazil</country>
          <institution content-type="original">Universidade Federal de Goi&#225;s, Goiania, GO - Brazil</institution>
        </aff>
      </contrib-group>
      <author-notes>
        <corresp id="c1"><bold>Mailing Address: Maria Margareth V. Naves,</bold> Universidade Federal de Goi&#225;s - Faculdade de Nutri&#231;&#227;o - Laborat&#243;rio de Nutri&#231;&#227;o Experimental - Rua 227, quadra 68, Setor Leste Universit&#225;rio, Postal Code 74605-080, Goi&#226;nia, GO - Brazil. E-mail: <email>mmvnaves@gmail.com</email>
				</corresp>
        <fn fn-type="con">
          <p>
            <bold>Author contributions</bold>
          </p>
          <p>Conception and design of the research and Obtaining financing: Naves MMV; Acquisition of data: Muniz LB, Alves-Santos AM, Camargo F, Martins DB, Celes MRN; Analysis and interpretation of the data, Statistical analysis and Writing of the manuscript: Muniz LB, Alves-Santos AM; Critical revision of the manuscript for intellectual content: Martins DB, Celes MRN, Naves MMV.</p>
        </fn>
        <fn fn-type="conflict">
          <p>
            <bold>Potential Conflict of Interest</bold>
          </p>
          <p>No potential conflict of interest relevant to this article was reported.</p>
        </fn>
      </author-notes>
      <pub-date date-type="pub" publication-format="electronic">
        <day>29</day>
        <month>08</month>
        <year>2019</year>
      </pub-date>
      <pub-date date-type="collection" publication-format="electronic">
        <month>11</month>
        <year>2019</year>
      </pub-date>
      <volume>113</volume>
      <issue>5</issue>
      <fpage>896</fpage>
      <lpage>902</lpage>
      <history>
        <date date-type="received">
          <day>27</day>
          <month>08</month>
          <year>2018</year>
        </date>
        <date date-type="rev-recd">
          <day>03</day>
          <month>12</month>
          <year>2018</year>
        </date>
        <date date-type="accepted">
          <day>23</day>
          <month>01</month>
          <year>2019</year>
        </date>
      </history>
      <permissions>
        <license license-type="open-access" xlink:href="https://creativecommons.org/licenses/by/4.0/" xml:lang="en">
          <license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited</license-p>
        </license>
      </permissions>
      <abstract>
        <title>Abstract</title>
        <sec>
          <title>Background:</title>
          <p>In view of the increased global prevalence of cardiovascular and hepatic diseases, the diet lipid content and its relationship with the accumulation of fat in hepatocytes have been investigated as key factors in preventing these diseases.</p>
        </sec>
        <sec>
          <title>Objective:</title>
          <p>To evaluate the metabolic effects of a high-lard diet supplemented or not with cholesterol on a modified dyslipidemia model.</p>
        </sec>
        <sec>
          <title>Methods:</title>
          <p>We divided 24 adult male Wistar rats into three groups: standard diet (STD - 4% lipids), high-lard diet (HLD - 21% lard), and high-lard and high-cholesterol diet (HL/HCD - 20% lard, 1% cholesterol, 0.1% cholic acid). After six weeks of treatment, blood and liver were collected for biochemical (serum lipid profile and liver enzymes) and morphological analyses. Statistical analysis included one-way analysis of variance (ANOVA), followed by Tukey test for mean comparisons, and a 5% probability was considered statistically significant.</p>
        </sec>
        <sec>
          <title>Results:</title>
          <p>Animals fed HL/HCD showed increased total cholesterol, triacylglycerol, LDL-c, non-HDL-c, alanine aminotransferase (ALT), and aspartate aminotransferase (AST) serum levels compared to those fed STD. In addition, the HL/HCD animals presented higher relative liver weight, with moderate macrovesicular hepatic steatosis and inflammatory infiltrate.</p>
        </sec>
        <sec>
          <title>Conclusion:</title>
          <p>A high-fat diet with lard (20%) and cholesterol (1%) triggered dyslipidemia with severe liver damage in rats in a shorter experimental time than the previously reported models. The high-lard diet without supplementation of cholesterol led to body weight gain, but not to dyslipidemia.</p>
        </sec>
      </abstract>
      <kwd-group xml:lang="en">
        <title>Keywords</title>
        <kwd>Dietary Fats</kwd>
        <kwd>Cholesterol</kwd>
        <kwd>Lipid Metabolism</kwd>
        <kwd>Fatty Liver</kwd>
        <kwd>Inflammation</kwd>
        <kwd>Rats</kwd>
      </kwd-group>
    </article-meta>
  </front>
  <body>
    <sec sec-type="intro">
      <title>Introduction</title>
      <p>The worldwide prevalence of metabolic diseases and associated health complications have increased in recent decades. Excess body fat, insulin resistance, non-alcoholic fatty liver disease (NAFLD), and dyslipidemia lead to metabolic disorders related to higher risks of developing cardiovascular diseases.<xref ref-type="bibr" rid="B1">1</xref> NAFLD ranges from a minor hepatocyte fat accumulation to more severe stages of inflammatory necrosis, with or without fibrosis. Studies indicate an association between NAFLD and insulin resistance, hepatocyte inflammation, and lipid metabolism impairment,<xref ref-type="bibr" rid="B2">2</xref><sup>,</sup><xref ref-type="bibr" rid="B3">3</xref> as most NAFLD patients present dyslipidemia.<xref ref-type="bibr" rid="B4">4</xref>
			</p>
      <p>Dyslipidemia is characterized by increased levels of triacylglycerol (TG) and low-density lipoprotein cholesterol (LDL-c) and decreased high-density lipoprotein cholesterol (HDL-c).<xref ref-type="bibr" rid="B5">5</xref> Hypercholesterolemia (isolated LDL-c increase) and hypertriglyceridemia (isolated TG increase) are the most common forms of dyslipidemia.<xref ref-type="bibr" rid="B6">6</xref> In general, lipid metabolism imbalance results from the interaction between genetics and environmental factors, such as eating habits, especially lipid consumption. Therefore, diet lipid content has been investigated as a key factor in preventing cardiovascular and hepatic diseases.<xref ref-type="bibr" rid="B7">7</xref>
			</p>
      <p>Experimental studies with high-fat diets have used very high contents of dietary fat (about 50% of the diet composition), in short-period (four weeks) protocols, without finding serum lipid impairment.<xref ref-type="bibr" rid="B8">8</xref><sup>,</sup><xref ref-type="bibr" rid="B9">9</xref> On the other hand, studies testing lipid concentrations closer to human consumption have been performed during a relatively long experimental time, as in previous reports with rats (21% fat for 9 weeks)<xref ref-type="bibr" rid="B10">10</xref> and with mice (15% to 20% fat for 12 to 16 weeks).<xref ref-type="bibr" rid="B11">11</xref><sup>,</sup><xref ref-type="bibr" rid="B12">12</xref>
			</p>
      <p>In this context, this study aimed to evaluate the metabolic effects of a high-lard diet supplemented or not with cholesterol on a modified dyslipidemia model, with shorter experimentation time and lower diet lipid concentration compared to previous reports.</p>
    </sec>
    <sec sec-type="methods">
      <title>Methods</title>
      <sec>
        <title>Animals, diets, and experimental design</title>
        <p>The experiment was carried out with adult male Wistar rats provided by the University of S&#227;o Paulo (Ribeir&#227;o Preto, Brazil). The rats were kept in plastic cages (2 animals/cage) for seven weeks (one week of acclimation and six weeks of assay), under controlled environmental conditions (12 h light, 12 h dark cycle, and temperature at 22 &#177; 2&#186;C). In the experiment, we randomly divided 24 rats into 3 groups of 8 animals, according to a randomized block design based on their body weight. The sample size was defined considering previous studies on experimental dyslipidemia. Each group received one of the following diets: standard diet (STD; RH19521, Rhoster, Brazil) prepared according to AIN-93M,<xref ref-type="bibr" rid="B13">13</xref> high-lard diet (HLD; RH195143, Rhoster, Brazil), and high-lard and high-cholesterol diet (HL/HCD; RH195142, Rhoster, Brazil). Soybean oil (STD) and lard were used as lipid sources; cholesterol, to induce hypercholesterolemia; and cholic acid, to increase the hypercholesterolemic effect of supplemented cholesterol<xref ref-type="bibr" rid="B14">14</xref> (<xref ref-type="table" rid="t1">Table 1</xref>). The diets and filtered water were provided <italic>ad libitum</italic>. Dietary intake and body weight of the animals were monitored three times a week.</p>
        <table-wrap id="t1">
          <label>Table 1</label>
          <caption>
            <title>Composition of the experimental diets</title>
          </caption>
          <table frame="hsides" rules="groups">
            <colgroup>
              <col width="40%"/>
              <col width="6%"/>
              <col width="20%"/>
              <col width="20%"/>
              <col width="20%"/>
            </colgroup>
            <thead>
              <tr>
                <th align="left" rowspan="2" style="border-bottom-width:thin;border-bottom-style:solid">Component (g/100g of diet)</th>
                <th align="center">
								</th>
                <th align="center" colspan="3" style="border-bottom-width:thin;border-bottom-style:solid">Diet<sup><xref ref-type="table-fn" rid="TFN1">1</xref></sup></th>
              </tr>
              <tr style="border-bottom-width:thin;border-bottom-style:solid">
                <th align="center">
								</th>
                <th align="center">STD</th>
                <th align="center">HLD</th>
                <th align="center">HL/HCD</th>
              </tr>
            </thead>
            <tbody>
              <tr>
                <td align="left">Casein (82.93 g of protein)</td>
                <td align="center">
								</td>
                <td align="center">16.47</td>
                <td align="center">16.47</td>
                <td align="center">16.47</td>
              </tr>
              <tr>
                <td align="left">L-cystine</td>
                <td align="center">
								</td>
                <td align="center">0.18</td>
                <td align="center">0.18</td>
                <td align="center">0.18</td>
              </tr>
              <tr>
                <td align="left">Soybean oil</td>
                <td align="center">
								</td>
                <td align="center">4.00</td>
                <td align="center">0.00</td>
                <td align="center">0.00</td>
              </tr>
              <tr>
                <td align="left">Lard<sup><xref ref-type="table-fn" rid="TFN2">2</xref></sup></td>
                <td align="center">
								</td>
                <td align="center">0.00</td>
                <td align="center">21.00</td>
                <td align="center">20.00</td>
              </tr>
              <tr>
                <td align="left">Cholesterol<sup><xref ref-type="table-fn" rid="TFN2">2</xref></sup></td>
                <td align="center">
								</td>
                <td align="center">0.00</td>
                <td align="center">0.00</td>
                <td align="center">1.00</td>
              </tr>
              <tr>
                <td align="left">Cholic acid<sup><xref ref-type="table-fn" rid="TFN2">2</xref></sup></td>
                <td align="center">
								</td>
                <td align="center">0.00</td>
                <td align="center">0.00</td>
                <td align="center">0.10</td>
              </tr>
              <tr>
                <td align="left">Sucrose</td>
                <td align="center">
								</td>
                <td align="center">10.00</td>
                <td align="center">10.00</td>
                <td align="center">10.00</td>
              </tr>
              <tr>
                <td align="left">Cellulose</td>
                <td align="center">
								</td>
                <td align="center">5.00</td>
                <td align="center">5.00</td>
                <td align="center">5.00</td>
              </tr>
              <tr>
                <td align="left">Mineral mix</td>
                <td align="center">
								</td>
                <td align="center">3.50</td>
                <td align="center">3.50</td>
                <td align="center">3.50</td>
              </tr>
              <tr>
                <td align="left">Choline bitartrate</td>
                <td align="center">
								</td>
                <td align="center">0.25</td>
                <td align="center">0.25</td>
                <td align="center">0.25</td>
              </tr>
              <tr>
                <td align="left">Vitamin mix</td>
                <td align="center">
								</td>
                <td align="center">1.00</td>
                <td align="center">1.00</td>
                <td align="center">1.00</td>
              </tr>
              <tr>
                <td align="left"><italic>tert</italic>-Butylhydroquinone (TBHQ)</td>
                <td align="center">
								</td>
                <td align="center">0.008</td>
                <td align="center">0.008</td>
                <td align="center">0.008</td>
              </tr>
              <tr>
                <td align="left">Dextrinized cornstarch</td>
                <td align="center">
								</td>
                <td align="center">15.50</td>
                <td align="center">15.50</td>
                <td align="center">15.50</td>
              </tr>
              <tr>
                <td align="left">Corn starch</td>
                <td align="center">
								</td>
                <td align="center">44.09</td>
                <td align="center">27.09</td>
                <td align="center">26.99</td>
              </tr>
              <tr>
                <td align="left">Lipids (g/100g)<sup><xref ref-type="table-fn" rid="TFN3">3</xref></sup></td>
                <td align="center">
								</td>
                <td align="center">4.1 &#177; 0.1</td>
                <td align="center">19.7 &#177; 1.4</td>
                <td align="center">20.8 &#177; 1.6</td>
              </tr>
              <tr>
                <td align="left">Energy from lipids<sup><xref ref-type="table-fn" rid="TFN4">4</xref></sup></td>
                <td align="center">
								</td>
                <td align="center">36</td>
                <td align="center">189</td>
                <td align="center">189</td>
              </tr>
              <tr>
                <td align="left">Diet energy (kcal/g)<sup><xref ref-type="table-fn" rid="TFN4">4</xref></sup></td>
                <td align="center">
								</td>
                <td align="center">3.41</td>
                <td align="center">4.26</td>
                <td align="center">4.26</td>
              </tr>
              <tr>
                <td align="left">(Energy from lipids x 100)/diet energy (%)</td>
                <td align="center">
								</td>
                <td align="center">11</td>
                <td align="center">44</td>
                <td align="center">44</td>
              </tr>
            </tbody>
          </table>
          <table-wrap-foot>
            <fn id="TFN1">
              <label>1</label>
              <p>
                <italic>Reeves et al.<sup><xref ref-type="bibr" rid="B13">13</xref></sup>; STD: standard diet; HLD: high-lard diet; HL/HCD: high-lard and high-cholesterol diet;</italic>
              </p>
            </fn>
            <fn id="TFN2">
              <label>2</label>
              <p>
                <italic>Fernandes et al.<sup><xref ref-type="bibr" rid="B10">10</xref></sup>;</italic>
              </p>
            </fn>
            <fn id="TFN3">
              <label>3</label>
              <p>
                <italic>Result of diet chemical analysis;</italic>
              </p>
            </fn>
            <fn id="TFN4">
              <label>4</label>
              <p>
                <italic>Diet energy value: 4, 4, and 9 kcal/g for protein, carbohydrate, and lipid, respectively.</italic>
              </p>
            </fn>
          </table-wrap-foot>
        </table-wrap>
        <p>After six weeks of experimentation, the animals were euthanized (xylazine + ketamine/ 10 mg/kg + 100 mg/kg). Next, we collected blood samples by abdominal puncture (about 5 mL) for biochemical analyses (serum lipid profile and liver enzymes). After the euthanasia by abdominal aorta exsanguination, we extracted, weighed, and prepared the liver of the animals for morphological evaluation. All procedures complied with the Guide for the Care and Use of Laboratory Animals<xref ref-type="bibr" rid="B15">15</xref> and were approved by the Animal Care and Use Ethics Committee of the Federal University of Goi&#225;s (protocol number 039/15).</p>
      </sec>
      <sec>
        <title>Biochemical analyses</title>
        <p>Blood samples were collected in heparin tubes and centrifuged at 4000 rpm for 10 min to separate the serum, which was immediately stored at -80&#176;C for analyses of lipid profile and liver enzymes. Total cholesterol (TC), TG, LDL-c, HDL-c, alanine aminotransferase (ALT), and aspartate aminotransferase (AST) levels were determined by commercially available kits (Labtest Diagn&#243;stica S.A., Lagoa Santa, Brazil). Very low-density lipoprotein cholesterol (VLDL-c) was estimated by the Friedewald equation, and non-HDL-c fraction was obtained by the difference between TC and HDL-c levels. The importance of non-HDL-c fraction has been highlighted in cardiovascular disease (CVD) risk prediction. Boekholdt et al.<xref ref-type="bibr" rid="B16">16</xref> revealed that non-HDL-c concentrations had a stronger direct association with CVD risk than LDL-c and apolipoprotein B (Apo B).</p>
      </sec>
      <sec>
        <title>Liver morphological evaluation</title>
        <p>We rinsed the liver lobes in ice-cold 0.9% physiological solution and fixed them by immersion in phosphate-buffered 10% formalin for 24 h. Subsequently, the lobes were cut into 4 to 5 mm thick fragments, dehydrated in increasing alcohol concentrations (80%, 95%, and 100%), clarified in xylol (3 baths of 30 min each), and embedded in paraffin. Five-micrometer-thick serial sections were obtained and stained with hematoxylin and eosin (HE). We used the HE-stained sections to analyze the alterations in the arrangement of hepatic parenchyma and the presence of inflammatory infiltrates with a Leica Las V4 Software (Leica Imaging Systems Ltd., Cambridge, UK), a Leica DM2000 microscope (Leica Microsystems Wetzlar GmbH, Wetzlar, Switzerland), a Leica DC230 video camera (Leica Microsystems AG, Heerbrugg, Switzerland), and an online computer. Twenty fields of hepatic parenchyma of each animal were randomly selected and analyzed, at 100x and 400x magnification.</p>
      </sec>
      <sec>
        <title>Statistical analysis</title>
        <p>Data were expressed as mean &#177; standard deviation. The literature considers body weight and biochemical parameters obtained in animal models as parametric data.<xref ref-type="bibr" rid="B8">8</xref><sup>-</sup><xref ref-type="bibr" rid="B12">12</xref> Thus, we determined statistical significance using the one-way analysis of variance (ANOVA), followed by Tukey test for mean comparisons (p &lt; 0.05). STATISTICA software, version 7.0 (StatSoft, Inc., Tulsa, OK, USA) was used for statistical analyses.</p>
      </sec>
    </sec>
    <sec sec-type="results">
      <title>Results</title>
      <p>The lard used in the formulation of diets contained 39 g/100 g of saturated fat and 72 mg/100 g of cholesterol. In high-fat diets (HLD and HL/HCD), lard contributed with approximately 15 mg of cholesterol/100 g of diet, besides the cholesterol added to the HL/HCD. Forty-four percent (44%) of the HLD and HL/HCD energy derived from lipids, a value four times higher than that of STD (11%).</p>
      <p>The initial body weight of the animals did not differ among the groups, ensuring the homogeneity of group repetitions. Animals fed HLD showed higher body weight gain than those from the STD group. Liver weight and relative liver weight of animals fed HL/HCD were higher (p &lt; 0.05) than those of other groups (<xref ref-type="table" rid="t2">Table 2</xref>).</p>
      <table-wrap id="t2">
        <label>Table 2</label>
        <caption>
          <title>Body and liver weight and biochemical parameters of Wistar rats after six weeks of treatment with standard and high-fat diets</title>
        </caption>
        <table frame="hsides" rules="groups">
          <colgroup>
            <col width="40%"/>
            <col width="20%"/>
            <col width="20%"/>
            <col width="20%"/>
          </colgroup>
          <thead>
            <tr style="border-bottom-width:thin;border-bottom-style:solid">
              <th align="left" rowspan="2">Parameter</th>
              <th align="center" colspan="3">Diet</th>
            </tr>
            <tr style="border-bottom-width:thin;border-bottom-style:solid">
              <th align="center">STD</th>
              <th align="center">HLD</th>
              <th align="center">HL/HCD</th>
            </tr>
          </thead>
          <tbody>
            <tr>
              <td align="left">
                <bold>Body weight (g)</bold>
              </td>
              <td align="center">
							</td>
              <td align="center">
							</td>
              <td align="center">
							</td>
            </tr>
            <tr>
              <td align="left">Initial</td>
              <td align="center">249.05 &#177; 21.44<sup>a</sup></td>
              <td align="center">243.85 &#177; 15.09<sup>a</sup></td>
              <td align="center">242.35 &#177; 16.78<sup>a</sup></td>
            </tr>
            <tr>
              <td align="left">Final</td>
              <td align="center">499.58 &#177; 65.32<sup>a</sup></td>
              <td align="center">564.08 &#177; 39.73<sup>a</sup></td>
              <td align="center">508.58 &#177; 47.68<sup>a</sup></td>
            </tr>
            <tr>
              <td align="left">Gain</td>
              <td align="center">250.53 &#177; 48.40<sup>b</sup></td>
              <td align="center">320.23 &#177; 44.50<sup>a</sup></td>
              <td align="center">266.23 &#177; 38.21<sup>a,b</sup></td>
            </tr>
            <tr>
              <td align="left">
                <bold>Liver</bold>
              </td>
              <td align="center">
							</td>
              <td align="center">
							</td>
              <td align="center">
							</td>
            </tr>
            <tr>
              <td align="left">Weight (g)</td>
              <td align="center">14.90 &#177; 2.33<sup>b</sup></td>
              <td align="center">15.92 &#177; 1.65<sup>b</sup></td>
              <td align="center">27.10 &#177; 5.94<sup>a</sup></td>
            </tr>
            <tr>
              <td align="left">Relative weight (g/100g body weight)</td>
              <td align="center">2.98 &#177; 0.24<sup>b</sup></td>
              <td align="center">2.82 &#177; 0.14<sup>b</sup></td>
              <td align="center">5.28 &#177; 0.80<sup>a</sup></td>
            </tr>
            <tr>
              <td align="left">
                <bold>Serum lipid profile (mg/dL)</bold>
              </td>
              <td align="center">
							</td>
              <td align="center">
							</td>
              <td align="center">
							</td>
            </tr>
            <tr>
              <td align="left">TC</td>
              <td align="center">59.83 &#177; 15.99<sup>b</sup></td>
              <td align="center">64.58 &#177; 14.13<sup>b</sup></td>
              <td align="center">87.75 &#177; 8.54<sup>a</sup></td>
            </tr>
            <tr>
              <td align="left">LDL-c</td>
              <td align="center">4.23 &#177; 0.71<sup>b</sup></td>
              <td align="center">6.98 &#177; 2.09<sup>b</sup></td>
              <td align="center">23.63 &#177; 4.55<sup>a</sup></td>
            </tr>
            <tr>
              <td align="left">HDL-c</td>
              <td align="center">30.74 &#177; 4.11<sup>a</sup></td>
              <td align="center">34.42 &#177; 7.77<sup>a</sup></td>
              <td align="center">26.74 &#177; 4.23<sup>a</sup></td>
            </tr>
            <tr>
              <td align="left">non-HDL-c</td>
              <td align="center">29.09 &#177; 12.13<sup>b</sup></td>
              <td align="center">30.17 &#177; 10.84<sup>b</sup></td>
              <td align="center">61.01 &#177; 6.95<sup>a</sup></td>
            </tr>
            <tr>
              <td align="left">VLDL-c</td>
              <td align="center">10.68 &#177; 1.58<sup>b</sup></td>
              <td align="center">16.77 &#177; 4.58<sup>a,b</sup></td>
              <td align="center">18.52 &#177; 7.51<sup>a</sup></td>
            </tr>
            <tr>
              <td align="left">TG</td>
              <td align="center">53.42 &#177; 7.91<sup>b</sup></td>
              <td align="center">83.83 &#177; 22.90<sup>a,b</sup></td>
              <td align="center">92.58 &#177; 37.55<sup>a</sup></td>
            </tr>
            <tr>
              <td align="left">
                <bold>Liver enzymes (U/L)</bold>
              </td>
              <td align="center">
							</td>
              <td align="center">
							</td>
              <td align="center">
							</td>
            </tr>
            <tr>
              <td align="left">ALT</td>
              <td align="center">48.72 &#177; 15.91<sup>b</sup></td>
              <td align="center">28.16 &#177; 6.00<sup>b</sup></td>
              <td align="center">210.30 &#177; 137.78<sup>a</sup></td>
            </tr>
            <tr>
              <td align="left">AST</td>
              <td align="center">154.67 &#177; 22.42<sup>b</sup></td>
              <td align="center">117.00 &#177; 29.84<sup>b</sup></td>
              <td align="center">300.63 &#177; 60.26<sup>a</sup></td>
            </tr>
          </tbody>
        </table>
        <table-wrap-foot>
          <fn id="TFN5">
            <p>
              <italic>Data are expressed as mean &#177; standard deviation. a,bValues in the same row with different superscript letters are significantly different (Tukey test, p &lt; 0.05). STD: standard diet; HLD: high-lard diet; HL/HCD: high-lard and high-cholesterol diet; Relative liver weight = (liver weight/body weight) x 100; TC: total cholesterol; LDL-c: low-density lipoprotein cholesterol; HDL-c: high-density lipoprotein cholesterol; VLDL-c: very low-density lipoprotein cholesterol; TG: triacylglycerol; non-HDL-c: non-high-density lipoprotein cholesterol; ALT: alanine aminotransferase; AST: aspartate aminotransferase.</italic>
            </p>
          </fn>
        </table-wrap-foot>
      </table-wrap>
      <p>Animals fed HL/HCD showed higher TC, TG, LDL-c, VLDL-c, non-HDL-c, ALT, and AST serum levels than those from STD and HLD groups. Serum lipid profile and liver enzymes of animals fed HLD were not different from those of the STD group (<xref ref-type="table" rid="t2">Table 2</xref>).</p>
      <p>We found microscopic changes (<xref ref-type="fig" rid="f1">Figure 1</xref>) in the liver of animals fed HL/HCD, as the hepatic tissue architecture was not preserved, with hepatocyte ballooning (characterized by swelling and/or vacuolation), alterations in sinusoidal blood capillaries, and passive hyperemia (capillaries and veins engorged with blood). In addition, rats fed HL/HCD presented moderate macrovesicular hepatic steatosis associated with a marked infiltration by lymphomononuclear cells. On the other hand, animals fed HLD had their hepatic tissue architecture preserved, containing hepatocytes with usual morphological aspect, and preserved vascular distribution, centrilobular vein, and portal triad. Furthermore, the HLD group showed mild microvesicular hepatic steatosis associated with lower infiltration by lymphomononuclear cells. The hepatic tissue architecture of the STD group was maintained with typical hepatocytes, preserved hepatic sinusoid, and capillary strands; conserved vascular distribution, intact portal triads, with portal vein branches, hepatic artery, and bile duct.</p>
      <p>
        <fig id="f1">
          <label>Figure 1</label>
          <caption>
            <title>Morphological evaluation of the liver of Wistar rats fed high-fat diets for six weeks. STD (standard diet): preserved hepatic tissue architecture with conserved vascular distribution. HLD (high-lard diet): preserved hepatic tissue architecture with mild and uniform hepatic steatosis (black arrows), mild inflammatory infiltrate (white arrows), and mild passive hyperemia (arrowheads). HL/HCD (high-lard and high-cholesterol diet): altered tissue architecture with moderate hepatic steatosis, fat microvesicles and macrovesicles (black arrows), and marked inflammatory infiltrate (white arrows). The bars indicate 100 &#956;m at 100x magnification (left panel) and 20 &#956;m at 400x magnification (right panel).</title>
          </caption>
          <graphic xlink:href="1678-4170-abc-113-05-0896-90149-gf01.jpg"/></fig>
      </p>
    </sec>
    <sec sec-type="discussion">
      <title>Discussion</title>
      <p>Dyslipidemia was triggered in rats fed a diet with 20% lard and 1% cholesterol, in six weeks, with increased liver weight, liver injury, and inflammatory infiltrate.</p>
      <p>In the present study, lipids contributed with 44% of high-fat diet energy, a percentage close to that reported for high-fat diet consumed by overweight or obese individuals (43% to 55%).<xref ref-type="bibr" rid="B17">17</xref><sup>-</sup><xref ref-type="bibr" rid="B19">19</xref> In previous animal studies, lipid contribution ranged from 67% to 75% of high-fat diet energy.<xref ref-type="bibr" rid="B8">8</xref><sup>,</sup><xref ref-type="bibr" rid="B9">9</xref> Therefore, these diets with very high contents of lipids do not reproduce, realistically, the high-fat diets consumed by humans. The daily recommendation for human adults is 20% to 35% energy from lipids, according to the AMDR (Acceptable Macronutrient Distribution Ranges), considering that high lipid intake indicates a greater risk of obesity and associated disorders.<xref ref-type="bibr" rid="B20">20</xref>
			</p>
      <p>Higher body weight gain in the HLD group can be explained by its higher food consumption (17.6 g/day/rat) compared to the HL/HCD group (13.8 g/day/rat) since the energy density of the diets was similar (4.26 kcal/g). Higher weight gain was reported in a previous study with mice fed a high-fat and high-cholesterol diet (energy density = 4.27 kcal/g) for 12 weeks, compared to the control group.<xref ref-type="bibr" rid="B12">12</xref>
			</p>
      <p>Despite the higher body weight gain, the HLD group did not differ from the STD group regarding liver weight (Table 2). The relative liver weight in the HL/HCD group was very high, above 5% of the body weight of these animals. The increased liver weight in the HL/HCD group is related to the strong presence of fat vesicles in hepatocytes, as observed in the liver morphological evaluation (<xref ref-type="fig" rid="f1">Figure 1</xref>). A previous study with mice on a high-fat and high-cholesterol diet, without cholic acid, for 16 weeks presented similar results regarding liver weight and hepatic tissue lipid accumulation.<xref ref-type="bibr" rid="B11">11</xref> In our study, the cholic acid probably accelerated the dyslipidemic effects of cholesterol in the HL/HCD group, given that we identified metabolic disorders in only 6 weeks, whereas the study by Jung et al.<xref ref-type="bibr" rid="B11">11</xref> reached the same effects in 16 weeks. The serum lipid impairment observed in animals fed HL/HCD is characteristic of dyslipidemia, and the marked increase in LDL-c may be related to the reduction in LDL-c receptor activity in hepatocytes. Previous studies revealed changes in TC and TG serum levels of rats and mice fed a high-fat and high-cholesterol diet.<xref ref-type="bibr" rid="B10">10</xref><sup>,</sup><xref ref-type="bibr" rid="B12">12</xref> However, the experimentation periods of the reported studies (9 and 12 weeks, respectively) were longer than that used in the present study.</p>
      <p>The serum lipid profile of the animals fed HLD did not differ from those fed STD. Studies with Wistar rats on 50% to 55% lard diets (67% to 75% of the diet energy) for four weeks showed similar results.<xref ref-type="bibr" rid="B8">8</xref><sup>,</sup><xref ref-type="bibr" rid="B9">9</xref> The harmful effect of very high intake of saturated fatty acids and its relation to dyslipidemia have been questioned.<xref ref-type="bibr" rid="B1">1</xref> Siri et al.<xref ref-type="bibr" rid="B21">21</xref> highlighted that the effects of saturated fat on serum lipid profile could be modulated by the content and/or availability of polyunsaturated fatty acids, so that saturated fat would only increase LDL-c if the polyunsaturated fat intake is below a threshold level (5% of the diet energy).<xref ref-type="bibr" rid="B22">22</xref> Our results confirmed that the excessive intake of saturated fatty acids explains only part of the changes in serum lipid profile. Other factors influence these changes, such as dietary cholesterol, obesity, insulin resistance, and hypertriglyceridemia.<xref ref-type="bibr" rid="B23">23</xref><sup>,</sup><xref ref-type="bibr" rid="B24">24</xref>
			</p>
      <p>High ALT and AST serum levels are characteristic of NAFLD and are associated with insulin resistance. In this study, increased ALT and AST serum levels were compatible with the hepatic damages observed in the animals fed HL/HCD. Other studies also found increased ALT and AST serum levels in mice fed a high-fat and high-cholesterol diet.<xref ref-type="bibr" rid="B11">11</xref><sup>,</sup><xref ref-type="bibr" rid="B12">12</xref>
			</p>
      <p>The morphological evaluation showed marked changes in the hepatic tissue of animals fed HL/HCD, such as fatty macrovesicles and inflammatory infiltrates, characterizing a moderate hepatic steatosis,<xref ref-type="bibr" rid="B25">25</xref> which was confirmed by the results of the hepatic enzymes (ALT and AST). Fat accumulation in the liver of these animals is related to high cholesterol consumption, as this overload in the cells alters the cholesterol homeostasis.<xref ref-type="bibr" rid="B26">26</xref> In addition, the accumulation of intermediate lipid metabolites, such as diacylglycerol and acylcarnitines, is associated with inflammation and insulin resistance.<xref ref-type="bibr" rid="B27">27</xref><sup>,</sup><xref ref-type="bibr" rid="B28">28</xref> A previous study suggested that high dietary cholesterol is a critical factor for the progression of hepatic steatosis and inflammation in animal models. However, features of NAFLD are more evident when the supplemented cholesterol is associated with cholic acid in a high-fat diet, as observed in our study.</p>
      <p>The presence of inflammatory infiltrate in the hepatic tissue promotes cytokine and chemokine secretion, such as tumor necrosis factor a (TNF-a) and interleukin 6 (IL-6), which induce insulin resistance. In this metabolic disorder, the increased lipolysis of TG stored in the adipose tissue raises fatty acid production. The fatty acids released in the circulation, in turn, inhibit the anti-lipolytic action of insulin and promote higher lipid absorption by the liver, leading to dyslipidemia and hepatic steatosis.<xref ref-type="bibr" rid="B3">3</xref><sup>,</sup><xref ref-type="bibr" rid="B32">32</xref><sup>,</sup><xref ref-type="bibr" rid="B33">33</xref> Hamsters on a 10-week hyperlipidemic diet containing cholesterol (0.2%) developed dyslipidemia and hepatic steatosis, with impaired TC, TG, LDL-c, ALT, and AST serum concentrations.<xref ref-type="bibr" rid="B34">34</xref> Liver histopathological analysis of Sprague-Dawley rats fed a high-cholesterol diet (1.5%) also revealed hepatic steatosis and inflammation.<xref ref-type="bibr" rid="B35">35</xref>
			</p>
      <p>One limitation of our study was the impossibility to use more accurate methods to evaluate liver fat macro- and microvesicles and foam cells, such as Oil Red and immunohistochemistry, respectively, which could allow us to analyze liver damages quantitatively. Moreover, we recommend further studies, including a treatment with lard and cholic acid, to investigate whether cholic acid can enhance the metabolic effects of lard cholesterol.</p>
    </sec>
    <sec sec-type="conclusions">
      <title>Conclusion</title>
      <p>A high-fat diet with lard (20%) and cholesterol (1%) triggered dyslipidemia with severe liver damage in rats in a shorter experimental time than the previously reported models. The high-lard diet without supplementation of cholesterol led to body weight gain, but not to dyslipidemia. This model may be useful to investigate metabolic disorders in different experimental designs related to dyslipidemia and its comorbidities.</p>
    </sec>
  </body>
  <back>
    <fn-group>
      <fn fn-type="supported-by">
        <p>
          <bold>Sources of Funding</bold>
        </p>
        <p>This study was funded by FAPEG.</p>
      </fn>
      <fn fn-type="other">
        <p>
          <bold>Study Association</bold>
        </p>
        <p>This article is part of the project of Post-Doctoral of Lidiane B. Muniz, conducted at Universidade Federal de Goi&#225;s.</p>
      </fn>
      <fn fn-type="other">
        <p>
          <bold>Ethics approval and consent to participate</bold>
        </p>
        <p>This study was approved by the Animal Care and Use Ethics Committee of the Universidade Federal de Goi&#225;s under the protocol number 039/15.</p>
      </fn>
    </fn-group>
    <ack>
      <title>Acknowledgments</title>
      <p>The authors thank the FAPEG (Funda&#231;&#227;o de Amparo &#224; Pesquisa do Estado de Goi&#225;s, Brazil) for the research funding and scholarship, and Professor Maria Aderuza Horst, Ph.D., for assistance with animal procedures.</p>
    </ack>
    <ref-list>
      <title>References</title>
      <ref id="B1">
        <label>1</label>
        <mixed-citation>1 Ruiz-N&#250;&#241;ez B, Dijck-Brouwer DA, Muskiet FA. The relation of saturated fatty acids with low-grade inflammation and cardiovascular disease. J Nutr Biochem. 2016 Oct;36:1-20.</mixed-citation>
        <element-citation publication-type="journal">
          <person-group person-group-type="author">
            <name>
              <surname>Ruiz-N&#250;&#241;ez</surname>
              <given-names>B</given-names>
            </name>
            <name>
              <surname>Dijck-Brouwer</surname>
              <given-names>DA</given-names>
            </name>
            <name>
              <surname>Muskiet</surname>
              <given-names>FA</given-names>
            </name>
          </person-group>
          <article-title>The relation of saturated fatty acids with low-grade inflammation and cardiovascular disease</article-title>
          <source>J Nutr Biochem</source>
          <year>2016</year>
          <month>10</month>
          <volume>36</volume>
          <fpage>1</fpage>
          <lpage>20</lpage>
        </element-citation>
      </ref>
      <ref id="B2">
        <label>2</label>
        <mixed-citation>2 Green CJ, Hodson L. The influence of dietary fat on liver fat accumulation. Nutrients. 2014;6(11):5018-33.</mixed-citation>
        <element-citation publication-type="journal">
          <person-group person-group-type="author">
            <name>
              <surname>Green</surname>
              <given-names>CJ</given-names>
            </name>
            <name>
              <surname>Hodson</surname>
              <given-names>L</given-names>
            </name>
          </person-group>
          <article-title>The influence of dietary fat on liver fat accumulation</article-title>
          <source>Nutrients</source>
          <year>2014</year>
          <volume>6</volume>
          <issue>11</issue>
          <fpage>5018</fpage>
          <lpage>5033</lpage>
        </element-citation>
      </ref>
      <ref id="B3">
        <label>3</label>
        <mixed-citation>3 Yu J, Marsh S, Hu J, Feng W, Wu C. The pathogenesis of nonalcoholic fatty liver disease: interplay between diet, gut microbiota, and genetic background. Gastroenterol Res Pract. 2016 May;2016:1-13.</mixed-citation>
        <element-citation publication-type="journal">
          <person-group person-group-type="author">
            <name>
              <surname>Yu</surname>
              <given-names>J</given-names>
            </name>
            <name>
              <surname>Marsh</surname>
              <given-names>S</given-names>
            </name>
            <name>
              <surname>Hu</surname>
              <given-names>J</given-names>
            </name>
            <name>
              <surname>Feng</surname>
              <given-names>W</given-names>
            </name>
            <name>
              <surname>Wu</surname>
              <given-names>C</given-names>
            </name>
          </person-group>
          <article-title>The pathogenesis of nonalcoholic fatty liver disease: interplay between diet, gut microbiota, and genetic background</article-title>
          <source>Gastroenterol Res Pract</source>
          <year>2016</year>
          <month>05</month>
          <volume>2016</volume>
          <fpage>1</fpage>
          <lpage>13</lpage>
        </element-citation>
      </ref>
      <ref id="B4">
        <label>4</label>
        <mixed-citation>4 Zhang QQ, Lu LG. Nonalcoholic fatty liver disease: dyslipidemia, risk for cardiovascular complications, and treatment strategy. J Clin Transl Hepatol. 2015;3(1):78-84.</mixed-citation>
        <element-citation publication-type="journal">
          <person-group person-group-type="author">
            <name>
              <surname>Zhang</surname>
              <given-names>QQ</given-names>
            </name>
            <name>
              <surname>Lu</surname>
              <given-names>LG</given-names>
            </name>
          </person-group>
          <article-title>Nonalcoholic fatty liver disease: dyslipidemia, risk for cardiovascular complications, and treatment strategy</article-title>
          <source>J Clin Transl Hepatol</source>
          <year>2015</year>
          <volume>3</volume>
          <issue>1</issue>
          <fpage>78</fpage>
          <lpage>84</lpage>
        </element-citation>
      </ref>
      <ref id="B5">
        <label>5</label>
        <mixed-citation>5 Katsiki N, Mikhailidis DP, Mantzoros CS. Non-alcoholic fatty liver disease and dyslipidemia: an update. Metabolism. 2016;65(8):1109-23.</mixed-citation>
        <element-citation publication-type="journal">
          <person-group person-group-type="author">
            <name>
              <surname>Katsiki</surname>
              <given-names>N</given-names>
            </name>
            <name>
              <surname>Mikhailidis</surname>
              <given-names>DP</given-names>
            </name>
            <name>
              <surname>Mantzoros</surname>
              <given-names>CS</given-names>
            </name>
          </person-group>
          <article-title>Non-alcoholic fatty liver disease and dyslipidemia: an update</article-title>
          <source>Metabolism</source>
          <year>2016</year>
          <volume>65</volume>
          <issue>8</issue>
          <fpage>1109</fpage>
          <lpage>1123</lpage>
        </element-citation>
      </ref>
      <ref id="B6">
        <label>6</label>
        <mixed-citation>6 Gaggini M, Morelli M, Buzzigoli E, DeFronzo RA, Bugianesi E, Gastaldelli A. Non-alcoholic fatty liver disease (NAFLD) and its connection with insulin resistance, dyslipidemia, atherosclerosis and coronary heart disease. Nutrients. 2013;5(5):1544-60.</mixed-citation>
        <element-citation publication-type="journal">
          <person-group person-group-type="author">
            <name>
              <surname>Gaggini</surname>
              <given-names>M</given-names>
            </name>
            <name>
              <surname>Morelli</surname>
              <given-names>M</given-names>
            </name>
            <name>
              <surname>Buzzigoli</surname>
              <given-names>E</given-names>
            </name>
            <name>
              <surname>DeFronzo</surname>
              <given-names>RA</given-names>
            </name>
            <name>
              <surname>Bugianesi</surname>
              <given-names>E</given-names>
            </name>
            <name>
              <surname>Gastaldelli</surname>
              <given-names>A</given-names>
            </name>
          </person-group>
          <article-title>Non-alcoholic fatty liver disease (NAFLD) and its connection with insulin resistance, dyslipidemia, atherosclerosis and coronary heart disease</article-title>
          <source>Nutrients</source>
          <year>2013</year>
          <volume>5</volume>
          <issue>5</issue>
          <fpage>1544</fpage>
          <lpage>1560</lpage>
        </element-citation>
      </ref>
      <ref id="B7">
        <label>7</label>
        <mixed-citation>7 Marais AD. Dietary lipid modification for mild and severe dyslipidemia. Proc Nutr Soc. 2013;72(3):337-41.</mixed-citation>
        <element-citation publication-type="journal">
          <person-group person-group-type="author">
            <name>
              <surname>Marais</surname>
              <given-names>AD</given-names>
            </name>
          </person-group>
          <article-title>Dietary lipid modification for mild and severe dyslipidemia</article-title>
          <source>Proc Nutr Soc</source>
          <year>2013</year>
          <volume>72</volume>
          <issue>3</issue>
          <fpage>337</fpage>
          <lpage>341</lpage>
        </element-citation>
      </ref>
      <ref id="B8">
        <label>8</label>
        <mixed-citation>8 Leonardi-Carvalho DS, Zucoloto S, Ovidio PP, Heidor R, Ong TP, Moreno FS, et al. Metabolic differences in the steatosis induced by a high-fat diet and high-protein-fat diet in rats. Advances in Biochemistry. 2015;3(6):86-95.</mixed-citation>
        <element-citation publication-type="journal">
          <person-group person-group-type="author">
            <name>
              <surname>Leonardi-Carvalho</surname>
              <given-names>DS</given-names>
            </name>
            <name>
              <surname>Zucoloto</surname>
              <given-names>S</given-names>
            </name>
            <name>
              <surname>Ovidio</surname>
              <given-names>PP</given-names>
            </name>
            <name>
              <surname>Heidor</surname>
              <given-names>R</given-names>
            </name>
            <name>
              <surname>Ong</surname>
              <given-names>TP</given-names>
            </name>
            <name>
              <surname>Moreno</surname>
              <given-names>FS</given-names>
            </name>
            <etal/>
          </person-group>
          <article-title>Metabolic differences in the steatosis induced by a high-fat diet and high-protein-fat diet in rats</article-title>
          <source>Advances in Biochemistry</source>
          <year>2015</year>
          <volume>3</volume>
          <issue>6</issue>
          <fpage>86</fpage>
          <lpage>95</lpage>
        </element-citation>
      </ref>
      <ref id="B9">
        <label>9</label>
        <mixed-citation>9 Picchi MG, Mattos AM, Barbosa MR, Duarte CP, Gandini MA, Portari GV, et al. A high-fat diet as a model of fatty liver disease in rats. Acta Cir Bras. 2011;26(Suppl 2):25-30.</mixed-citation>
        <element-citation publication-type="journal">
          <person-group person-group-type="author">
            <name>
              <surname>Picchi</surname>
              <given-names>MG</given-names>
            </name>
            <name>
              <surname>Mattos</surname>
              <given-names>AM</given-names>
            </name>
            <name>
              <surname>Barbosa</surname>
              <given-names>MR</given-names>
            </name>
            <name>
              <surname>Duarte</surname>
              <given-names>CP</given-names>
            </name>
            <name>
              <surname>Gandini</surname>
              <given-names>MA</given-names>
            </name>
            <name>
              <surname>Portari</surname>
              <given-names>GV</given-names>
            </name>
            <etal/>
          </person-group>
          <article-title>A high-fat diet as a model of fatty liver disease in rats</article-title>
          <source>Acta Cir Bras</source>
          <year>2011</year>
          <volume>26</volume>
          <supplement>Suppl 2</supplement>
          <fpage>25</fpage>
          <lpage>30</lpage>
        </element-citation>
      </ref>
      <ref id="B10">
        <label>10</label>
        <mixed-citation>10 Fernandes DC, Alves AM, Castro GSF, Jord&#227;o J&#250;nior AA, Naves MMV. Effects of baru almond and Brazil nut against hyperlipidemia and oxidative stress in vivo. J Food Res. 2015;4(4):38-46.</mixed-citation>
        <element-citation publication-type="journal">
          <person-group person-group-type="author">
            <name>
              <surname>Fernandes</surname>
              <given-names>DC</given-names>
            </name>
            <name>
              <surname>Alves</surname>
              <given-names>AM</given-names>
            </name>
            <name>
              <surname>Castro</surname>
              <given-names>GSF</given-names>
            </name>
            <name>
              <surname>Jord&#227;o</surname>
              <given-names>AA</given-names>
              <suffix>J&#250;nior</suffix>
            </name>
            <name>
              <surname>Naves</surname>
              <given-names>MMV</given-names>
            </name>
          </person-group>
          <article-title>Effects of baru almond and Brazil nut against hyperlipidemia and oxidative stress in vivo</article-title>
          <source>J Food Res</source>
          <year>2015</year>
          <volume>4</volume>
          <issue>4</issue>
          <fpage>38</fpage>
          <lpage>46</lpage>
        </element-citation>
      </ref>
      <ref id="B11">
        <label>11</label>
        <mixed-citation>11 Jung UJ, Cho YY, Choi MS. Apigenin ameliorates dyslipidemia, hepatic steatosis and insulin resistance by modulating metabolic and transcriptional profiles in the liver of high-fat diet-induced obese mice. Nutrients. 2016;8(5):305.</mixed-citation>
        <element-citation publication-type="journal">
          <person-group person-group-type="author">
            <name>
              <surname>Jung</surname>
              <given-names>UJ</given-names>
            </name>
            <name>
              <surname>Cho</surname>
              <given-names>YY</given-names>
            </name>
            <name>
              <surname>Choi</surname>
              <given-names>MS</given-names>
            </name>
          </person-group>
          <article-title>Apigenin ameliorates dyslipidemia, hepatic steatosis and insulin resistance by modulating metabolic and transcriptional profiles in the liver of high-fat diet-induced obese mice</article-title>
          <source>Nutrients</source>
          <year>2016</year>
          <volume>8</volume>
          <issue>5</issue>
          <fpage>305</fpage>
          <lpage>305</lpage>
        </element-citation>
      </ref>
      <ref id="B12">
        <label>12</label>
        <mixed-citation>12 Zidani S, Benakmoum A, Ammouche A, Benali Y, Bouhadef A, Abbeddou S. Effect of dry tomato peel supplementation on glucose tolerance, insulin resistance, and hepatic markers in mice fed high-saturated-fat/high-cholesterol diets. J Nutr Biochem. 2017 Feb;40:164-71.</mixed-citation>
        <element-citation publication-type="journal">
          <person-group person-group-type="author">
            <name>
              <surname>Zidani</surname>
              <given-names>S</given-names>
            </name>
            <name>
              <surname>Benakmoum</surname>
              <given-names>A</given-names>
            </name>
            <name>
              <surname>Ammouche</surname>
              <given-names>A</given-names>
            </name>
            <name>
              <surname>Benali</surname>
              <given-names>Y</given-names>
            </name>
            <name>
              <surname>Bouhadef</surname>
              <given-names>A</given-names>
            </name>
            <name>
              <surname>Abbeddou</surname>
              <given-names>S</given-names>
            </name>
          </person-group>
          <article-title>Effect of dry tomato peel supplementation on glucose tolerance, insulin resistance, and hepatic markers in mice fed high-saturated-fat/high-cholesterol diets</article-title>
          <source>J Nutr Biochem</source>
          <year>2017</year>
          <month>02</month>
          <volume>40</volume>
          <fpage>164</fpage>
          <lpage>171</lpage>
        </element-citation>
      </ref>
      <ref id="B13">
        <label>13</label>
        <mixed-citation>13 Reeves PG, Nielsen FN, Fahey Jr GC. AIN-93 purified diets for laboratory rodents: final report of the American institute of nutrition ad hoc writing committee on the reformulation of the AIN-76A rodent diet. J Nutr. 1993;123(11):1939-51.</mixed-citation>
        <element-citation publication-type="journal">
          <person-group person-group-type="author">
            <name>
              <surname>Reeves</surname>
              <given-names>PG</given-names>
            </name>
            <name>
              <surname>Nielsen</surname>
              <given-names>FN</given-names>
            </name>
            <name>
              <surname>Fahey</surname>
              <given-names>GC</given-names>
              <suffix>Jr</suffix>
            </name>
          </person-group>
          <article-title>AIN-93 purified diets for laboratory rodents: final report of the American institute of nutrition ad hoc writing committee on the reformulation of the AIN-76A rodent diet</article-title>
          <source>J Nutr</source>
          <year>1993</year>
          <volume>123</volume>
          <issue>11</issue>
          <fpage>1939</fpage>
          <lpage>1951</lpage>
        </element-citation>
      </ref>
      <ref id="B14">
        <label>14</label>
        <mixed-citation>14 Takahashi Y, Soejima Y, Fukusato T. Animal models of nonalcoholic fatty liver disease/nonalcoholic steatohepatitis. World J Gastroenterol, 2012;18(19):2300-9.</mixed-citation>
        <element-citation publication-type="journal">
          <person-group person-group-type="author">
            <name>
              <surname>Takahashi</surname>
              <given-names>Y</given-names>
            </name>
            <name>
              <surname>Soejima</surname>
              <given-names>Y</given-names>
            </name>
            <name>
              <surname>Fukusato</surname>
              <given-names>T</given-names>
            </name>
          </person-group>
          <article-title>Animal models of nonalcoholic fatty liver disease/nonalcoholic steatohepatitis</article-title>
          <source>World J Gastroenterol</source>
          <year>2012</year>
          <volume>18</volume>
          <issue>19</issue>
          <fpage>2300</fpage>
          <lpage>2309</lpage>
        </element-citation>
      </ref>
      <ref id="B15">
        <label>15</label>
        <mixed-citation>15 National Research Council. Guide for the care and use of laboratory animal, Washington, DC: The National Academies Press, 2011.</mixed-citation>
        <element-citation publication-type="book">
          <person-group person-group-type="author">
            <collab>National Research Council</collab>
          </person-group>
          <source>Guide for the care and use of laboratory animal</source>
          <year>2011</year>
          <publisher-loc>Washington, DC</publisher-loc>
          <publisher-name>The National Academies Press</publisher-name>
        </element-citation>
      </ref>
      <ref id="B16">
        <label>16</label>
        <mixed-citation>16 Boekholdt SM, Arsenault BJ, Mora S, Pedersen TR, LaRosa JC, Nestel PJ, et al. Association of LDL cholesterol, non-HDL cholesterol, and apolipoprotein B levels with risk of cardiovascular events among patients treated with statins: a meta-analysis. JAMA 2012;307(12):1302e9.</mixed-citation>
        <element-citation publication-type="journal">
          <person-group person-group-type="author">
            <name>
              <surname>Boekholdt</surname>
              <given-names>SM</given-names>
            </name>
            <name>
              <surname>Arsenault</surname>
              <given-names>BJ</given-names>
            </name>
            <name>
              <surname>Mora</surname>
              <given-names>S</given-names>
            </name>
            <name>
              <surname>Pedersen</surname>
              <given-names>TR</given-names>
            </name>
            <name>
              <surname>LaRosa</surname>
              <given-names>JC</given-names>
            </name>
            <name>
              <surname>Nestel</surname>
              <given-names>PJ</given-names>
            </name>
            <etal/>
          </person-group>
          <article-title>Association of LDL cholesterol, non-HDL cholesterol, and apolipoprotein B levels with risk of cardiovascular events among patients treated with statins: a meta-analysis</article-title>
          <source>JAMA</source>
          <year>2012</year>
          <volume>307</volume>
          <issue>12</issue>
          <fpage>1302e9</fpage>
          <lpage>1302e9</lpage>
        </element-citation>
      </ref>
      <ref id="B17">
        <label>17</label>
        <mixed-citation>17 van Herpen NA, Schrauwen-Hinderling VB, Schaart G, Mensink RP, Schrauwen P. Three weeks on a high-fat diet increases intrahepatic lipid accumulation and decreases metabolic flexibility in healthy overweight men. J Clin Endocrinol Metab. 2011;96(4):E691-5.</mixed-citation>
        <element-citation publication-type="journal">
          <person-group person-group-type="author">
            <name>
              <surname>van Herpen</surname>
              <given-names>NA</given-names>
            </name>
            <name>
              <surname>Schrauwen-Hinderling</surname>
              <given-names>VB</given-names>
            </name>
            <name>
              <surname>Schaart</surname>
              <given-names>G</given-names>
            </name>
            <name>
              <surname>Mensink</surname>
              <given-names>RP</given-names>
            </name>
            <name>
              <surname>Schrauwen</surname>
              <given-names>P</given-names>
            </name>
          </person-group>
          <article-title>Three weeks on a high-fat diet increases intrahepatic lipid accumulation and decreases metabolic flexibility in healthy overweight men</article-title>
          <source>J Clin Endocrinol Metab</source>
          <year>2011</year>
          <volume>96</volume>
          <issue>4</issue>
          <fpage>E691</fpage>
          <lpage>E695</lpage>
        </element-citation>
      </ref>
      <ref id="B18">
        <label>18</label>
        <mixed-citation>18 von Frankenberg AD, Marina A, Song X, Callahan HS, Kratz M, Utzschneider KM. A high-fat, high-saturated fat diet decreases insulin sensitivity without changing intra-abdominal fat in weight-stable overweight and obese adults. Eur J Nutr. 2017;56(1):431-43.</mixed-citation>
        <element-citation publication-type="journal">
          <person-group person-group-type="author">
            <name>
              <surname>von Frankenberg</surname>
              <given-names>AD</given-names>
            </name>
            <name>
              <surname>Marina</surname>
              <given-names>A</given-names>
            </name>
            <name>
              <surname>Song</surname>
              <given-names>X</given-names>
            </name>
            <name>
              <surname>Callahan</surname>
              <given-names>HS</given-names>
            </name>
            <name>
              <surname>Kratz</surname>
              <given-names>M</given-names>
            </name>
            <name>
              <surname>Utzschneider</surname>
              <given-names>KM</given-names>
            </name>
          </person-group>
          <article-title>A high-fat, high-saturated fat diet decreases insulin sensitivity without changing intra-abdominal fat in weight-stable overweight and obese adults</article-title>
          <source>Eur J Nutr</source>
          <year>2017</year>
          <volume>56</volume>
          <issue>1</issue>
          <fpage>431</fpage>
          <lpage>443</lpage>
        </element-citation>
      </ref>
      <ref id="B19">
        <label>19</label>
        <mixed-citation>19 Utzschneider KM, Bayer-Carter JL, Arbuckle MD, Tidwell JM, Richards TL, Craft S. Beneficial effect of a weight-stable, low-fat/low-saturated fat/low-glycaemic index diet to reduce liver fat in older subjects. Br J Nutr. 2013;109(6):1096-104.</mixed-citation>
        <element-citation publication-type="journal">
          <person-group person-group-type="author">
            <name>
              <surname>Utzschneider</surname>
              <given-names>KM</given-names>
            </name>
            <name>
              <surname>Bayer-Carter</surname>
              <given-names>JL</given-names>
            </name>
            <name>
              <surname>Arbuckle</surname>
              <given-names>MD</given-names>
            </name>
            <name>
              <surname>Tidwell</surname>
              <given-names>JM</given-names>
            </name>
            <name>
              <surname>Richards</surname>
              <given-names>TL</given-names>
            </name>
            <name>
              <surname>Craft</surname>
              <given-names>S</given-names>
            </name>
          </person-group>
          <article-title>Beneficial effect of a weight-stable, low-fat/low-saturated fat/low-glycaemic index diet to reduce liver fat in older subjects</article-title>
          <source>Br J Nutr</source>
          <year>2013</year>
          <volume>109</volume>
          <issue>6</issue>
          <fpage>1096</fpage>
          <lpage>1104</lpage>
        </element-citation>
      </ref>
      <ref id="B20">
        <label>20</label>
        <mixed-citation>20 Institute of Medicine. Dietary Reference Intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids, Washington, DC: The National Academies Press, 2005.</mixed-citation>
        <element-citation publication-type="book">
          <person-group person-group-type="author">
            <collab>Institute of Medicine</collab>
          </person-group>
          <source>Dietary Reference Intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids</source>
          <year>2005</year>
          <publisher-loc>Washington, DC</publisher-loc>
          <publisher-name>The National Academies Press</publisher-name>
        </element-citation>
      </ref>
      <ref id="B21">
        <label>21</label>
        <mixed-citation>21 Z&#225;rate A, Manuel-Apolinar L, Saucedo R, Hern&#225;ndez-Valencia M, Basurto L. Hypercholesterolemia as a risk factor for cardiovascular disease: current controversial therapeutic management. Arch Med Res. 2016;47(7):491-5.</mixed-citation>
        <element-citation publication-type="journal">
          <person-group person-group-type="author">
            <name>
              <surname>Z&#225;rate</surname>
              <given-names>A</given-names>
            </name>
            <name>
              <surname>Manuel-Apolinar</surname>
              <given-names>L</given-names>
            </name>
            <name>
              <surname>Saucedo</surname>
              <given-names>R</given-names>
            </name>
            <name>
              <surname>Hern&#225;ndez-Valencia</surname>
              <given-names>M</given-names>
            </name>
            <name>
              <surname>Basurto</surname>
              <given-names>L</given-names>
            </name>
          </person-group>
          <article-title>Hypercholesterolemia as a risk factor for cardiovascular disease: current controversial therapeutic management</article-title>
          <source>Arch Med Res</source>
          <year>2016</year>
          <volume>47</volume>
          <issue>7</issue>
          <fpage>491</fpage>
          <lpage>495</lpage>
        </element-citation>
      </ref>
      <ref id="B22">
        <label>22</label>
        <mixed-citation>22 Siri-Tarino PW, Sun Q, Hu FB, Krauss RM. Saturated fat, carbohydrate, and cardiovascular disease. Am J Clin Nutr. 2010;91(3):502-9.</mixed-citation>
        <element-citation publication-type="journal">
          <person-group person-group-type="author">
            <name>
              <surname>Siri-Tarino</surname>
              <given-names>PW</given-names>
            </name>
            <name>
              <surname>Sun</surname>
              <given-names>Q</given-names>
            </name>
            <name>
              <surname>Hu</surname>
              <given-names>FB</given-names>
            </name>
            <name>
              <surname>Krauss</surname>
              <given-names>RM</given-names>
            </name>
          </person-group>
          <article-title>Saturated fat, carbohydrate, and cardiovascular disease</article-title>
          <source>Am J Clin Nutr</source>
          <year>2010</year>
          <volume>91</volume>
          <issue>3</issue>
          <fpage>502</fpage>
          <lpage>509</lpage>
        </element-citation>
      </ref>
      <ref id="B23">
        <label>23</label>
        <mixed-citation>23 Kuipers RS, Graaf DJ, Luxwolda MF, Muskiet MH, Dijck-Brouwer DA, Muskiet FA. Saturated fat, carbohydrates and cardiovascular disease. Neth J Med. 2011;69(9):372-8.</mixed-citation>
        <element-citation publication-type="journal">
          <person-group person-group-type="author">
            <name>
              <surname>Kuipers</surname>
              <given-names>RS</given-names>
            </name>
            <name>
              <surname>Graaf</surname>
              <given-names>DJ</given-names>
            </name>
            <name>
              <surname>Luxwolda</surname>
              <given-names>MF</given-names>
            </name>
            <name>
              <surname>Muskiet</surname>
              <given-names>MH</given-names>
            </name>
            <name>
              <surname>Dijck-Brouwer</surname>
              <given-names>DA</given-names>
            </name>
            <name>
              <surname>Muskiet</surname>
              <given-names>FA</given-names>
            </name>
          </person-group>
          <article-title>Saturated fat, carbohydrates and cardiovascular disease</article-title>
          <source>Neth J Med</source>
          <year>2011</year>
          <volume>69</volume>
          <issue>9</issue>
          <fpage>372</fpage>
          <lpage>378</lpage>
        </element-citation>
      </ref>
      <ref id="B24">
        <label>24</label>
        <mixed-citation>24 Siri-Tarino PW, Sun Q, Hu FB, Krauss RM. Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease. Am J Clin Nutr. 2010;91(3):535-46.</mixed-citation>
        <element-citation publication-type="journal">
          <person-group person-group-type="author">
            <name>
              <surname>Siri-Tarino</surname>
              <given-names>PW</given-names>
            </name>
            <name>
              <surname>Sun</surname>
              <given-names>Q</given-names>
            </name>
            <name>
              <surname>Hu</surname>
              <given-names>FB</given-names>
            </name>
            <name>
              <surname>Krauss</surname>
              <given-names>RM</given-names>
            </name>
          </person-group>
          <article-title>Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease</article-title>
          <source>Am J Clin Nutr</source>
          <year>2010</year>
          <volume>91</volume>
          <issue>3</issue>
          <fpage>535</fpage>
          <lpage>546</lpage>
        </element-citation>
      </ref>
      <ref id="B25">
        <label>25</label>
        <mixed-citation>25 Vetelainen R, van Vliet AK, van Gulik TM. Severe steatosis increases hepatocellular injury and impairs liver regeneration in a rat model of partial hepatectomy. Ann Surg. 2007;245(1):44-50.</mixed-citation>
        <element-citation publication-type="journal">
          <person-group person-group-type="author">
            <name>
              <surname>Vetelainen</surname>
              <given-names>R</given-names>
            </name>
            <name>
              <surname>van Vliet</surname>
              <given-names>AK</given-names>
            </name>
            <name>
              <surname>van Gulik</surname>
              <given-names>TM</given-names>
            </name>
          </person-group>
          <article-title>Severe steatosis increases hepatocellular injury and impairs liver regeneration in a rat model of partial hepatectomy</article-title>
          <source>Ann Surg</source>
          <year>2007</year>
          <volume>245</volume>
          <issue>1</issue>
          <fpage>44</fpage>
          <lpage>50</lpage>
        </element-citation>
      </ref>
      <ref id="B26">
        <label>26</label>
        <mixed-citation>26 Musso G, Gambino R, Cassader M. Cholesterol metabolism and the pathogenesis of non-alcoholic steatohepatitis. Prog Lipid Res. 2013;52(1):175-91.</mixed-citation>
        <element-citation publication-type="journal">
          <person-group person-group-type="author">
            <name>
              <surname>Musso</surname>
              <given-names>G</given-names>
            </name>
            <name>
              <surname>Gambino</surname>
              <given-names>R</given-names>
            </name>
            <name>
              <surname>Cassader</surname>
              <given-names>M</given-names>
            </name>
          </person-group>
          <article-title>Cholesterol metabolism and the pathogenesis of non-alcoholic steatohepatitis</article-title>
          <source>Prog Lipid Res</source>
          <year>2013</year>
          <volume>52</volume>
          <issue>1</issue>
          <fpage>175</fpage>
          <lpage>191</lpage>
        </element-citation>
      </ref>
      <ref id="B27">
        <label>27</label>
        <mixed-citation>27 Birkenfeld AL, Shulman GI. Nonalcoholic fatty liver disease, hepatic insulin resistance, and type 2 diabetes. Hepatology. 2014;59(2):713-23.</mixed-citation>
        <element-citation publication-type="journal">
          <person-group person-group-type="author">
            <name>
              <surname>Birkenfeld</surname>
              <given-names>AL</given-names>
            </name>
            <name>
              <surname>Shulman</surname>
              <given-names>GI</given-names>
            </name>
          </person-group>
          <article-title>Nonalcoholic fatty liver disease, hepatic insulin resistance, and type 2 diabetes</article-title>
          <source>Hepatology</source>
          <year>2014</year>
          <volume>59</volume>
          <issue>2</issue>
          <fpage>713</fpage>
          <lpage>723</lpage>
        </element-citation>
      </ref>
      <ref id="B28">
        <label>28</label>
        <mixed-citation>28 Perry RJ, Samuel VT, Petersen KF, Shulman GI. The role of hepatic lipids in hepatic insulin resistance and type 2 diabetes. Nature. 2014;510(7503):84-91.</mixed-citation>
        <element-citation publication-type="journal">
          <person-group person-group-type="author">
            <name>
              <surname>Perry</surname>
              <given-names>RJ</given-names>
            </name>
            <name>
              <surname>Samuel</surname>
              <given-names>VT</given-names>
            </name>
            <name>
              <surname>Petersen</surname>
              <given-names>KF</given-names>
            </name>
            <name>
              <surname>Shulman</surname>
              <given-names>GI</given-names>
            </name>
          </person-group>
          <article-title>The role of hepatic lipids in hepatic insulin resistance and type 2 diabetes</article-title>
          <source>Nature</source>
          <year>2014</year>
          <volume>510</volume>
          <issue>7503</issue>
          <fpage>84</fpage>
          <lpage>91</lpage>
        </element-citation>
      </ref>
      <ref id="B29">
        <label>29</label>
        <mixed-citation>29 Lau JK, Zhang X, Yu J. Animal models of non-alcoholic fatty liver disease: current perspectives and recent advances. J Pathol. 2017;241(1):36-44.</mixed-citation>
        <element-citation publication-type="journal">
          <person-group person-group-type="author">
            <name>
              <surname>Lau</surname>
              <given-names>JK</given-names>
            </name>
            <name>
              <surname>Zhang</surname>
              <given-names>X</given-names>
            </name>
            <name>
              <surname>Yu</surname>
              <given-names>J</given-names>
            </name>
          </person-group>
          <article-title>Animal models of non-alcoholic fatty liver disease: current perspectives and recent advances</article-title>
          <source>J Pathol</source>
          <year>2017</year>
          <volume>241</volume>
          <issue>1</issue>
          <fpage>36</fpage>
          <lpage>44</lpage>
        </element-citation>
      </ref>
      <ref id="B30">
        <label>30</label>
        <mixed-citation>30 Matsuzawa N, Takamura T, Kurita S, Misu H, Ota T, Ando H, et al. Lipid-induced oxidative stress causes steatohepatitis in mice fed an atherogenic diet. Hepatology. 2007;46(5):1392-403.</mixed-citation>
        <element-citation publication-type="journal">
          <person-group person-group-type="author">
            <name>
              <surname>Matsuzawa</surname>
              <given-names>N</given-names>
            </name>
            <name>
              <surname>Takamura</surname>
              <given-names>T</given-names>
            </name>
            <name>
              <surname>Kurita</surname>
              <given-names>S</given-names>
            </name>
            <name>
              <surname>Misu</surname>
              <given-names>H</given-names>
            </name>
            <name>
              <surname>Ota</surname>
              <given-names>T</given-names>
            </name>
            <name>
              <surname>Ando</surname>
              <given-names>H</given-names>
            </name>
            <etal/>
          </person-group>
          <article-title>Lipid-induced oxidative stress causes steatohepatitis in mice fed an atherogenic diet</article-title>
          <source>Hepatology</source>
          <year>2007</year>
          <volume>46</volume>
          <issue>5</issue>
          <fpage>1392</fpage>
          <lpage>1403</lpage>
        </element-citation>
      </ref>
      <ref id="B31">
        <label>31</label>
        <mixed-citation>31 Vergnes L, Phan J, Strauss M, Tafuri S, Reue K. Cholesterol and cholate components of an atherogenic diet induce distinct stages of hepatic inflammatory gene expression. J Biol Chem. 2003;278(44):42774-784.</mixed-citation>
        <element-citation publication-type="journal">
          <person-group person-group-type="author">
            <name>
              <surname>Vergnes</surname>
              <given-names>L</given-names>
            </name>
            <name>
              <surname>Phan</surname>
              <given-names>J</given-names>
            </name>
            <name>
              <surname>Strauss</surname>
              <given-names>M</given-names>
            </name>
            <name>
              <surname>Tafuri</surname>
              <given-names>S</given-names>
            </name>
            <name>
              <surname>Reue</surname>
              <given-names>K</given-names>
            </name>
          </person-group>
          <article-title>Cholesterol and cholate components of an atherogenic diet induce distinct stages of hepatic inflammatory gene expression</article-title>
          <source>J Biol Chem</source>
          <year>2003</year>
          <volume>278</volume>
          <issue>44</issue>
          <fpage>42774</fpage>
          <lpage>42784</lpage>
        </element-citation>
      </ref>
      <ref id="B32">
        <label>32</label>
        <mixed-citation>32 Asrih M, Jornayvaz FR. Diets and nonalcoholic fatty liver disease: the good and the bad. Clin Nutr. 2014;33(2):186-190.</mixed-citation>
        <element-citation publication-type="journal">
          <person-group person-group-type="author">
            <name>
              <surname>Asrih</surname>
              <given-names>M</given-names>
            </name>
            <name>
              <surname>Jornayvaz</surname>
              <given-names>FR</given-names>
            </name>
          </person-group>
          <article-title>Diets and nonalcoholic fatty liver disease: the good and the bad</article-title>
          <source>Clin Nutr</source>
          <year>2014</year>
          <volume>33</volume>
          <issue>2</issue>
          <fpage>186</fpage>
          <lpage>190</lpage>
        </element-citation>
      </ref>
      <ref id="B33">
        <label>33</label>
        <mixed-citation>33 Polyzos SA, Kountouras J, Mantzoros CS. Adipokines in nonalcoholic fatty liver disease. Metabolism. 2016;65(8):1062-79.</mixed-citation>
        <element-citation publication-type="journal">
          <person-group person-group-type="author">
            <name>
              <surname>Polyzos</surname>
              <given-names>SA</given-names>
            </name>
            <name>
              <surname>Kountouras</surname>
              <given-names>J</given-names>
            </name>
            <name>
              <surname>Mantzoros</surname>
              <given-names>CS</given-names>
            </name>
          </person-group>
          <article-title>Adipokines in nonalcoholic fatty liver disease</article-title>
          <source>Metabolism</source>
          <year>2016</year>
          <volume>65</volume>
          <issue>8</issue>
          <fpage>1062</fpage>
          <lpage>1079</lpage>
        </element-citation>
      </ref>
      <ref id="B34">
        <label>34</label>
        <mixed-citation>34 Cui CX, Deng JN, Yan L, Liu YY, Fan JY, Um HN, et al. Silibinin capsules improves high fat diet-induced nonalcoholic fatty liver disease in hamsters through modifying hepatic de novo lipogenesis and fatty acid oxidation. J Ethnopharmacol. 2017 Aug;208:24-35.</mixed-citation>
        <element-citation publication-type="journal">
          <person-group person-group-type="author">
            <name>
              <surname>Cui</surname>
              <given-names>CX</given-names>
            </name>
            <name>
              <surname>Deng</surname>
              <given-names>JN</given-names>
            </name>
            <name>
              <surname>Yan</surname>
              <given-names>L</given-names>
            </name>
            <name>
              <surname>Liu</surname>
              <given-names>YY</given-names>
            </name>
            <name>
              <surname>Fan</surname>
              <given-names>JY</given-names>
            </name>
            <name>
              <surname>Um</surname>
              <given-names>HN</given-names>
            </name>
            <etal/>
          </person-group>
          <article-title>Silibinin capsules improves high fat diet-induced nonalcoholic fatty liver disease in hamsters through modifying hepatic de novo lipogenesis and fatty acid oxidation</article-title>
          <source>J Ethnopharmacol</source>
          <year>2017</year>
          <month>08</month>
          <volume>208</volume>
          <fpage>24</fpage>
          <lpage>35</lpage>
        </element-citation>
      </ref>
      <ref id="B35">
        <label>35</label>
        <mixed-citation>35 Hu X, Wang T, Liang S, Li W, Wu X, Jin F. Antibiotic-induced imbalances in gut microbiota aggravates cholesterol accumulation and liver injuries in rats fed a high-cholesterol diet. Appl Microbiol Biotechnol. 2015;99(21):9111-22.</mixed-citation>
        <element-citation publication-type="journal">
          <person-group person-group-type="author">
            <name>
              <surname>Hu</surname>
              <given-names>X</given-names>
            </name>
            <name>
              <surname>Wang</surname>
              <given-names>T</given-names>
            </name>
            <name>
              <surname>Liang</surname>
              <given-names>S</given-names>
            </name>
            <name>
              <surname>Li</surname>
              <given-names>W</given-names>
            </name>
            <name>
              <surname>Wu</surname>
              <given-names>X</given-names>
            </name>
            <name>
              <surname>Jin</surname>
              <given-names>F</given-names>
            </name>
          </person-group>
          <article-title>Antibiotic-induced imbalances in gut microbiota aggravates cholesterol accumulation and liver injuries in rats fed a high-cholesterol diet</article-title>
          <source>Appl Microbiol Biotechnol</source>
          <year>2015</year>
          <volume>99</volume>
          <issue>21</issue>
          <fpage>9111</fpage>
          <lpage>9122</lpage>
        </element-citation>
      </ref>
    </ref-list>
  </back>
  <sub-article article-type="translation" id="s1" xml:lang="pt">
    <front-stub>
      <article-categories>
        <subj-group subj-group-type="heading">
          <subject>Artigo Original</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title>Dieta Rica em Banha e Colesterol, mas n&#227;o Dieta Rica em Banha, Leva a Dist&#250;rbios Metab&#243;licos em um Modelo Modificado de Dislipidemia</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <name>
            <surname>Muniz</surname>
            <given-names>Lidiane B.</given-names>
          </name>
          <xref ref-type="aff" rid="aff2"/>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Alves-Santos</surname>
            <given-names>Aline M.</given-names>
          </name>
          <xref ref-type="aff" rid="aff2"/>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Camargo</surname>
            <given-names>Fabricio</given-names>
          </name>
          <xref ref-type="aff" rid="aff2"/>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Martins</surname>
            <given-names>Danieli Brolo</given-names>
          </name>
          <xref ref-type="aff" rid="aff2"/>
        </contrib>
        <contrib contrib-type="author">
          <contrib-id contrib-id-type="orcid">0000-0002-4733-007X</contrib-id>
          <name>
            <surname>Celes</surname>
            <given-names>Mara Rubia N.</given-names>
          </name>
          <xref ref-type="aff" rid="aff2"/>
        </contrib>
        <contrib contrib-type="author">
          <contrib-id contrib-id-type="orcid">0000-0003-4332-6206</contrib-id>
          <name>
            <surname>Naves</surname>
            <given-names>Maria Margareth V.</given-names>
          </name>
          <xref ref-type="aff" rid="aff2"/>
          <xref ref-type="corresp" rid="c2"/>
        </contrib>
        <aff id="aff2">
          <institution content-type="original">Universidade Federal de Goi&#225;s, Goiania, GO - Brasil</institution>
        </aff>
      </contrib-group>
      <author-notes>
        <corresp id="c2"><bold>Correspond&#234;ncia: Maria Margareth V. Naves,</bold> Universidade Federal de Goi&#225;s - Faculdade de Nutri&#231;&#227;o - Laborat&#243;rio de Nutri&#231;&#227;o Experimental - Rua 227, quadra 68, Setor Leste Universit&#225;rio, CEP 74605-080, Goi&#226;nia, GO - Brasil. E-mail: <email>mmvnaves@gmail.com</email>
				</corresp>
        <fn fn-type="con">
          <p>
            <bold>Contribui&#231;&#227;o dos autores</bold>
          </p>
          <p>Concep&#231;&#227;o e desenho da pesquisa e Obten&#231;&#227;o de financiamento: Naves MMV; Obten&#231;&#227;o de dados: Muniz LB, Alves-Santos AM, Camargo F, Martins DB, Celes MRN; An&#225;lise e interpreta&#231;&#227;o dos dados, An&#225;lise estat&#237;stica e Reda&#231;&#227;o do manuscrito: Muniz LB, Alves-Santos AM; Revis&#227;o cr&#237;tica do manuscrito quanto ao conte&#250;do intelectual: Martins DB, Celes MRN, Naves MMV.</p>
        </fn>
        <fn fn-type="conflict">
          <p>
            <bold>Potencial conflito de interesses</bold>
          </p>
          <p>Declaro n&#227;o haver conflito de interesses pertinentes.</p>
        </fn>
      </author-notes>
      <abstract>
        <title>Resumo</title>
        <sec>
          <title>Fundamento:</title>
          <p>Tendo em vista o aumento da preval&#234;ncia global de doen&#231;as cardiovasculares e hep&#225;ticas, o conte&#250;do lip&#237;dico da dieta e sua rela&#231;&#227;o com o ac&#250;mulo de gordura nos hepat&#243;citos t&#234;m sido investigados como fatores-chave na preven&#231;&#227;o dessas doen&#231;as.</p>
        </sec>
        <sec>
          <title>Objetivo:</title>
          <p>Avaliar os efeitos metab&#243;licos de uma dieta rica em banha suplementada com colesterol ou n&#227;o, em um modelo modificado de dislipidemia.</p>
        </sec>
        <sec>
          <title>M&#233;todos:</title>
          <p>Foram divididos 24 ratos Wistar machos adultos em tr&#234;s grupos: dieta padr&#227;o (DP - 4% de lip&#237;dios), dieta rica em banha (DRB - 21% de banha) e dieta rica em banha e colesterol (DRB/RC - 20% de banha, 1% de colesterol e 0,1% de &#225;cido c&#243;lico). Ap&#243;s seis semanas de tratamento, o sangue e o f&#237;gado foram coletados para an&#225;lises bioqu&#237;micas (perfil lip&#237;dico s&#233;rico e enzimas hep&#225;ticas) e morfol&#243;gicas. A an&#225;lise estat&#237;stica incluiu an&#225;lise de vari&#226;ncia unidirecional (ANOVA), seguida do teste de Tukey para compara&#231;&#245;es de m&#233;dias. Uma probabilidade de 5% foi considerada estatisticamente significativa.</p>
        </sec>
        <sec>
          <title>Resultados:</title>
          <p>Animais alimentados com DRB/RC apresentaram um aumento nos n&#237;veis s&#233;ricos de colesterol total, triacilglicerol, LDL-c, n&#227;o-HDL-c, alanina aminotransferase (ALT) e aspartato aminotransferase (AST) em compara&#231;&#227;o com aqueles alimentados com DP. Al&#233;m disso, os animais tratados com DRB/RC apresentaram um peso relativo do f&#237;gado maior, com esteatose hep&#225;tica macrovesicular moderada e infiltrado inflamat&#243;rio.</p>
        </sec>
        <sec>
          <title>Conclus&#227;o:</title>
          <p>Uma dieta rica em gordura com banha (20%) e colesterol (1%) desencadeou dislipidemia com danos graves ao f&#237;gado em ratos em um tempo experimental menor do que os modelos previamente relatados. A dieta rica em banha sem suplementa&#231;&#227;o de colesterol levou ao ganho de peso corporal, mas n&#227;o &#224; dislipidemia.</p>
        </sec>
      </abstract>
      <kwd-group xml:lang="pt">
        <title>Palavras-chave</title>
        <kwd>Gorduras da dieta</kwd>
        <kwd>Colesterol</kwd>
        <kwd>Metabolismo lip&#237;dico</kwd>
        <kwd>F&#237;gado Gorduroso</kwd>
        <kwd>Inflama&#231;&#227;o</kwd>
        <kwd>Ratos</kwd>
      </kwd-group>
    </front-stub>
    <body>
      <sec sec-type="intro">
        <title>Introdu&#231;&#227;o</title>
        <p>A preval&#234;ncia mundial de doen&#231;as metab&#243;licas e complica&#231;&#245;es de sa&#250;de associadas aumentou nas &#250;ltimas d&#233;cadas. Excesso de gordura corporal, resist&#234;ncia &#224; insulina, doen&#231;a hep&#225;tica gordurosa n&#227;o alco&#243;lica (DHGNA) e dislipidemia levam a dist&#250;rbios metab&#243;licos relacionados ao maior risco de desenvolver doen&#231;as cardiovasculares.<xref ref-type="bibr" rid="B1">1</xref> A DHGNA varia desde um pequeno ac&#250;mulo de gordura no hepat&#243;cito at&#233; est&#225;gios mais graves de necrose inflamat&#243;ria, com ou sem fibrose. Estudos indicam uma associa&#231;&#227;o entre DHGNA e resist&#234;ncia &#224; insulina, inflama&#231;&#227;o de hepat&#243;citos e comprometimento do metabolismo lip&#237;dico,<xref ref-type="bibr" rid="B2">2</xref><sup>,</sup><xref ref-type="bibr" rid="B3">3</xref> j&#225; que a maioria dos pacientes com DHGNA apresenta dislipidemia.<xref ref-type="bibr" rid="B4">4</xref>
				</p>
        <p>A dislipidemia &#233; caracterizada por n&#237;veis aumentados de triacilglicerol (TG) e colesterol de lipoprote&#237;na de baixa densidade (LDL-c), e diminui&#231;&#227;o do colesterol de lipoprote&#237;na de alta densidade (HDL-c).<xref ref-type="bibr" rid="B5">5</xref> Hipercolesterolemia (aumento isolado do LDL-c) e hipertrigliceridemia (aumento isolado do TG) s&#227;o as formas mais comuns de dislipidemia.<xref ref-type="bibr" rid="B6">6</xref> Em geral, o desequil&#237;brio do metabolismo lip&#237;dico resulta da intera&#231;&#227;o entre fatores gen&#233;ticos e ambientais, como h&#225;bitos alimentares, especialmente o consumo de lip&#237;dios. Portanto, o conte&#250;do lip&#237;dico da dieta tem sido investigado como um fator chave na preven&#231;&#227;o de doen&#231;as cardiovasculares e hep&#225;ticas.<xref ref-type="bibr" rid="B7">7</xref>
				</p>
        <p>Estudos experimentais com dietas hiperlip&#237;dicas usaram teores muito altos de gordura diet&#233;tica (cerca de 50% da composi&#231;&#227;o da dieta), em protocolos de curto per&#237;odo (quatro semanas), sem constatar um comprometimento lip&#237;dico s&#233;rico.<xref ref-type="bibr" rid="B8">8</xref><sup>,</sup><xref ref-type="bibr" rid="B9">9</xref> Por outro lado, estudos testando concentra&#231;&#245;es lip&#237;dicas mais pr&#243;ximas do consumo humano t&#234;m sido realizados durante um per&#237;odo experimental relativamente longo, como em relatos anteriores com ratos (21% de gordura por 9 semanas)<xref ref-type="bibr" rid="B10">10</xref> e com camundongos (15% a 20% de gordura durante 12 a 16 semanas).<xref ref-type="bibr" rid="B11">11</xref><sup>,</sup><xref ref-type="bibr" rid="B12">12</xref>
				</p>
        <p>Nesse contexto, este estudo teve por objetivo avaliar os efeitos metab&#243;licos de uma dieta rica em banha suplementada com colesterol ou n&#227;o, num modelo modificado de dislipidemia, com tempo de experimenta&#231;&#227;o e concentra&#231;&#227;o lip&#237;dica da dieta menores em rela&#231;&#227;o aos relatos anteriores.</p>
      </sec>
      <sec sec-type="methods">
        <title>M&#233;todos</title>
        <sec>
          <title>Animais, dietas e desenho experimental</title>
          <p>O experimento foi conduzido com ratos Wistar machos adultos fornecidos pela Universidade de S&#227;o Paulo (Ribeir&#227;o Preto, Brasil). Os ratos foram mantidos em gaiolas pl&#225;sticas (2 animais/gaiola) por sete semanas (uma semana de aclimata&#231;&#227;o e seis semanas de ensaio), sob condi&#231;&#245;es ambientais controladas (ciclo claro-escuro de 12 h e temperatura de 22 &#177; 2&#176;C). No experimento, dividimos aleatoriamente 24 ratos em 3 grupos de 8 animais, de acordo com um delineamento de blocos casualizados, com base no peso corporal. O tamanho da amostra foi definido com base em estudos pr&#233;vios sobre dislipidemia experimental. Cada grupo recebeu uma das seguintes dietas: dieta padr&#227;o (DP; RH19521, Rhoster, Brasil) preparada de acordo com AIN-93M,<xref ref-type="bibr" rid="B13">13</xref> uma dieta rica em banha (DRB; RH195143, Rhoster, Brasil), e dieta rica em banha e colesterol (DRB/RC; RH195142, Rhoster, Brasil). &#211;leo de soja e banha foram utilizados como fontes lip&#237;dicas; colesterol, para induzir hipercolesterolemia; e &#225;cido c&#243;lico, para aumentar o efeito hipercolesterol&#234;mico do colesterol suplementado<xref ref-type="bibr" rid="B14">14</xref> (<xref ref-type="table" rid="t3">Tabela 1</xref>). As dietas e &#225;gua filtrada foram fornecidas <italic>ad libitum</italic>. A ingest&#227;o diet&#233;tica e o peso corporal dos animais foram monitorados tr&#234;s vezes por semana.</p>
          <table-wrap id="t3">
            <label>Tabela 1</label>
            <caption>
              <title>Composi&#231;&#227;o das dietas experimentais</title>
            </caption>
            <table frame="hsides" rules="groups">
              <colgroup>
                <col width="40%"/>
                <col width="8%"/>
                <col width="20%"/>
                <col width="20%"/>
                <col width="20%"/>
              </colgroup>
              <thead>
                <tr>
                  <th align="left" rowspan="2" style="border-bottom-width:thin;border-bottom-style:solid">Componente (g/100g de dieta)</th>
                  <th align="center">
									</th>
                  <th align="center" colspan="3" style="border-bottom-width:thin;border-bottom-style:solid">Dieta<sup><xref ref-type="table-fn" rid="TFN6">1</xref></sup></th>
                </tr>
                <tr style="border-bottom-width:thin;border-bottom-style:solid">
                  <th align="center">
									</th>
                  <th align="center">DP</th>
                  <th align="center">DRB</th>
                  <th align="center">DRB/RC</th>
                </tr>
              </thead>
              <tbody>
                <tr>
                  <td align="left">Case&#237;na (82,93 g de prote&#237;na)</td>
                  <td align="center">
									</td>
                  <td align="center">16,47</td>
                  <td align="center">16,47</td>
                  <td align="center">16,47</td>
                </tr>
                <tr>
                  <td align="left">L-cistina</td>
                  <td align="center">
									</td>
                  <td align="center">0,18</td>
                  <td align="center">0,18</td>
                  <td align="center">0,18</td>
                </tr>
                <tr>
                  <td align="left">&#211;leo de soja</td>
                  <td align="center">
									</td>
                  <td align="center">4,00</td>
                  <td align="center">0,00</td>
                  <td align="center">0,00</td>
                </tr>
                <tr>
                  <td align="left">Banha<sup><xref ref-type="table-fn" rid="TFN7">2</xref></sup></td>
                  <td align="center">
									</td>
                  <td align="center">0,00</td>
                  <td align="center">21,00</td>
                  <td align="center">20,00</td>
                </tr>
                <tr>
                  <td align="left">Colesterol<sup><xref ref-type="table-fn" rid="TFN7">2</xref></sup></td>
                  <td align="center">
									</td>
                  <td align="center">0,00</td>
                  <td align="center">0,00</td>
                  <td align="center">1,00</td>
                </tr>
                <tr>
                  <td align="left">&#193;cido c&#243;lico<sup><xref ref-type="table-fn" rid="TFN7">2</xref></sup></td>
                  <td align="center">
									</td>
                  <td align="center">0,00</td>
                  <td align="center">0,00</td>
                  <td align="center">0,10</td>
                </tr>
                <tr>
                  <td align="left">Sacarose</td>
                  <td align="center">
									</td>
                  <td align="center">10,00</td>
                  <td align="center">10,00</td>
                  <td align="center">10,00</td>
                </tr>
                <tr>
                  <td align="left">Celulose</td>
                  <td align="center">
									</td>
                  <td align="center">5,00</td>
                  <td align="center">5,00</td>
                  <td align="center">5,00</td>
                </tr>
                <tr>
                  <td align="left">Mistura de minerais</td>
                  <td align="center">
									</td>
                  <td align="center">3,50</td>
                  <td align="center">3,50</td>
                  <td align="center">3,50</td>
                </tr>
                <tr>
                  <td align="left">Bitartrato de colina</td>
                  <td align="center">
									</td>
                  <td align="center">0,25</td>
                  <td align="center">0,25</td>
                  <td align="center">0,25</td>
                </tr>
                <tr>
                  <td align="left">Mistura de vitaminas</td>
                  <td align="center">
									</td>
                  <td align="center">1,00</td>
                  <td align="center">1,00</td>
                  <td align="center">1,00</td>
                </tr>
                <tr>
                  <td align="left"><italic>tert</italic>-Butilhidroquinona (TBHQ)</td>
                  <td align="center">
									</td>
                  <td align="center">0,008</td>
                  <td align="center">0,008</td>
                  <td align="center">0,008</td>
                </tr>
                <tr>
                  <td align="left">Amido de milho dextrinizado</td>
                  <td align="center">
									</td>
                  <td align="center">15,50</td>
                  <td align="center">15,50</td>
                  <td align="center">15,50</td>
                </tr>
                <tr>
                  <td align="left">Amido de milho</td>
                  <td align="center">
									</td>
                  <td align="center">14,09</td>
                  <td align="center">27,09</td>
                  <td align="center">26,99</td>
                </tr>
                <tr>
                  <td align="left">Lip&#237;dios (g/100g)<sup><xref ref-type="table-fn" rid="TFN8">3</xref></sup></td>
                  <td align="center">
									</td>
                  <td align="center">4,1 &#177; 0,1</td>
                  <td align="center">19,7 &#177; 1,4</td>
                  <td align="center">20,8 &#177; 1,6</td>
                </tr>
                <tr>
                  <td align="left">Energia dos lip&#237;dios<sup><xref ref-type="table-fn" rid="TFN9">4</xref></sup></td>
                  <td align="center">
									</td>
                  <td align="center">36</td>
                  <td align="center">189</td>
                  <td align="center">189</td>
                </tr>
                <tr>
                  <td align="left">Energia da dieta (kcal/g)<sup><xref ref-type="table-fn" rid="TFN9">4</xref></sup></td>
                  <td align="center">
									</td>
                  <td align="center">3,41</td>
                  <td align="center">4,26</td>
                  <td align="center">4,26</td>
                </tr>
                <tr>
                  <td align="left">(Energia dos lip&#237;dios x 100)/energia da dieta (%)</td>
                  <td align="center">
									</td>
                  <td align="center">11</td>
                  <td align="center">44</td>
                  <td align="center">44</td>
                </tr>
              </tbody>
            </table>
            <table-wrap-foot>
              <fn id="TFN6">
                <label>1</label>
                <p>
                  <italic>Reeves et al.<sup><xref ref-type="bibr" rid="B13">13</xref></sup>; DP: dieta padr&#227;o; DRB: dieta rica em banha; DRB/RC: dieta rica em banha e colesterol;</italic>
                </p>
              </fn>
              <fn id="TFN7">
                <label>2</label>
                <p>
                  <italic>Fernandes et al.<sup><xref ref-type="bibr" rid="B10">10</xref></sup>;</italic>
                </p>
              </fn>
              <fn id="TFN8">
                <label>3</label>
                <p>
                  <italic>Resultado da an&#225;lise qu&#237;mica da dieta;</italic>
                </p>
              </fn>
              <fn id="TFN9">
                <label>4</label>
                <p>V<italic>alor energ&#233;tico da dieta: 4, 4 e 9 kcal/g para prote&#237;na, carboidrato e lip&#237;dio, respectivamente.</italic></p>
              </fn>
            </table-wrap-foot>
          </table-wrap>
          <p>Ap&#243;s seis semanas de experimenta&#231;&#227;o, os animais foram eutanasiados (xilazina + cetamina /10 mg/kg + 100 mg/kg). Em seguida, coletamos amostras de sangue por pun&#231;&#227;o abdominal (cerca de 5 mL) para an&#225;lises bioqu&#237;micas (perfil lip&#237;dico s&#233;rico e enzimas hep&#225;ticas). Ap&#243;s a eutan&#225;sia por exsanguina&#231;&#227;o da aorta abdominal, extra&#237;mos, pesamos e preparamos o f&#237;gado dos animais para avalia&#231;&#227;o morfol&#243;gica. Todos os procedimentos estavam de acordo com o Guia para o Cuidado e Uso de Animais de Laborat&#243;rio<xref ref-type="bibr" rid="B15">15</xref> e foram aprovados pela Comiss&#227;o de &#201;tica no Uso de Animais da Universidade Federal de Goi&#225;s (protocolo n&#250;mero 039/15).</p>
        </sec>
        <sec>
          <title>An&#225;lises bioqu&#237;micas</title>
          <p>Amostras de sangue foram coletadas em tubos de heparina e centrifugadas a 4.000 rpm por 10 min para separar o soro, que foi imediatamente armazenado a -80&#176;C para as an&#225;lises de perfil lip&#237;dico e enzimas hep&#225;ticas. Os n&#237;veis de colesterol total (CT), TG, LDL-c, HDL-c, alanina aminotransferase (ALT) e aspartato aminotransferase (AST) foram determinados por kits comercialmente dispon&#237;veis (Labtest Diagn&#243;stica SA, Lagoa Santa, Brasil). O colesterol da lipoprote&#237;na de muito baixa densidade (VLDL-c) foi estimado pela equa&#231;&#227;o de Friedewald. A fra&#231;&#227;o n&#227;o-HDL-c foi obtida pela diferen&#231;a entre os n&#237;veis de CT e HDL-c. A import&#226;ncia da fra&#231;&#227;o n&#227;o-HDL-c tem sido destacada na predi&#231;&#227;o do risco de doen&#231;a cardiovascular. Boekholdt et al.<xref ref-type="bibr" rid="B16">16</xref> revelaram que as concentra&#231;&#245;es de n&#227;o-HDL-c tiveram uma associa&#231;&#227;o direta mais forte com o risco de DCV que o LDL-c e a apolipoprote&#237;na B (Apo B).</p>
        </sec>
        <sec>
          <title>Avalia&#231;&#227;o morfol&#243;gica do f&#237;gado</title>
          <p>Os l&#243;bulos do f&#237;gado foram lavados em solu&#231;&#227;o fisiol&#243;gica gelada a 0,9% e fixados por imers&#227;o em formalina a 10% tamponada com fosfato por 24 h. Posteriormente, os lobos foram cortados em fragmentos de 4 a 5 mm de espessura, desidratados em concentra&#231;&#245;es crescentes de &#225;lcool (80%, 95% e 100%), clarificados em xilol (3 banhos de 30 min cada) e embebidos em parafina. Sec&#231;&#245;es seriadas de 5 &#181;m de espessura foram obtidas e coradas com hematoxilina e eosina (HE). Usamos as sec&#231;&#245;es coradas com HE para analisar as altera&#231;&#245;es no arranjo do par&#234;nquima hep&#225;tico e a presen&#231;a de infiltrados inflamat&#243;rios com um Leica Las V4 <italic>Software</italic> (<italic>Leica Imaging Systems Ltd</italic>., Cambridge, Reino Unido), um microsc&#243;pio Leica DM2000 (<italic>Leica Microsystems Wetzlar GmbH</italic>, Wetzlar, Su&#237;&#231;a), uma c&#226;mera de v&#237;deo Leica DC230 (<italic>Leica Microsystems</italic> AG, Heerbrugg, Su&#237;&#231;a) e um computador com internet. Vinte campos de par&#234;nquima hep&#225;tico de cada animal foram selecionados aleatoriamente e analisados, com aumentos de 100x e 400x.</p>
        </sec>
        <sec>
          <title>An&#225;lise estat&#237;stica</title>
          <p>Dados foram expressos em m&#233;dia &#177; desvio padr&#227;o. A literatura considera o peso corporal e par&#226;metros bioqu&#237;micos obtidos em modelos animais como dados param&#233;tricos.<xref ref-type="bibr" rid="B8">8</xref><sup>-</sup><xref ref-type="bibr" rid="B12">12</xref> Assim, determinamos a signific&#226;ncia estat&#237;stica usando a an&#225;lise de vari&#226;ncia unidirecional (ANOVA), seguida pelo teste de Tukey para compara&#231;&#245;es das m&#233;dias (p &lt; 0,05). O software STATISTICA, vers&#227;o 7.0 (StatSoft, Inc., Tulsa, OK, USA) foi utilizado para an&#225;lises estat&#237;sticas.</p>
        </sec>
      </sec>
      <sec sec-type="results">
        <title>Resultados</title>
        <p>A banha utilizada na formula&#231;&#227;o das dietas continha 39 g/100 g de gordura saturada e 72 mg/100 g de colesterol. Nas dietas ricas em gordura (DRB e DRB/RC), a banha contribuiu com aproximadamente 15 mg de colesterol/100 g de dieta, al&#233;m do colesterol adicionado &#224; DRB/RC. Quarenta e quatro por cento (44%) da energia da DRB e DRB/RC derivaram de lip&#237;dios, um valor quatro vezes maior que o da DP (11%).</p>
        <p>O peso corporal inicial dos animais n&#227;o diferiu entre os grupos, o que garantiu a homogeneidade das repeti&#231;&#245;es do grupo. Os animais alimentados com DRB apresentaram maior ganho de peso corporal do que os do grupo DP. O peso do f&#237;gado e o peso relativo do f&#237;gado dos animais alimentados com DRB/RC foram maiores (p &lt; 0,05) que os dos demais grupos (<xref ref-type="table" rid="t4">Tabela 2</xref>).</p>
        <table-wrap id="t4">
          <label>Tabela 2</label>
          <caption>
            <title>Peso corporal e do f&#237;gado e par&#226;metros bioqu&#237;micos de ratos Wistar ap&#243;s seis semanas de tratamento com dietas padr&#227;o e hiperlip&#237;dicas</title>
          </caption>
          <table frame="hsides" rules="groups">
            <colgroup>
              <col width="40%"/>
              <col width="20%"/>
              <col width="20%"/>
              <col width="20%"/>
            </colgroup>
            <thead>
              <tr style="border-bottom-width:thin;border-bottom-style:solid">
                <th align="left" rowspan="2">Par&#226;metro</th>
                <th align="center" colspan="3">Dieta</th>
              </tr>
              <tr style="border-bottom-width:thin;border-bottom-style:solid">
                <th align="center">DP</th>
                <th align="center">DRB</th>
                <th align="center">DRB/RC</th>
              </tr>
            </thead>
            <tbody>
              <tr>
                <td align="left">
                  <bold>Peso corporal (g)</bold>
                </td>
                <td align="center">
								</td>
                <td align="center">
								</td>
                <td align="center">
								</td>
              </tr>
              <tr>
                <td align="left">Inicial</td>
                <td align="center">249,05 &#177; 21,44<sup>a</sup></td>
                <td align="center">243,85 &#177; 15,09<sup>a</sup></td>
                <td align="center">242,35 &#177; 16,78<sup>a</sup></td>
              </tr>
              <tr>
                <td align="left">Final</td>
                <td align="center">499,58 &#177; 65,32<sup>a</sup></td>
                <td align="center">564,08 &#177; 39,73<sup>a</sup></td>
                <td align="center">508,58 &#177; 47,68<sup>a</sup></td>
              </tr>
              <tr>
                <td align="left">Ganho</td>
                <td align="center">250,53 &#177; 48,40<sup>b</sup></td>
                <td align="center">320,23 &#177; 44,50<sup>a</sup></td>
                <td align="center">266,23 &#177; 38,21<sup>a, b</sup></td>
              </tr>
              <tr>
                <td align="left">
                  <bold>F&#237;gado</bold>
                </td>
                <td align="center">
								</td>
                <td align="center">
								</td>
                <td align="center">
								</td>
              </tr>
              <tr>
                <td align="left">Peso (g)</td>
                <td align="center">14,90 &#177; 2,33<sup>b</sup></td>
                <td align="center">15,92 &#177; 1,65<sup>b</sup></td>
                <td align="center">27,10 &#177; 5,94<sup>a</sup></td>
              </tr>
              <tr>
                <td align="left">Peso relativo (g/100g de peso corporal)</td>
                <td align="center">2,98 &#177; 0,24<sup>b</sup></td>
                <td align="center">2,82 &#177; 0,14<sup>b</sup></td>
                <td align="center">5,28 &#177; 0,80<sup>a</sup></td>
              </tr>
              <tr>
                <td align="left">
                  <bold>Perfil lip&#237;dico s&#233;rico (mg/dL)</bold>
                </td>
                <td align="center">
								</td>
                <td align="center">
								</td>
                <td align="center">
								</td>
              </tr>
              <tr>
                <td align="left">CT</td>
                <td align="center">59,83 &#177; 15,99<sup>b</sup></td>
                <td align="center">64,58 &#177; 14,13<sup>b</sup></td>
                <td align="center">87,75 &#177; 8,54<sup>a</sup></td>
              </tr>
              <tr>
                <td align="left">LDL-c</td>
                <td align="center">4,23 &#177; 0,71<sup>b</sup></td>
                <td align="center">6,98 &#177; 2,09<sup>b</sup></td>
                <td align="center">23,63 &#177; 4,55<sup>a</sup></td>
              </tr>
              <tr>
                <td align="left">HDL-c</td>
                <td align="center">30,74 &#177; 4,11<sup>a</sup></td>
                <td align="center">34,42 &#177; 7,77<sup>a</sup></td>
                <td align="center">26,74 &#177; 4,23<sup>a</sup></td>
              </tr>
              <tr>
                <td align="left">n&#227;o-HDL-c</td>
                <td align="center">29,09 &#177; 12,13<sup>b</sup></td>
                <td align="center">30,17 &#177; 10,84<sup>b</sup></td>
                <td align="center">61,01 &#177; 6,95<sup>a</sup></td>
              </tr>
              <tr>
                <td align="left">VLDL-c</td>
                <td align="center">10,68 &#177; 1,58<sup>b</sup></td>
                <td align="center">16,77 &#177; 4,58<sup>a, b</sup></td>
                <td align="center">18,52 &#177; 7,51<sup>a</sup></td>
              </tr>
              <tr>
                <td align="left">TG</td>
                <td align="center">53,42 &#177; 7,91<sup>b</sup></td>
                <td align="center">83,83 &#177; 22,90<sup>a, b</sup></td>
                <td align="center">92,58 &#177; 37,55<sup>a</sup></td>
              </tr>
              <tr>
                <td align="left">
                  <bold>Enzimas hep&#225;ticas (U/L)</bold>
                </td>
                <td align="center">
								</td>
                <td align="center">
								</td>
                <td align="center">
								</td>
              </tr>
              <tr>
                <td align="left">ALT</td>
                <td align="center">48,72 &#177; 15,91<sup>b</sup></td>
                <td align="center">28,16 &#177; 6,00<sup>b</sup></td>
                <td align="center">210,30 &#177; 137,78<sup>a</sup></td>
              </tr>
              <tr>
                <td align="left">AST</td>
                <td align="center">154,67 &#177; 22,42<sup>b</sup></td>
                <td align="center">117,00 &#177; 29,84<sup>b</sup></td>
                <td align="center">300,63 &#177; 60,26<sup>a</sup></td>
              </tr>
            </tbody>
          </table>
          <table-wrap-foot>
            <fn id="TFN10">
              <p>
                <italic>Os dados s&#227;o expressos como m&#233;dia &#177; desvio padr&#227;o. a, bValores na mesma linha com letras sobrescritos diferentes s&#227;o significativamente diferentes (teste de Tukey, p &lt; 0,05). DP: dieta padr&#227;o; DRB: dieta rica em banha; DRB/RC: dieta rica em banha e colesterol; Peso relativo do f&#237;gado = (peso do f&#237;gado / peso corporal) x 100; CT: colesterol total; LDL-c: colesterol de lipoprote&#237;na de baixa densidade; HDL-c: colesterol de lipoprote&#237;na de alta densidade; VLDL-c: colesterol de lipoprote&#237;na de densidade muito baixa; TG: triacilglicerol; n&#227;o-HDL-c: colesterol da lipoprote&#237;na de alta densidade; ALT: alanina aminotransferase; AST: aspartato aminotransferase.</italic>
              </p>
            </fn>
          </table-wrap-foot>
        </table-wrap>
        <p>Animais alimentados com DRB/RC apresentaram maiores n&#237;veis s&#233;ricos de CT, TG, LDL-c, VLDL-c, n&#227;o-HDL-c, ALT e AST do que aqueles tratados com DP e com DRB. O perfil lip&#237;dico s&#233;rico e as enzimas hep&#225;ticas de animais alimentados com a DRB n&#227;o foram diferentes daqueles do grupo DP (<xref ref-type="table" rid="t4">Tabela 2</xref>).</p>
        <p>Altera&#231;&#245;es microsc&#243;picas foram encontradas no f&#237;gado dos animais alimentados com DRB/RC (<xref ref-type="fig" rid="f2">Figura 1</xref>), pois a arquitetura do tecido hep&#225;tico n&#227;o estava preservada, com balonamento dos hepat&#243;citos (caracterizado por incha&#231;o e/ou vacuoliza&#231;&#227;o), altera&#231;&#245;es nos capilares sangu&#237;neos sinusoidais e hiperemia passiva (capilares e veias ingurgitadas com sangue). Al&#233;m disso, ratos alimentados com DRB/RC apresentaram esteatose hep&#225;tica macrovesicular moderada, associada a uma infiltra&#231;&#227;o acentuada por c&#233;lulas linfomononucleares. Por outro lado, animais alimentados com DRB tiveram sua arquitetura de tecido hep&#225;tico preservada, com hepat&#243;citos de aspecto morfol&#243;gico normal, e distribui&#231;&#227;o vascular, veia centrolobular e tr&#237;ade portal preservadas. Ainda o grupo tratado com DRB mostrou esteatose hep&#225;tica microvesicular leve, associada a menor infiltra&#231;&#227;o por c&#233;lulas linfomononucleares. A arquitetura do tecido hep&#225;tico do grupo tratado com DP foi mantida com hepat&#243;citos t&#237;picos, sinus&#243;ides hep&#225;ticos preservados e cadeias capilares; distribui&#231;&#227;o vascular conservada, tr&#237;ades portais intactas, com ramos da veia porta, art&#233;ria hep&#225;tica e ducto biliar.</p>
        <p>
          <fig id="f2">
            <label>Figura 1</label>
            <caption>
              <title>Avalia&#231;&#227;o morfol&#243;gica do f&#237;gado de ratos Wistar alimentados com dietas hiperlip&#237;dicas por seis semanas. DP (dieta padr&#227;o): arquitetura preservada do tecido hep&#225;tico com distribui&#231;&#227;o vascular conservada. DRB (dieta rica em banha): arquitetura de tecido hep&#225;tico preservada com esteatose hep&#225;tica leve e uniforme (setas pretas), infiltrado inflamat&#243;rio leve (setas brancas) e hiperemia passiva leve (cabe&#231;as de setas). DRB/RC (dieta rica em banha e colesterol): arquitetura tecidual alterada com esteatose hep&#225;tica moderada, microves&#237;culas e macroves&#237;culas de gordura (setas pretas) e infiltrado inflamat&#243;rio acentuado (setas brancas). As barras indicam 100 &#956;m a uma amplia&#231;&#227;o de 100x (painel esquerdo) e 20 &#956;m a uma amplia&#231;&#227;o de 400x (painel direito).</title>
            </caption>
            <graphic xlink:href="1678-4170-abc-113-05-0896-90149-gf01-pt.jpg"/></fig>
        </p>
      </sec>
      <sec sec-type="discussion">
        <title>Discuss&#227;o</title>
        <p>A dislipidemia foi desencadeada em ratos alimentados com uma dieta com 20% de banha e 1% de colesterol, em seis semanas, com aumento do peso do f&#237;gado, les&#227;o hep&#225;tica e infiltrado inflamat&#243;rio.</p>
        <p>No presente estudo, os lip&#237;dios contribu&#237;ram com 44% da energia da dieta rica em gordura, um percentual pr&#243;ximo ao relatado para dieta hiperlip&#237;dica consumida por indiv&#237;duos com sobrepeso ou obesos (43% a 55%).<xref ref-type="bibr" rid="B17">17</xref><sup>-</sup><xref ref-type="bibr" rid="B19">19</xref> Em estudos pr&#233;vios com animais, a contribui&#231;&#227;o lip&#237;dica variou de 67% a 75% da energia da dieta rica em gordura.<xref ref-type="bibr" rid="B8">8</xref><sup>,</sup><xref ref-type="bibr" rid="B9">9</xref> Portanto, estas dietas com alto teor de lip&#237;dios n&#227;o reproduzem, realisticamente, as dietas ricas em gordura consumidas pelos seres humanos. A recomenda&#231;&#227;o di&#225;ria para adultos humanos &#233; de 20% a 35% de energia a partir de lip&#237;deos, de acordo com o AMDR (<italic>Acceptable Macronutrient Distribution Ranges</italic>), considerando que a alta ingest&#227;o lip&#237;dica indica um maior risco de obesidade e dist&#250;rbios associados.<xref ref-type="bibr" rid="B20">20</xref>
				</p>
        <p>O maior ganho de peso corporal no grupo DRB pode ser explicado pelo maior consumo de dieta (17,6 g/dia/rato) em rela&#231;&#227;o ao grupo DRB/RC (13,8 g/dia/rato), pois a densidade energ&#233;tica das dietas foi semelhante (4,26 kcal/g). Um maior ganho de peso foi relatado em estudo anterior com ratos alimentados com uma dieta rica em gordura e colesterol (densidade energ&#233;tica = 4,27 kcal/g) por 12 semanas, em compara&#231;&#227;o ao grupo controle.<xref ref-type="bibr" rid="B12">12</xref>
				</p>
        <p>Apesar do maior ganho de peso corporal, o grupo DRB n&#227;o diferiu do grupo DP em rela&#231;&#227;o ao peso do f&#237;gado (Tabela 2). O peso relativo do f&#237;gado no grupo DRB/RC foi muito elevado, representando mais de 5% do peso corporal destes animais. O aumento do peso do f&#237;gado no grupo DRB/RC est&#225; relacionado &#224; forte presen&#231;a de ves&#237;culas de gordura nos hepat&#243;citos, como observado na avalia&#231;&#227;o morfol&#243;gica do f&#237;gado (<xref ref-type="fig" rid="f2">Figura 1</xref>). Um estudo anterior com ratos em uma dieta rica em gordura e colesterol, sem &#225;cido c&#243;lico, por 16 semanas apresentou resultados semelhantes em rela&#231;&#227;o ao peso do f&#237;gado e ac&#250;mulo de lip&#237;dios no tecido hep&#225;tico.<xref ref-type="bibr" rid="B11">11</xref> Em nosso estudo, o &#225;cido c&#243;lico provavelmente acelerou os efeitos dislipid&#234;micos do colesterol no grupo DRB/RC, uma vez que identificamos dist&#250;rbios metab&#243;licos em apenas 6 semanas, enquanto o estudo de Jung et al.<xref ref-type="bibr" rid="B11">11</xref> alcan&#231;ou os mesmos efeitos em 16 semanas. O comprometimento lip&#237;dico s&#233;rico observado em animais alimentados com DRB/RC &#233; caracter&#237;stico de dislipidemia, e o aumento acentuado do LDL-c pode estar relacionado &#224; redu&#231;&#227;o na atividade do receptor de LDL-c nos hepat&#243;citos. Estudos pr&#233;vios revelaram mudan&#231;as nos n&#237;veis s&#233;ricos de CT e TG de ratos e camundongos alimentados com dieta em gordura e rica em colesterol.<xref ref-type="bibr" rid="B10">10</xref><sup>,</sup><xref ref-type="bibr" rid="B12">12</xref> No entanto, os per&#237;odos de experimenta&#231;&#227;o dos estudos relatados (9 e 12 semanas, respectivamente) foram maiores do que o usado no presente estudo.</p>
        <p>O perfil lip&#237;dico s&#233;rico dos animais alimentados com DRB n&#227;o diferiu daqueles alimentados com DP. Estudos com ratos Wistar tratados com dietas contendo 50% a 55% de banha (67% a 75% da energia da dieta) por quatro semanas mostraram resultados semelhantes.<xref ref-type="bibr" rid="B8">8</xref><sup>,</sup><xref ref-type="bibr" rid="B9">9</xref> O efeito delet&#233;rio do consumo muito alto de &#225;cidos graxos saturados e sua rela&#231;&#227;o com a dislipidemia t&#234;m sido questionados.<xref ref-type="bibr" rid="B1">1</xref> Siri et al.<xref ref-type="bibr" rid="B21">21</xref> destacaram que os efeitos da gordura saturada no perfil lip&#237;dico s&#233;rico poderiam ser modulados pelo conte&#250;do e/ou disponibilidade de &#225;cidos graxos polinsaturados, de modo que a gordura saturada aumentaria apenas o LDL-c se a ingest&#227;o de gordura polinsaturada estivesse abaixo de um n&#237;vel limiar (5% da energia da dieta).<xref ref-type="bibr" rid="B22">22</xref> Nossos resultados confirmaram que a ingest&#227;o excessiva de &#225;cidos graxos saturados explica apenas parte das altera&#231;&#245;es no perfil lip&#237;dico s&#233;rico. Outros fatores influenciam essas altera&#231;&#245;es, como colesterol na dieta, obesidade, resist&#234;ncia &#224; insulina e hipertrigliceridemia.<xref ref-type="bibr" rid="B23">23</xref><sup>,</sup><xref ref-type="bibr" rid="B24">24</xref>
				</p>
        <p>Altos n&#237;veis s&#233;ricos de ALT e AST s&#227;o caracter&#237;sticos da DHGNA e est&#227;o associados &#224; resist&#234;ncia &#224; insulina. Neste estudo, os n&#237;veis s&#233;ricos aumentados de ALT e AST foram compat&#237;veis com os danos hep&#225;ticos observados nos animais alimentados com a DRB/RC. Outros estudos tamb&#233;m encontraram aumento dos n&#237;veis s&#233;ricos de ALT e AST em camundongos alimentados com uma dieta rica em gordura e colesterol.<xref ref-type="bibr" rid="B11">11</xref><sup>,</sup><xref ref-type="bibr" rid="B12">12</xref>
				</p>
        <p>A avalia&#231;&#227;o morfol&#243;gica mostrou altera&#231;&#245;es marcantes no tecido hep&#225;tico de animais alimentados com DRB/RC, como macroves&#237;culas gordurosas e infiltrados inflamat&#243;rios, caracterizando uma esteatose hep&#225;tica moderada,<xref ref-type="bibr" rid="B25">25</xref> que foi confirmada pelos resultados das enzimas hep&#225;ticas (ALT e AST). O ac&#250;mulo de gordura no f&#237;gado desses animais est&#225; relacionado ao alto consumo de colesterol, pois essa sobrecarga nas c&#233;lulas altera a homeostase do colesterol.<xref ref-type="bibr" rid="B26">26</xref> Al&#233;m disso, o ac&#250;mulo de metab&#243;litos lip&#237;dicos intermedi&#225;rios, como diacilglicerol e acilcarnitinas, est&#225; associado &#224; inflama&#231;&#227;o e resist&#234;ncia &#224; insulina.<xref ref-type="bibr" rid="B27">27</xref><sup>,</sup><xref ref-type="bibr" rid="B28">28</xref> Um estudo anterior sugeriu que o colesterol elevado na dieta &#233; um fator cr&#237;tico para a progress&#227;o da esteatose hep&#225;tica e da inflama&#231;&#227;o em modelos animais. No entanto, caracter&#237;sticas da DHGNA s&#227;o mais evidentes quando o colesterol suplementado &#233; associado ao &#225;cido c&#243;lico em uma dieta rica em gordura, como observado em nosso estudo.</p>
        <p>A presen&#231;a de infiltrado inflamat&#243;rio no tecido hep&#225;tico promove a secre&#231;&#227;o de citocinas e quimiocinas, como o fator de necrose tumoral a (TNF-a) e a interleucina 6 (IL-6), que induzem a resist&#234;ncia &#224; insulina. Neste dist&#250;rbio metab&#243;lico, a lip&#243;lise aumentada de TG armazenada no tecido adiposo eleva a produ&#231;&#227;o de &#225;cidos graxos. Os &#225;cidos graxos liberados na circula&#231;&#227;o, por sua vez, inibem a a&#231;&#227;o anti-lipol&#237;tica da insulina e promovem maior absor&#231;&#227;o lip&#237;dica pelo f&#237;gado, levando &#224; dislipidemia e &#224; esteatose hep&#225;tica.<xref ref-type="bibr" rid="B3">3</xref><sup>,</sup><xref ref-type="bibr" rid="B32">32</xref><sup>,</sup><xref ref-type="bibr" rid="B33">33</xref> Hamsters alimentados com dieta hiperlipid&#234;mica contendo colesterol (0,2%), por 10 semanas, desenvolveram dislipidemia e esteatose hep&#225;tica, com concentra&#231;&#245;es s&#233;ricas aumentadas de CT, TG, LDL-c, ALT e AST.<xref ref-type="bibr" rid="B34">34</xref> An&#225;lise histopatol&#243;gica do f&#237;gado de ratos Sprague-Dawley alimentados com dieta rica em colesterol (1,5%) tamb&#233;m revelou esteatose hep&#225;tica e inflama&#231;&#227;o.<xref ref-type="bibr" rid="B35">35</xref>
				</p>
        <p>Uma limita&#231;&#227;o do nosso estudo foi a impossibilidade de usar m&#233;todos mais precisos para avaliar macro- e micro-ves&#237;culas de gordura hep&#225;tica e c&#233;lulas espumosas, como Oil Red e imuno-histoqu&#237;mica, respectivamente, o que poderia nos permitir analisar quantitativamente os danos hep&#225;ticos. Al&#233;m disso, recomendamos estudos adicionais, incluindo um tratamento com banha e &#225;cido c&#243;lico, para investigar se o &#225;cido c&#243;lico pode aumentar os efeitos metab&#243;licos do colesterol presente na banha.</p>
      </sec>
      <sec sec-type="conclusions">
        <title>Conclus&#227;o</title>
        <p>Uma dieta rica em gordura com banha (20%) e colesterol (1%) desencadeou dislipidemia com danos graves ao f&#237;gado de ratos, em um tempo experimental menor do que os modelos previamente relatados. A dieta rica em banha sem suplementa&#231;&#227;o de colesterol levou ao ganho de peso corporal, mas n&#227;o &#224; dislipidemia. Este modelo pode ser &#250;til para investigar dist&#250;rbios metab&#243;licos em diferentes delineamentos experimentais relacionados &#224; dislipidemia e suas comorbidades.</p>
      </sec>
    </body>
    <back>
      <fn-group>
        <fn fn-type="supported-by">
          <p><bold>Fontes de financiamento</bold> O presente estudo foi financiado pela FAPEG</p>
        </fn>
        <fn fn-type="other">
          <p>
            <bold>Vincula&#231;&#227;o acad&#234;mica</bold>
          </p>
          <p>Este artigo &#233; parte do projeto de P&#243;s-doutorado de Lidiane B. Muniz, realizado na Universidade Federal de Goi&#225;s.</p>
        </fn>
        <fn fn-type="other">
          <p>
            <bold>Aprova&#231;&#227;o &#233;tica e consentimento informado</bold>
          </p>
          <p>Este estudo foi aprovado pelo Comit&#234; de &#201;tica no Uso de Animais, da Universidade Federal de Goi&#225;s, sob o n&#250;mero de protocolo 039/15.</p>
        </fn>
      </fn-group>
      <ack>
        <title>Agradecimentos</title>
        <p>Os autores agradecem &#224; Funda&#231;&#227;o de Amparo &#224; Pesquisa do Estado de Goi&#225;s (FAPEG) pelo financiamento da pesquisa e concess&#227;o de bolsa de estudo, e &#224; professora Maria Aderuza Horst, Ph.D., pela assist&#234;ncia nos procedimentos com animais.</p>
      </ack>
    </back>
  </sub-article>
</article>
