Non-alcoholic steatohepatitis (NASH) is one of the conditions in the spectrum of non-alcoholic fatty liver disease (NAFLD) and is marked by hepatocellular damage with lobular inflammation. The present study assessed the individual and combined effects of fat and cholesterol on NAFLD progression. C57BL/6 control animals (CTL) received a standard diet and water ad libitum, while the diet-induced NASH model was induced by high-fat and hypercarbohydrate diet (HFHC) composed of 55% kcal of fat or by the same diet plus 2% cholesterol (HFHC+COL), added in the final 12 weeks of the experimental protocol. Both diets were associated with the addition of 250 g/L of fructose in drinking water and the induction lasted 43 weeks. All the parameters were evaluated at the end of the experimental protocol. The advanced glycation end-products (AGEs) were evaluated by spectroscopy. The weights of body, liver, heart and all deposits of adipose tissue were increased in the HFHC and HFHC+COL compared to CTL. HFHC had impaired glucose metabolism when compared to CTL. HFHC and HFHC+COL had an increase in serum cholesterol and hepatic triglyceride when compared to CTL. HFHC+COL had LDL, HDL, ALT, AST, hepatic cholesterol and SOD activity levels significantly increased compared to CTL and HFHC. Liver tissue of HFHC and HFHC+COL presented increase in malondialdehyde (MDA) levels and decrease in CAT enzyme activity. At 43 weeks, there was a significantly increase in AGE content in the serum of HFHC and HFHC+COL groups, while hepatic AGE was increased in the HFHC+COL. HFHC and HFHC+COL showed a significant increase in hepatic steatosis and inflammatory infiltrates compared to CTL, with significant increased values for HFHC+COL group. HFHC and HFHC+COL had NAFLD activity score (NAS) of 5 and 8, respectively, being classified as NASH and presented fibrosis. Thus, the addition of cholesterol to the diet increased NAFLD severity.
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