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Hu W, Luo L, Li M, Xiong X, Huang W, Huang Y, Sun J, Ding H, Yu H. Anti-inflammatory diet reduces risk of metabolic dysfunction-associated fatty liver disease among US adults: a nationwide survey. Scand J Gastroenterol 2024; 59:1192-1201. [PMID: 39215699 DOI: 10.1080/00365521.2024.2395851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 08/12/2024] [Accepted: 08/18/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND While dietary intervention was an important public health strategy for the prevention and intervention of metabolic dysfunction-associated fatty liver disease (MAFLD), the effect of diet-induced inflammation on MAFLD has not been studied in detail. Therefore, we aimed to analyze the relationship between dietary inflammatory index (DII) and MAFLD. METHODS This study included data from the National Health and Nutrition Examination Survey 2017-2018. MAFLD was diagnosed based on the presence of hepatic steatosis, as determined by transient elastography, along with evidence of either overweight/obesity, type 2 diabetes mellitus, or metabolic dysfunction. DII was calculated using 27 dietary components collected through 24-hour dietary recall questionnaire. Weighted logistic regression was used to analyze the relationship between DII and MAFLD and its main components in three different models. Subgroup analyses were performed by age, sex, and alcohol use. RESULTS A total of 1991 participants were included, and the MAFLD group had higher DII scores. After adjusting for age, sex, race, physical activity, smoking status, and alcohol use, the highest quartile of DII was associated with increased risk of MAFLD (OR:2.90, 95% CIs: 1.46, 5.75). Overweight/obesity, central obesity, low high density lipoprotein cholesterol (HDL-C) and high C-reactive protein (CRP) also shared the same characteristics in the main components of MAFLD. Results were consistent across subgroups (age, sex, and alcohol use). CONCLUSIONS A higher DII diet was positively associated with the risk of MAFLD in American adults, particularly as related to overweight/obesity, central obesity, high CRP level, and low HDL-C level.
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Affiliation(s)
- Wei Hu
- The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan, China
- The First Dongguan Affiliated Hospital, Guangdong Medical University; State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Dongguan, China
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Ling Luo
- Department of Epidemiology and Medical Statistics, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Mingzi Li
- Department of Epidemiology and Medical Statistics, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Xi Xiong
- Department of Epidemiology and Medical Statistics, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Wenlong Huang
- Department of Epidemiology and Medical Statistics, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Yanfang Huang
- Department of Epidemiology and Medical Statistics, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Jianbo Sun
- The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan, China
| | - Haifeng Ding
- The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan, China
| | - Haibing Yu
- The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan, China
- The First Dongguan Affiliated Hospital, Guangdong Medical University; State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Dongguan, China
- Department of Epidemiology and Medical Statistics, School of Public Health, Guangdong Medical University, Dongguan, China
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Yu J, Guo P. Association between dietary intake of carotenoids and metabolic dysfunction-associated fatty liver disease in US adults: National Health and Nutrition Examination Survey 2017-March 2020. Public Health Nutr 2024; 27:e168. [PMID: 39313756 DOI: 10.1017/s1368980024001502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/25/2024]
Abstract
OBJECTIVE To assess the relationship between dietary intake of α-carotene, β-carotene, β-cryptoxanthin, lycopene and lutein+zeaxanthin (LZ) and occurrence of metabolic dysfunction-associated fatty liver disease (MAFLD). DESIGN Cross-sectional study design. The MAFLD diagnosis was based on hepatic steatosis and metabolic dysregulation. Carotenoid intake was adjusted for using an energy-adjusted model. Logistic regression and restricted cubic spline (RCS) analyses were used to assess the relationships, with sensitivity analysis to validate the findings. Weighted quantile sum regression (WQS) was used to explore the combined effect of these carotenoids on MAFLD. Subgroup analyses were conducted to identify population-specific associations. SETTING National Health and Nutrition Examination Survey (NHANES) 2017-March 2020. PARTICIPANTS This study included 5098 individuals aged 18 years and older. RESULTS After adjusting for potential confounders, a weak inverse association was observed between α-carotene and β-carotene intakes and MAFLD occurrence (all P value <0·05). The highest quartile of β-carotene intake showed a significantly lower occurrence of MAFLD compared with the lowest quartile (OR = 0·65; 95 % CI: 0·44, 0·97). RCS analysis showed that a significantly lower occurrence of MAFLD was associated with a higher intake of the four carotenoids, excluding lycopene. Furthermore, the WQS analysis revealed a negative relationship between combined carotenoid intake and MAFLD occurrence (OR = 0·95, 95 % CI: 0·90, 1·00, P = 0·037). Subgroup analyses showed dietary carotenoid intake was associated with reduced MAFLD occurrence in populations aged 50-69 years, females, physically active individuals and non-drinkers. CONCLUSION Higher dietary intake of carotenoids is associated with lower MAFLD occurrence. However, this relationship varies among individuals of different ages, sexes and lifestyles.
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Affiliation(s)
- Jiahui Yu
- The Center of Gastrointestinal and Minimally Invasive Surgery, Department of General Surgery, The Third People's Hospital of Chengdu/The Affiliated Hospital of Southwest Jiaotong University, Chengdu, People's Republic of China
| | - Peisen Guo
- The Center of Gastrointestinal and Minimally Invasive Surgery, Department of General Surgery, The Third People's Hospital of Chengdu/The Affiliated Hospital of Southwest Jiaotong University, Chengdu, People's Republic of China
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Wang Y, Sun M, Liu Y, Yao N, Wang F, Guo R, Wang X, Li J, Wu Z, Xie Z, Han Y, Li B. Interaction between nutrition-related parameters and sexual orientation on depression. Public Health 2024; 237:7-13. [PMID: 39316852 DOI: 10.1016/j.puhe.2024.08.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 08/12/2024] [Accepted: 08/24/2024] [Indexed: 09/26/2024]
Abstract
OBJECTIVES Sexual minorities may be more vulnerable to mental disorders. Previous studies have found associations between diet and depression, but no studies have focused on the interaction between nutrition-related parameters and sexual orientation regarding depression. This study aims to explore the interaction between nutrition-related parameters and sexual orientation regarding depression. STUDY DESIGN Cross-sectional analysis using NHANES 2007-2016 data. METHODS This study utilized data from NHANES 2007-2016, with 11,065 participants involved. Nutrition-related parameters were evaluated using the healthy eating index-2015 (HEI-2015) and the dietary inflammation index (DII), while depression was obtained through Patient Health Questionnaire (PHQ-9). Logistic regression and stratified analysis of subgroups were used in this study. RESULTS Compared to those who consumed healthy and anti-inflammatory diets, the ORs for depression in groups consuming unhealthy and pro-inflammatory diets were 1.366 (95%CI:1.073,1.738) and 1.652 (95%CI:1.345,2.028), respectively. Sexual minorities have a higher risk of depression than heterosexuals. There is an interaction effect (P = 0.037) between HEI-2015 and sexual orientation on depression, while it was not found in DII. Subgroup analysis indicated that the interaction between sexual orientation and HEI-2015 persisted in males (P = 0.024), but not in females. CONCLUSION Both diet and sexual orientation had impacts on depression. There was an interaction between HEI-2015 and sexual orientation on depression, and this association was different by gender. Sexual minorities who are Gay/lesbian, Bisexual, and Something else are at higher risk for depression, and adopting healthy eating patterns and anti-inflammatory diets that are consistent with the recommendations of the USDA may appropriately reduce the risk of depression.
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Affiliation(s)
- Y Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, PR China
| | - M Sun
- The First Affiliated Hospital of Xi'an JiaoTong University, Department of Endocrinology, No. 277, West Yanta Road, Xi'an, Shaanxi 710061, P.R. China; Global Health Institute, School of Public Health, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Y Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, PR China
| | - N Yao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, PR China
| | - F Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, PR China
| | - R Guo
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, PR China
| | - X Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, PR China
| | - J Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, PR China
| | - Z Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, PR China
| | - Z Xie
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, PR China
| | - Y Han
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, PR China
| | - B Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, PR China.
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Qiao Y, Guo F, Liu P. Addressing the Complexities of Food Insecurity and MASLD: A Call for Comprehensive and Culturally Sensitive Public Health Strategies. J Hepatol 2024:S0168-8278(24)02552-2. [PMID: 39299455 DOI: 10.1016/j.jhep.2024.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2024] [Accepted: 09/05/2024] [Indexed: 09/22/2024]
Affiliation(s)
- Yi Qiao
- Chengdu Integrated TCM and Western Medicine Hospital
| | - Fulin Guo
- Hospital of Chengdu University of Traditional Chinese Medicine
| | - Pan Liu
- Chengdu Integrated TCM and Western Medicine Hospital.
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Zhang M, Chang D, Guan Q, Dong R, Zhang R, Zhang W, Wang H, Wang J. High-density lipoprotein cholesterol trajectory and new-onset metabolic dysfunction-associated fatty liver disease incidence: a longitudinal study. Diabetol Metab Syndr 2024; 16:223. [PMID: 39261925 PMCID: PMC11389356 DOI: 10.1186/s13098-024-01457-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 08/25/2024] [Indexed: 09/13/2024] Open
Abstract
BACKGROUND Although high-density lipoprotein cholesterol (HDL-C) exerts a significant influence on the development of metabolic dysfunction-associated fatty liver disease (MAFLD), the association of dynamic changes in HDL-C levels with the risk of MAFLD remains unclear. Thus, the aim of the current study was to explore the association between the changing trajectories of HDL-C and new-onset MAFLD. The findings of this study may provide a theoretical basis for future personalized intervention and prevention targeting MAFLD. METHODS A total of 1507 participants who met the inclusion criteria were recruited from a community-based physical examination population in Nanjing, China from 2017 to 2021. Group-based trajectory models were constructed to determine the heterogeneous HDL-C trajectories. The incidence of MAFLD in each group in 2022 was followed up, and the Cox proportional hazards regression model was applied to investigate the associations between different HDL-C trajectories and the risk of new-onset MAFLD. RESULTS The incidences of MAFLD in the low-stable, moderate-stable, moderate-high-stable, and high-stable groups of HDL-C trajectory were 26.5%, 13.8%, 7.2% and 2.6%, respectively. The incidence rate of MAFLD in the order of the above trajectory groups exhibited a decreasing trend (χ2 = 72.55, Ptrend<0.001). After adjusting for confounders, the risk of MAFLD onset in HDL-C low-stable group was still 5.421 times (95%CI: 1.303-22.554, P = 0.020) higher than that in the high-stable group. Subgroup analyses of the combined (moderate high-stable and high-stable groups combined), moderate-stable and low-stable groups showed that sex, age, and overweight/obesity did not affect the association between HDL-C trajectory and MAFLD risk. CONCLUSIONS Persistently low HDL-C level is a risk factor for the onset of MAFLD. Long-term monitoring of HDL-C levels and timely intervention for those experiencing persistent declines are crucial for early prevention of MAFLD.
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Grants
- 2019, WSN-049 the Six Talent Peaks Project in Jiangsu Province, China
- 2019, WSN-049 the Six Talent Peaks Project in Jiangsu Province, China
- 2019, WSN-049 the Six Talent Peaks Project in Jiangsu Province, China
- 2019, WSN-049 the Six Talent Peaks Project in Jiangsu Province, China
- 2019, WSN-049 the Six Talent Peaks Project in Jiangsu Province, China
- Nursing Science, 2018, No.87 Priority Academic Program Development of Jiangsu Higher Education Institutions
- Nursing Science, 2018, No.87 Priority Academic Program Development of Jiangsu Higher Education Institutions
- Nursing Science, 2018, No.87 Priority Academic Program Development of Jiangsu Higher Education Institutions
- Nursing Science, 2018, No.87 Priority Academic Program Development of Jiangsu Higher Education Institutions
- Nursing Science, 2018, No.87 Priority Academic Program Development of Jiangsu Higher Education Institutions
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Affiliation(s)
- Mengting Zhang
- Department of Gastroenterology, the Third Affiliated Hospital of Soochow University, Changzhou, 213003, Jiangsu, China
- Department of Fundamental and Community Nursing, School of Nursing, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Dongchun Chang
- Department of Fundamental and Community Nursing, School of Nursing, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Qing Guan
- Department of Fundamental and Community Nursing, School of Nursing, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Rui Dong
- Department of Fundamental and Community Nursing, School of Nursing, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Ru Zhang
- School of Nursing and Midwifery, Jiangsu College of Nursing, Huai'an, 223003, Jiangsu, China
| | - Wei Zhang
- Department of Epidemiology, Shanghai Cancer Institute, Shanghai, 200032, China
| | - Hongliang Wang
- Department of General Practice, Ninghai Road Community Health Service Center, Gulou District, Nanjing, 210024, Jiangsu, China
| | - Jie Wang
- Department of Fundamental and Community Nursing, School of Nursing, Nanjing Medical University, Nanjing, 211166, Jiangsu, China.
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Sualeheen A, Tan SY, Georgousopoulou E, Daly RM, Tierney AC, Roberts SK, George ES. Mediterranean diet for the management of metabolic dysfunction-associated steatotic liver disease in non-Mediterranean, Western countries: What's known and what's needed? NUTR BULL 2024. [PMID: 39258424 DOI: 10.1111/nbu.12707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 08/14/2024] [Accepted: 08/14/2024] [Indexed: 09/12/2024]
Abstract
Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common liver disease worldwide, affecting 30% of the population in Western countries. MASLD is considered the hepatic manifestation of the metabolic syndrome, pathophysiologically underpinned by insulin resistance and frequently co-exists with hypertension, central obesity and dyslipidaemia. Currently, safe and effective pharmacotherapies for MASLD are limited, making weight loss with lifestyle changes the mainstay therapy. A Mediterranean diet (MedDiet) has emerged as an effective dietary pattern for preventing and managing MASLD, but most studies have been conducted in Mediterranean countries, necessitating further investigation into its benefits in Western populations. Additionally, the effect of holistic multimodal lifestyle interventions, including physical activity combined with the MedDiet, is not well established. Finally, MASLD's widespread prevalence and rapid growth require improved accessibility to interventions. Digital health delivery platforms, designed for remote access, could be a promising approach to providing timely support to individuals with MASLD. This narrative review summarises the current evidence related to the effects of the MedDiet in Western, multicultural populations with MASLD. This includes a detailed description of the composition, prescription and adherence to dietary interventions in terms of how they have been designed and applied. The evidence related to the role of physical activity or exercise interventions prescribed in combination with the MedDiet for MASLD will also be reviewed. Finally, recommendations for the design and delivery of dietary and physical activity or exercise interventions to inform the design of future randomised controlled trials to facilitate the optimal management of MASLD are outlined.
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Affiliation(s)
- Ayesha Sualeheen
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Sze-Yen Tan
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Ekavi Georgousopoulou
- Discipline of Nutrition and Dietetics, Faculty of Health, University of Canberra, Canberra, New South Wales, Australia
| | - Robin M Daly
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Audrey C Tierney
- School of Allied Health, Centre for Implementation Research, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Stuart K Roberts
- Department of Gastroenterology, Alfred Health, Prahran, Victoria, Australia
- Central Clinical School, Monash University, Clayton, Victoria, Australia
| | - Elena S George
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
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Xu M, Han S, Wu Q, Ma S, Cai H, Xue M, Liu F, Xiao X, Chen X, Lin M. Non-linear associations between cardiovascular metabolic indices and metabolic-associated fatty liver disease: A cross-sectional study in the US population (2017-2020). Open Life Sci 2024; 19:20220947. [PMID: 39290497 PMCID: PMC11406434 DOI: 10.1515/biol-2022-0947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 07/22/2024] [Accepted: 08/07/2024] [Indexed: 09/19/2024] Open
Abstract
The cardiometabolic index (CMI) is an emerging and effective indicator for predicting the presence of metabolic-associated fatty liver disease (MAFLD). This study aims to investigate the relationship between CMI and MAFLD using data from NHANES 2017-2020. In this cross-sectional study, a total of 3,749 subjects were included. The study conducted a thorough analysis of CMI with three multivariate logistic regression models, subgroup analyses, and restricted cubic splines (RCS) were utilized. Using multifactorial logistic regression as the primary method of analysis, we found that a higher CMI was also significantly associated with an increased risk of MAFLD (OR = 1.45, 95% CI (1.05-2.01)). This result was further visualized by the RCS curve: There was a non-linear positive correlation between CMI and MAFLD incidence (the turning point is CMI = 0.4554). These findings were strongly reinforced by subsequent subgroup and sensitivity analyses. There is a robust positive relationship between the CMI and the risk of MAFLD, providing valuable clinical benefits for early detection and screening of MAFLD. It is important to highlight the presence of a non-linear association between CMI and MAFLD, with an inflection point identified at CMI = 0.4554.
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Affiliation(s)
- Meimei Xu
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120, Guangdong, China
- Hunan University of Chinese Medicine, Changsha, 410208, Hunan, China
| | - Sibo Han
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, 510120, Guangdong, China
| | - Qiaomei Wu
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120, Guangdong, China
| | - Shihong Ma
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120, Guangdong, China
| | - Huiying Cai
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120, Guangdong, China
| | - Mengqi Xue
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, 510120, Guangdong, China
| | - Fengling Liu
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120, Guangdong, China
| | - Xiaozhen Xiao
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120, Guangdong, China
| | - Xiaoshuang Chen
- Guangzhou Jiangnan Foreign Language School, Guangzhou, 510120, Guangdong, China
| | - MeiZhen Lin
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120, Guangdong, China
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Fu W, Zhao J, Chen G, Lv L. Social work's role in severe depression of MASLD. Liver Int 2024. [PMID: 39206765 DOI: 10.1111/liv.16042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2024] [Accepted: 07/04/2024] [Indexed: 09/04/2024]
Affiliation(s)
- Wei Fu
- Department of Gastroenterology, 925th Hospital of PLA Joint Logistics Support Force, Guiyang, China
| | - Junlong Zhao
- State Key Laboratory of Cancer Biology, Department of Medical Genetics and Developmental Biology, School of Basic Medicine, Fourth Military Medical University, Xi'an, China
| | - Guobin Chen
- Department of Gastroenterology, 925th Hospital of PLA Joint Logistics Support Force, Guiyang, China
| | - Linya Lv
- Department of Gastroenterology, 925th Hospital of PLA Joint Logistics Support Force, Guiyang, China
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Xu M, Zhan Y, Gao G, Zhu L, Wu T, Xin G. Associations of five dietary indices with metabolic dysfunction-associated steatotic liver disease and liver fibrosis among the United States population. Front Nutr 2024; 11:1446694. [PMID: 39221157 PMCID: PMC11363712 DOI: 10.3389/fnut.2024.1446694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Accepted: 08/06/2024] [Indexed: 09/04/2024] Open
Abstract
Background and aims The role of dietary factors in metabolic dysfunction-associated steatotic liver disease (MASLD)-which represents a new definition of liver steatosis and metabolic dysfunction- remains unclear. This study aimed to explore the relationships between dietary indices and MASLD. Methods We analyzed data from the United States National Health and Nutrition Examination Survey (NHANES) 2017-2020 cycle, including 4,690 participants with complete vibration-controlled transient elastography (VCTE) data. Multivariate logistic regression models adjusted for covariates were used to assess the association between dietary indices, MASLD, and MASLD-associated liver fibrosis (MASLD-LF). Restricted cubic spline (RCS) models and subgroup analyses were also performed. Results The Alternative Healthy Eating Index (AHEI), Healthy Eating Index-2020 (HEI-2020), Dietary Approaches to Stop Hypertension Index (DASHI), and Mediterranean Diet Index (MEDI) were found to be negatively associated with MASLD risk, while the Dietary Inflammatory Index (DII) had a positive association. The highest quartile of MEDI was linked to a 44% reduction in MASLD risk [Q1 vs. Q4 odds ratio (OR): 0.56; 95% confidence interval (CI): 0.34-0.94, P for trend: 0.012]. DASHI was uniquely associated with a reduced risk of MASLD-LF (continuous OR: 0.79; 95% CI: 0.64-0.97; p for trend: 0.003). Our RCS curves indicated a nonlinear association with DASHI-MASLD (p-overall: 0.0001, p-nonlinear: 0.0066). Subgroup analyses showed robust associations among the non-Hispanic White and highly educated populations. Conclusion Specific dietary patterns were associated with reduced risks of MASLD and MASLD-LF. The DASHI, in particular, showed a significant protective effect against MASLD-LF. These findings suggest potential dietary interventions for managing MASLD and MASLD-LF, although large-scale randomized controlled trials are warranted to validate these findings.
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Affiliation(s)
- Min Xu
- Department of Hepatology, Center of Infectious Diseases and Pathogen Biology, The First Hospital of Jilin University, Changchun, China
| | - Yamei Zhan
- Department of Nephrology, The First Hospital of Jilin University, Changchun, China
| | - Guohui Gao
- Department of Hepatology, Center of Infectious Diseases and Pathogen Biology, The First Hospital of Jilin University, Changchun, China
| | - Li Zhu
- Department of Hepatology, Center of Infectious Diseases and Pathogen Biology, The First Hospital of Jilin University, Changchun, China
| | - Tong Wu
- Department of Hepatology, Center of Infectious Diseases and Pathogen Biology, The First Hospital of Jilin University, Changchun, China
| | - Guijie Xin
- Department of Hepatology, Center of Infectious Diseases and Pathogen Biology, The First Hospital of Jilin University, Changchun, China
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Yang M, Chen X, Shen Q, Xiong Z, Liu T, Leng Y, Jiao Y. Development and validation of a predictive nomogram for the risk of MAFLD in postmenopausal women. Front Endocrinol (Lausanne) 2024; 15:1334924. [PMID: 39165508 PMCID: PMC11334217 DOI: 10.3389/fendo.2024.1334924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 07/09/2024] [Indexed: 08/22/2024] Open
Abstract
Background and aim Metabolic-associated fatty liver disease (MAFLD) has gradually become one of the main health concerns regarding liver diseases. Postmenopausal women represent a high-risk group for MAFLD; therefore, it is of great importance to identify and intervene with patients at risk at an early stage. This study established a predictive nomogram model of MAFLD in postmenopausal women and to enhance the clinical utility of the new model, the researchers limited variables to simple clinical and laboratory indicators that are readily obtainable. Methods Data of 942 postmenopausal women from January 2023 to October 2023 were retrospectively collected and divided into two groups according to the collection time: the training group (676 cases) and the validation group (226 cases). Significant indicators independently related to MAFLD were identified through univariate logistic regression and stepwise regression, and the MAFLD prediction nomogram was established. The C-index and calibration curve were used to quantify the nomogram performance, and the model was evaluated by measuring the area under the receiver operating characteristic curve (AUC), calibration curve, and decision curve analysis (DCA). Results Of 37 variables, 11 predictors were identified, including occupation (worker), body mass index, waist-to-hip ratio, number of abortions, anxiety, hypertension, hyperlipidemia, diabetes, hyperuricemia, and diet (meat and processed meat). The C-index of the training group predicting the related risk factors was 0.827 (95% confidence interval [CI] 0.794-0.860). The C-index of the validation group was 0.787 (95% CI 0.728-0.846). Calibration curves 1 and 2 (BS1000 times) were close to the diagonal, showing a good agreement between the predicted probability and the actual incidence in the two groups. The AUC of the training group was 0.827, the sensitivity was 0.784, and the specificity was 0.735. The AUC of the validation group was 0.787, the sensitivity was 0.674, and the specificity was 0.772. The DCA curve showed that the nomogram had a good net benefit in predicting MAFLD in postmenopausal women. Conclusions A predictive nomogram for MAFLD in postmenopausal women was established and verified, which can assist clinicians in evaluating the risk of MAFLD at an early stage.
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Affiliation(s)
- Ming Yang
- College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
- Department of Liver, Spleen and Gastroenterology, First Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, China
| | - Xingyu Chen
- Department of Liver, Spleen and Gastroenterology, First Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, China
| | - Qiaohui Shen
- College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Zhuang Xiong
- Department of Liver, Spleen and Gastroenterology, First Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, China
| | - Tiejun Liu
- College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
- Department of Liver, Spleen and Gastroenterology, First Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, China
| | - Yan Leng
- College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
- Department of Liver, Spleen and Gastroenterology, First Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, China
| | - Yue Jiao
- Department of Intensive Care Unit, Changchun Tongyuan Hospital, Changchun, China
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Li J, Wu Z, Xin S, Xu Y, Wang F, Liu Y, Wang S, Dong Y, Guo Y, Han Y, Zhao J, Gao Y, Sun M, Li B. Body mass index mediates the association between four dietary indices and phenotypic age acceleration in adults: a cross-sectional study. Food Funct 2024; 15:7828-7836. [PMID: 38916856 DOI: 10.1039/d4fo01088d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
Background: Diet and body mass index (BMI) are widely recognized as being closely associated with aging. However, it remains unclear which dietary indices are associated with aging, and the extent to which BMI mediates the relationship between diet and aging. Therefore, this study investigates the mediating role of BMI in the association between various dietary indices and phenotypic age acceleration (PhenoAgeAccel). Methods: Data were sourced from the National Health and Nutrition Examination Survey (NHANES), using two 24 hour recall interviews to compute four dietary indices: the Dietary Inflammatory Index (DII), Healthy Eating Index-2020 (HEI-2020), Alternative Healthy Eating Index-2010 (AHEI-2010), and Composite Dietary Antioxidant Index (CDAI). Linear regression analyses and mediation analyses assessed the associations between dietary indices and PhenoAgeAccel and the mediating effects of BMI. Z-score transformations (zDII, zHEI-2020, zAHEI-2010, and zCDAI) were used to ensure comparability between different dietary indices. Results: After adjusting for covariates, the zHEI-2020, zAHEI-2010, and zCDAI were negatively associated with PhenoAgeAccel (P < 0.05), with β values being -0.36, -0.40, and -0.41, respectively. The zDII was positively associated with PhenoAgeAccel (P < 0.001) with a β value of 0.70. Mediation analyses suggested that BMI significantly mediated the relationships between these dietary indices and PhenoAgeAccel. The mediation proportions were 23.7% for zDII, 43.3% for zHEI-2020, 24.5% for zAHEI-2010, and 23.6% for zCDAI. Conclusions: This study indicates that all dietary indices and BMI were significantly associated with PhenoAgeAccel. In addition, BMI exhibited the highest mediation proportion in the relationship between HEI-2020 and PhenoAgeAccel.
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Affiliation(s)
- Jing Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street No.1163, Changchun, 130021, P. R. China.
| | - Zibo Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street No.1163, Changchun, 130021, P. R. China.
| | - Sitong Xin
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street No.1163, Changchun, 130021, P. R. China.
| | - Yang Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street No.1163, Changchun, 130021, P. R. China.
| | - Fengdan Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street No.1163, Changchun, 130021, P. R. China.
| | - Yan Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street No.1163, Changchun, 130021, P. R. China.
| | - Sizhe Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street No.1163, Changchun, 130021, P. R. China.
| | - Yibo Dong
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street No.1163, Changchun, 130021, P. R. China.
| | - Yuangang Guo
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street No.1163, Changchun, 130021, P. R. China.
| | - Yu Han
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street No.1163, Changchun, 130021, P. R. China.
| | - Jing Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street No.1163, Changchun, 130021, P. R. China.
| | - Yuqi Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street No.1163, Changchun, 130021, P. R. China.
| | - Mengzi Sun
- The First Affiliated Hospital of Xi'an Jiaotong University, No. 69, Xiaozhai West Road, Xi'an, 710061, P. R. China
- Global Health Institute, School of Public Health, Xi'an Jiaotong University, Xi'an, Shaanxi, 710100, P. R. China
| | - Bo Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street No.1163, Changchun, 130021, P. R. China.
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12
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Zhang Z, Wang H, Chen Y. Association between composite dietary antioxidant index and metabolic dysfunction associated steatotic liver disease: result from NHANES, 2017-2020. Front Nutr 2024; 11:1412516. [PMID: 39104752 PMCID: PMC11299214 DOI: 10.3389/fnut.2024.1412516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Accepted: 07/11/2024] [Indexed: 08/07/2024] Open
Abstract
Background The development of metabolic dysfunction associated steatotic liver disease (MASLD) has been associated with lipid accumulation, oxidative stress, endoplasmic reticulum stress, and lipotoxicity. The Composite Dietary Antioxidant Index (CDAI) is a comprehensive score representing an individual intake of various dietary antioxidants, including vitamin A, vitamin C, vitamin E, selenium, zinc, and carotenoids. This study investigated the association between CDAI and MASLD. Materials and methods Clinical and demographic data, as well as ultrasound transient elastography measurements at baseline, were collected from the National Health and Nutrition Examination Survey 2017-2020 (NHANES 2017-2020). The controlled attenuation parameter was utilized to diagnose the presence of hepatic steatosis and to categorize individuals into those with and without MASLD. Liver stiffness was measured by ultrasound transient elastography, and subjects were classified as those with and without advanced liver fibrosis. Results This study included 5,884 adults, of whom 3,433 were diagnosed with MASLD, resulting in a weighted prevalence of 57.3%. After adjusting for covariates, the odds ratios for MASLD were 0.96 (95% CI: 0.82, 1.12) in the second quartile, 0.80 (95% CI: 0.68, 0.95) in the third quartile and 0.60 (95% CI: 0.49, 0.73) in the fourth quartile, respectively. CDAI, however, was not significantly associated with advanced liver fibrosis. Conclusion These findings suggested that scores on the CDAI were linearly and negatively associated with the prevalence of MASLD in the United States adults.
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Affiliation(s)
| | | | - Youpeng Chen
- Department of Infectious Diseases, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
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13
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Zhiyi L, Shuhan Z, Libing Z, Jiaqi L, Xin D, Lingxi Q, Yuan-Mei S, Hong Z, Jiaqi N, Hui L, Sanyou F. Association of the Healthy Dietary Index 2020 and its components with chronic respiratory disease among U.S. adults. Front Nutr 2024; 11:1402635. [PMID: 39021605 PMCID: PMC11252059 DOI: 10.3389/fnut.2024.1402635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 06/18/2024] [Indexed: 07/20/2024] Open
Abstract
Background Chronic respiratory disease is an important public health problem in the United States and globally. Diet, an important part of a healthy lifestyle, is also relevant to chronic respiratory health. We aimed to explore the relationship between overall dietary quality and the risk of chronic respiratory disease (CRD), include chronic bronchitis (CB), emphysema and asthma. Method A total of 4,499 United States adults were extracted from the National Health and Nutrition Examination Survey (NHANES) in 2017-2018. Diet quality was assessed using 2 day, 24 h dietary recall data and quantified as the Healthy Diet Index (HEI)-2020 score. Binary logistic regression models, restricted cubic splines (RCS) and generalized additive modeling (GAM), the weighted quartile sum (WQS) and qgcom models were used to assess the relationship between HEI-2020 scores and risk of CB, emphysema and asthma. Results High HEI-2020 scores are associated with low risk of chronic respiratory disease (CB: 0.98, 0.97-0.99; emphysema: 0.98, 0.97-0.99; asthma: 0.98, 0.97-0.99) and consistent results across different dietary variable categorization (Tertile: CB: 0.58, 0.42-0.81; asthma: 0.51, 0.35-0.74; Quartile: CB: 0.57, 0.34-0.97; asthma: 0.56, 0.36-0.86) and different weighting models. Negative dose-response relationship between dietary quality and risk of chronic respiratory disease also shown in RCS and GAM models. The WQS and qgcom models also showed a healthy mixing effect of dietary components on respiratory disease, with high-quality proteins, vegetables, and fruits making the heaviest contributions. Conclusion Higher HEI-2020 scores were associated with lower risk of CB, emphysema, and asthma. Following Dietary Guidelines for Americans 2020-2025 could support enhanced respiratory health.
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Affiliation(s)
- Liu Zhiyi
- School of Traditional Chinese Medicine, Hubei University of Chinese Medicine, Wuhan, China
| | - Zhou Shuhan
- School of Traditional Chinese Medicine, Hubei University of Chinese Medicine, Wuhan, China
| | - Zhang Libing
- School of Traditional Chinese Medicine, Hubei University of Chinese Medicine, Wuhan, China
| | - Li Jiaqi
- Hospital of Stomatology Wuhan University, Wuhan, China
| | - Ding Xin
- School of Pharmacy, Hubei University of Chinese Medicine, Wuhan, China
| | - Qin Lingxi
- School of Traditional Chinese Medicine, Hubei University of Chinese Medicine, Wuhan, China
| | | | - Zhang Hong
- Taixing People’s Hospital, Taixing, China
| | - Nie Jiaqi
- Xiaogan Center for Disease Control and Prevention, Xiaogan, China
| | - Li Hui
- Taixing People’s Hospital, Taixing, China
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14
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Zhou H, Chen H, Lu H, Wu B, Zhang S, Gu Y, Zhou G, Xiang J, Yang J. Sex differences in mortality and liver-related events in non-alcoholic fatty liver disease: A systematic review and meta-analysis. Liver Int 2024; 44:1600-1609. [PMID: 38506430 DOI: 10.1111/liv.15910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 02/15/2024] [Accepted: 03/11/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND & AIMS Many systematic reviews explore the association of non-alcoholic fatty liver disease (NAFLD) with mortality, but none of them explores sex-based differences in detail. We aimed to assess whether NAFLD is associated with cause-specific mortality, all-cause mortality, and cancer incidence in both men and women. METHODS The PubMed, Embase, and Medline databases were searched from inception through April 2023 for eligible studies. We separately pooled relative risks (RRs) for men and women using a random effects model. Subsequently, the RRs and 95% CIs (confidence intervals) in each study were used to calculate the women-to-men ratio of RRs (RRR). Furthermore, subgroup analyses were performed to explore the robustness of outcomes. The random-effects model was employed to conduct sensitivity analyses to determine the impact of specific studies on the overall findings. RESULTS The meta-analysis included nine cohort studies comprising 557 614 patients with NAFLD were chosen. Women were 44% more likely than men to get cancer among those with NAFLD (RRR: 1.44; 95% CI: 1.02-2.04; p = .039). However, no sex-related differences were observed between NAFLD and all-cause mortality (RRR: 1.06; 95% CI: 0.56-2.01; p = .861), liver-related mortality (RRR: 1.06; 95% CI: 0.02-69.82; p = .977), cardiovascular mortality (RRR: 1; 95% CI: 0.65-1.53; p = .987) and liver cancer (RRR: 0.76; 95% CI: 0.43-1.36; p = .36). CONCLUSIONS There may be sex variations between NAFLD and the risk of cancer, with the connection being stronger in females than in males.
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Affiliation(s)
- Huimin Zhou
- Department of Medicine, Jiangnan University, Wuxi, Jiangsu, China
- Division of General Surgery, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China
| | - Haiyan Chen
- Department of Medicine, Jiangnan University, Wuxi, Jiangsu, China
- Division of General Surgery, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China
| | - Hanxiao Lu
- Department of Medicine, Jiangnan University, Wuxi, Jiangsu, China
- Division of General Surgery, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China
| | - Bo Wu
- Department of Medicine, Jiangnan University, Wuxi, Jiangsu, China
- Division of General Surgery, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China
| | - Shuo Zhang
- Division of General Surgery, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China
| | - Yuanlong Gu
- Division of General Surgery, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China
| | - Guangwen Zhou
- Department of General Surgery, Shanghai Sixth People's Hospital, Shanghai, China
| | - Jie Xiang
- Wuxi Mingci Cardiovascular Hospital, Wuxi, Jiangsu, China
| | - Jun Yang
- Division of General Surgery, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China
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15
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Dai Z, Zhou X. Associations between allostatic load and hepatic steatosis and liver fibrosis: evidence from NHANES 2017-2020. BMC Public Health 2024; 24:1602. [PMID: 38879469 PMCID: PMC11179389 DOI: 10.1186/s12889-024-19111-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 06/12/2024] [Indexed: 06/19/2024] Open
Abstract
BACKGROUND Allostatic load, the cumulative strain resulting from chronic stress responses, has been linked to disease occurrence and progression, yet research quantifying this relationship is limited. This study aimed to explore the relationship between allostatic load score (ALS) levels and the degree of hepatic steatosis and fibrosis. METHODS Data from the National Health and Nutrition Examination Survey 2017-2020 were analyzed. The ALS was based on the statistical distribution, assigning one point for each biomarker if it was in the highest risk quartile, and then summing them to generate the ALS score (range, 0-8). The multivariate linear regression was employed to analyze the association between the controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) with ALS. Additionally, multinomial logistic regression was used to investigate the association between ALS and the degree of hepatic steatosis and fibrosis. RESULTS Participants had a weighted mean age of 52.69 years and 56.14% were female. In the multivariate linear regression analysis, ALS showed a significant positive correlation with CAP (β = 15.56, 95% CI: 14.50-16.62) and LSM (β = 0.58, 95% CI: 0.48-0.67). Age, healthy dietary level, and PIR had significant interactions with this positive correlation. In the multinomial logistic regression analysis, ALS exhibited a significant positive correlation with different degrees of hepatic steatosis and fibrosis. Consistency of the results was observed in sensitivity analyses using clinical thresholds of ALS. CONCLUSIONS Comprehensive clinical assessment targeting load adaptation may enhance the effectiveness of risk assessment in patients with hepatic steatosis and fibrosis.
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Affiliation(s)
- Zhikun Dai
- Department of Infectious Diseases, The First Affiliated Hospital of Shantou University Medical College, Shantou , Guangdong, 515041, China
| | - Xiaohui Zhou
- Department of Infectious Diseases, The First Affiliated Hospital of Shantou University Medical College, Shantou , Guangdong, 515041, China.
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16
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Chen Y, Lu C, Ju H, Zhou Q, Zhao X. Elevated AIP is associated with the prevalence of MAFLD in the US adults: evidence from NHANES 2017-2018. Front Endocrinol (Lausanne) 2024; 15:1405828. [PMID: 38808115 PMCID: PMC11130487 DOI: 10.3389/fendo.2024.1405828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Accepted: 04/30/2024] [Indexed: 05/30/2024] Open
Abstract
Background Atherogenic Index of plasma (AIP) is closely related to metabolic abnormalities. But as of now, there is no definitive conclusion on the dose-response relationship pattern between AIP and metabolic associated fatty liver disease (MAFLD). Objective The objective of this study was to provide a fresh insight for understanding the intrinsic link between AIP and the prevalence of MAFLD by exploring the dose-response pattern between AIP and MAFLD. Methods A total of 9254 participants received the survey and 1090 participants were finally included according to the screening criteria. To evaluate the association between AIP and the prevalence of MAFLD based on weighted multivariate logistic regression. Sensitivity analysis of the association between AIP and MAFLD was performed using propensity score matching (PSM). Restrictive cubic splines (RCS) were used to identify patterns of dose-response relationships between AIP and MAFLD, and receiver operator characteristic (ROC) curves were used to evaluate the predictive ability of AIP and traditional lipid parameters for MAFLD. Results In this study, a total of 563 participants were found to have MAFLD. The results of weighted multivariate logistic regression analysis demonstrated that, after adjusting for sex and age, participants in the highest quartile (Q4) of AIP had a significantly increased risk of developing MAFLD compared to those in the lowest quartile (Q1) (Model 2: OR = 9.03, 95% CI 4.75-17.17). A similar trend was observed in the fully adjusted model (Model 3: OR = 3.85, 95% CI 1.55-9.52). The RCS analysis revealed a linear dose-response association between AIP and MAFLD(P for crude non-linearity = 0.087). This association remained significant after accounting for potential confounding variables(P for adjusted non-linearity = 0.663). The ROC curve results suggest that AIP performs better than traditional lipid indicators in predicting MAFLD (AUC = 0.732, 95%CI 0.705-0.758). Conclusion A linear dose-response relationship exists between AIP and MAFLD, suggesting that as AIP increases, so does the risk of developing MAFLD.
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Affiliation(s)
| | | | | | | | - Xin Zhao
- Department of Cardiology, The Second Hospital of Dalian Medical University, Dalian, China
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17
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Li L, Shu X, Yi Y, Wang C, Li J, Ding Y, Li J, Chang Y. Dietary inflammatory impact on NAFLD development in obese vs. lean individuals: an analysis based on NHANES 2003-2018. Lipids Health Dis 2024; 23:127. [PMID: 38685122 DOI: 10.1186/s12944-024-02082-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 03/18/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Non-alcoholic fatty liver disease (NAFLD), often linked with obesity, can also affect individuals with normal weight, a condition known as "lean NAFLD", imposing comparable burdens and adverse effects. However, the impact of diet on lean NAFLD remains underexplored. The objective of this study is to investigate the correlation between the Dietary Inflammatory Index (DII) and NAFLD among Americans, stratified by waist-to-height ratio (WHtR) and body mass index (BMI). METHODS Five thousand one hundred fifty-two participants from the National Health and Nutrition Examination Survey (NHANES) 2003-2018 were comprised in the final analysis. NAFLD and advanced liver fibrosis were diagnosed by serological markers. Lean and abdominal lean individuals were identified using BMI and WHtR, separately. DII was determined by assigning scores to 28 distinct food parameters based on their inflammatory potential, obtained from the NAHNES website. Differences across DII quartiles were evaluated using the Kruskal-Wallis H Test, Chi-Square Test along with One-Way ANOVA. The correlation between DII and NAFLD was determined by multiple regression models and subgroup analyses. RESULTS Among the 5152 subjects, 2503 were diagnosed with NAFLD, including 86 cases of lean NAFLD and 8 cases of abdominal lean NAFLD. DII was positively linked with NAFLD (Odds Ratio (OR) = 1.81 [1.48-2.21], P < 0.001) and advanced liver fibrosis (OR = 1.46 [1.02-2.07], P = 0.037). Further analysis revealed that this association was primarily observed in obese or abdominal obese participants (In BMI ≥ 25.00 kg/m^2, OR = 1.56 [1.23-1.98], P < 0.001. In WHtR> 0.50, OR = 1.48 [1.23-1.79], P < 0.001.), rather than their lean counterparts. Subgroup analyses indicated that female individuals, without a diagnosis of hypertension or diabetes appeared to be more sensitive to the rise in DII. CONCLUSIONS Our data demonstrated a significant positive correlation between DII and NAFLD in the general population. However, the impact of a pro-inflammatory diet was less prominent in lean individuals compared to obese ones.
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Affiliation(s)
- Lurao Li
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China
- Hubei Clinical Center and Key Laboratory of Intestinal and Colorectal Diseases, Wuhan, Hubei, China
| | - Xiawen Shu
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China
- Hubei Clinical Center and Key Laboratory of Intestinal and Colorectal Diseases, Wuhan, Hubei, China
| | - Yun Yi
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China
- Hubei Clinical Center and Key Laboratory of Intestinal and Colorectal Diseases, Wuhan, Hubei, China
| | - Chun Wang
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China
- Hubei Clinical Center and Key Laboratory of Intestinal and Colorectal Diseases, Wuhan, Hubei, China
| | - Jianghui Li
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China
- Hubei Clinical Center and Key Laboratory of Intestinal and Colorectal Diseases, Wuhan, Hubei, China
| | - Yang Ding
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China
- Hubei Clinical Center and Key Laboratory of Intestinal and Colorectal Diseases, Wuhan, Hubei, China
| | - Jin Li
- Department of Laboratory Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China.
| | - Ying Chang
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China.
- Hubei Clinical Center and Key Laboratory of Intestinal and Colorectal Diseases, Wuhan, Hubei, China.
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18
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Zhao Q, Deng Y, Gong R, Chen T, Yang L. Association between dietary inflammatory index and risk of fatty liver disease: A systematic review and meta-analysis. Dig Liver Dis 2024; 56:541-550. [PMID: 37813810 DOI: 10.1016/j.dld.2023.09.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 09/11/2023] [Accepted: 09/27/2023] [Indexed: 10/11/2023]
Abstract
AIMS This meta-analysis aimed to investigate the correlation between dietary inflammatory index (DII) and risks of fatty liver disease. METHODS A comprehensive systematic literature search was conducted to select studies published from database inception to 6 September 2023 from five databases. Observational studies examining the association between elevated DII levels and the prevalence of fatty liver disease/liver fibrosis were included. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using either random-effects or fixed-effect models. RESULTS In total, 10 studies comprising 242,006 participants were included in the meta-analysis. Individuals with higher DII had a significantly increased risk of fatty liver disease (OR 1.63; 95% CI 1.08-2.45) and liver fibrosis (OR 1.15; 95% CI 1.09-1.21) compared to those with lower DII. CONCLUSIONS This meta-analysis demonstrated an association between higher DII and increased odds of fatty liver disease. However, additional prospective studies are required to further address this question.
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Affiliation(s)
- Qianwen Zhao
- Department of Gastroenterology & Hepatology, Sichuan University-University of Oxford Huaxi Joint Centre for Gastrointestinal Cancer, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan 610200, China
| | - Yunlei Deng
- Department of Nephrology, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, 82# Qinglong Street, Qingyang District, Chengdu, Sichuan 610031, China
| | - Rong Gong
- Department of Nephrology, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, 82# Qinglong Street, Qingyang District, Chengdu, Sichuan 610031, China
| | - Ting Chen
- Department of Nephrology and Rheumatology, Jiangjin Hospital, Chongqing University, Chongqing 402260, China
| | - Li Yang
- Department of Gastroenterology & Hepatology, Sichuan University-University of Oxford Huaxi Joint Centre for Gastrointestinal Cancer, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan 610200, China.
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Guo P, Yu J. Association of multiple serum minerals and vitamins with metabolic dysfunction-associated fatty liver disease in US adults: National Health and Nutrition Examination Survey 2017-2018. Front Nutr 2024; 11:1335831. [PMID: 38562487 PMCID: PMC10982334 DOI: 10.3389/fnut.2024.1335831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 03/06/2024] [Indexed: 04/04/2024] Open
Abstract
Background Despite the rapid increase in the global prevalence of Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD), there are no approved therapeutic drugs for MAFLD yet. Nutrient supplementation might mitigate the risk of MAFLD. It is more typical for individuals to consume multiple nutrients simultaneously. However, the studies exploring the combined effects of multiple nutrients on MAFLD are limited. This study aimed to investigate the relationship between both individual nutrients and their combined influence on the risk of MAFLD. Methods Data were obtained from National Health and Nutrition Examination Survey (NHANES), and 18 types of nutrients were considered in this study. Logistic regression analysis was performed to evaluate the correlation between single nutrients and the risk of MAFLD. The Least Absolute Shrinkage and Selection Operator (LASSO) regression analysis was performed to pinpoint the most relevant nutrient associated with the risk of MAFLD. Subsequently, both Weighted Quantile Sum (WQS) regression and Quantile g-computation (Qgcomp) were used to assess the combined effects of multiple nutrients on the risk of MAFLD. Results A total of 3,069 participants were included in this study. LASSO regression analysis showed that Se, α-tocopherol, and γ-tocopherol exhibited a positive association with the risk of MAFLD. In contrast, the serum levels of Co, P, α-cryptoxanthin, LZ, and trans-β-carotene were inversely associated with the prevalence of MAFLD. When Se and two types of vitamin E were excluded, the WQS index showed a significant inverse relationship between the remaining 15 nutrients and the risk of MAFLD; α-cryptoxanthin showed the most substantial contribution. Similarly, Qgcomp suggested that the combined effects of these 15 nutrients were associated with a lower risk of MAFLD, with α-cryptoxanthin possessing the most significant negative weights. Conclusion This study suggested that the complex nutrients with either a low proportion of Se, α-tocopherol, and γ-tocopherol or without them should be recommended for patients with MAFLD to reduce its risk.
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Affiliation(s)
| | - Jiahui Yu
- The Center of Gastrointestinal and Minimally Invasive Surgery, Department of General Surgery, The Third People’s Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, Chengdu, China
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Li X, Xia X, Jiang B, Yao Y, Ding F, Qin S. Higher serum chromium level may be associated with the presentation of depression in patients with metabolic dysfunction-associated fatty liver disease: evidence from NHANES survey. Front Psychiatry 2024; 15:1330283. [PMID: 38563024 PMCID: PMC10982505 DOI: 10.3389/fpsyt.2024.1330283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 02/21/2024] [Indexed: 04/04/2024] Open
Abstract
Background Depressive symptoms are frequently observed in patients with Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD), a prevalent metabolic disorder that affects many individuals. It is not yet clear whether there is an association between serum chromium levels and depression. Objective The purpose of this research was to explore the association between serum chromium level and the manifestation of depression among patients with MAFLD. Methods The selection of 1837 patients diagnosed with MAFLD was based on data obtained from the 2017-2018 National Health and Nutrition Examination Survey (NHANES) database in this research. The Patient Health Questionnaire-9 (PHQ-9) was employed to evaluate the severity of depression. The researchers utilized logistic regression models that were weighted for multiple variables to investigate the association between depression and serum chromium levels. Results In our study, we found that 8.98% of US adults with MAFLD were suffering from depression at the time of evaluation. In the logistic regression model, serum chromium levels showed an inverse association with depression (OR=0.82, 95%CI: 0.69-0.96; p=0.016), this relationship remained after adjusting for fully confounding factors (OR=0.83, 95%CI: 0.71-0.97; p=0.021), subgroup analyses showed that the association between serum chromium levels and depression existed in relatively high-prevalence of depression groups. Conclusion Patients diagnosed with MAFLD have a greater likelihood of experiencing depression, whereas individuals with higher levels of serum chromium are less likely to suffer from depression, and this association persists even after adjusting for other factors. These findings indicate supplementing chromium may be a viable treatment for their depressive symptoms.
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Affiliation(s)
- Xiuhua Li
- Department of Gastroenterology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
- Department of Gastroenterology, Yiyang Central Hospital, Yiyang, China
| | - Xuezhong Xia
- Department of Nursing, Yiyang Central Hospital, Yiyang, China
| | - Bolin Jiang
- Department of Nursing, Yiyang Central Hospital, Yiyang, China
| | - Yao Yao
- Department of Gastroenterology, Yiyang Central Hospital, Yiyang, China
| | - Fengjiao Ding
- Department of Mental Health, No. 1 Middle School, Yiyang, China
| | - Shanyu Qin
- Department of Gastroenterology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
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21
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Yan J, Zhou J, Ding Y, Tu C. Dietary inflammatory index is associated with metabolic dysfunction-associated fatty liver disease among United States adults. Front Nutr 2024; 11:1340453. [PMID: 38559780 PMCID: PMC10978608 DOI: 10.3389/fnut.2024.1340453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 03/04/2024] [Indexed: 04/04/2024] Open
Abstract
Background Metabolic dysfunction-associated fatty liver disease (MAFLD) is presently the most prevalent chronic liver disorder globally that is closely linked to obesity, dyslipidemia metabolic syndrome, and type 2 diabetes mellitus (T2DM). Its pathogenesis is strongly associated with inflammation, and diet is a major factor in reducing inflammation. However, current research has focused primarily on exploring the relationship between diet and NAFLD, with less research on its link to MAFLD. Methods In this research, using dietary inflammatory index (DII) as a measure to assess dietary quality, we analyzed the relationship between diet and MAFLD. Data from the National Health and Nutrition Examination Survey (NHANES) 2017-2018, including 3,633 adults with complete DII and MAFLD, were used to develop cross-sectional analyses. Logistic regression analysis was adapted for investigating the relationship between DII and MAFLD development. Additionally, subgroup analysis and threshold effect analysis were carried out. Results A positive link between DII and MAFLD was found in the fully adjusted model (OR = 1.05; 95%CI, 1.00-1.11, p < 0.05). Subgroup analysis indicated that there was no significant dependence for the connection between DII and MAFLD except for the subgroup stratified by age. Compared with other age groups, people with MAFLD had 20% higher DII scores than non-MAFLD participants in those aged 20-41 years old (OR = 1.20; 95%CI, 1.08-1.33, p < 0.001). Furthermore, we found a U-shaped curve with an inflection point of 3.06 illustrating the non-linear connection between DII and MAFLD. Conclusion As a result, our research indicates that pro-inflammatory diet may increase the chance of MAFLD development, thus improved dietary patterns as a lifestyle intervention is an important strategy to decrease the incidence of MAFLD.
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Affiliation(s)
- Jing Yan
- Shanghai Health Development Research Center (Shanghai Medical Information Center), Shanghai, China
- School of Public Health, Fudan University, Shanghai, China
| | - Jun Zhou
- Shanghai Health Development Research Center (Shanghai Medical Information Center), Shanghai, China
| | - Yuanyuan Ding
- Shanghai Health Development Research Center (Shanghai Medical Information Center), Shanghai, China
| | - Chuantao Tu
- Department of Gastroenterology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
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22
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Feng Z, Zhao F, Wang Z, Tang X, Xie Y, Qiu L. The relationship between sarcopenia and metabolic dysfunction-associated fatty liver disease among the young and middle-aged populations. BMC Gastroenterol 2024; 24:111. [PMID: 38491346 PMCID: PMC10943823 DOI: 10.1186/s12876-024-03192-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 03/01/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Metabolic dysfunction-associated fatty liver disease (MAFLD) has been proposed as a new term for diagnosing fatty liver disease, which is considered to be a multi-systemic disease with multiple extrahepatic manifestations, including sarcopenia. The link between sarcopenia and MAFLD remains uncertain, especially among young and middle-aged adults. Thus, we examined the relationship between MAFLD and sarcopenia in young and middle-aged individuals in this study. METHODS A total of 2214 individuals with laboratory tests, dual-energy X-ray absorptiometry and ultrasound transient elastography from NHANES 2017-2018 were selected for this study. MAFLD was diagnosed as fatty liver disease with any one of the situations: overweight/obesity, diabetes mellitus, presence of metabolic dysregulation. Sarcopenia was defined by appendicular lean mass adjusted for body mass index (BMI). Multivariable logistic regression and restricted cubic spline (RCS) model were applied to explore the relationship between MAFLD and sarcopenia, and the mediation analyses were also conducted. Moreover, subgroup analyses stratified by BMI and lifestyles were done. RESULTS The prevalence of MAFLD was 47.85%, and nearly 8.05% of participants had sarcopenia. The prevalence of sarcopenia was higher in participants with MAFLD (12.75%; 95% CI 10.18-15.31%) than in the non-MAFLD (3.73%; 95% CI 2.16-5.31%). MAFLD was significantly positively associated with sarcopenia after adjustments [OR = 2.87 (95% CI: 1.62-5.09)]. Moreover, significant positive associations were observed between liver fibrosis and sarcopenia prevalence in MAFLD patients (OR = 2.16; 95% CI 1.13-4.15). The RCS curve revealed that MAFLD was linearly associated with sarcopenia. The relationship between the MAFLD and sarcopenia were mediated by C-reactive protein (mediation proportion: 15.9%) and high-density lipoprotein cholesterol (mediation proportion: 18.9%). Subgroup analyses confirmed the association between MAFLD and sarcopenia differed in different lifestyle groups. CONCLUSIONS Both MAFLD prevalence and severity was significantly associated with sarcopenia. Thus, clinicians should advise comorbidity screening and lifestyle changes to young and middle-aged patients.
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Affiliation(s)
- Ziyan Feng
- Department of Medical Ultrasound and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Wuhou District, Chengdu, Sichuan Province, China
| | - Fanrong Zhao
- Department of gastroenterology, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Wuhou District, Chengdu, Sichuan Province, China
| | - Ziyao Wang
- Department of Medical Ultrasound and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Wuhou District, Chengdu, Sichuan Province, China
| | - Xinyi Tang
- Department of Medical Ultrasound and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Wuhou District, Chengdu, Sichuan Province, China
| | - Yan Xie
- Department of gastroenterology, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Wuhou District, Chengdu, Sichuan Province, China.
| | - Li Qiu
- Department of Medical Ultrasound and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Wuhou District, Chengdu, Sichuan Province, China.
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23
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Wang S, Zhang Q, Qin B. Association between remnant cholesterol and insulin resistance levels in patients with metabolic-associated fatty liver disease. Sci Rep 2024; 14:4596. [PMID: 38409335 PMCID: PMC10897142 DOI: 10.1038/s41598-024-55282-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 02/22/2024] [Indexed: 02/28/2024] Open
Abstract
The relationship between remnant cholesterol (RC) and homeostasis model assessment-insulin resistance (HOMA-IR) in the context of metabolic-associated fatty liver disease (MAFLD) remains an area of ambiguity. This investigation was designed to elucidate the potential association between RC and HOMA-IR in a cohort of American adults diagnosed with MAFLD. Data from 5533 participants were procured from the 2017-2018 US National Health and Nutrition Examination (NHANES) databases. A weighted linear regression model was employed to analyze the association between RC and HOMA-IR in the context of MAFLD. Preliminary analysis revealed that 44.67% of the participants were diagnosed with MAFLD, with a higher prevalence observed in individuals aged 50-64 years (31.84%, p < 0.0001) and in males compared to females (53.48% vs. 46.52%, p < 0.0001). A positive correlation was identified between RC and HOMA-IR in MAFLD patients. The threshold effect analysis model indicated a breakpoint at RC = 30 mg/dl, with a more pronounced positive correlation when RC < 30 mg/dl (β = 0.17, p < 0.001). Receiver operating characteristic analysis further demonstrated that among all lipid parameters, RC exhibited the largest area under the curve. The study findings suggest a positive correlation between RC and HOMA-IR in MAFLD patients, indicating that elevated RC may serve as an independent risk factor for MAFLD.
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Affiliation(s)
- Shuang Wang
- Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qiang Zhang
- Department of Gastroenterology, The People's Hospital of Changshou, Chongqing, China
| | - Bo Qin
- Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
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24
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Li Z, Wu X, Chen Z, Wei X, Chen W. Association between low-normal thyroid function and advanced liver fibrosis in metabolic dysfunction-associated fatty liver disease patients: a retrospective cohort study. Gastroenterol Rep (Oxf) 2024; 12:goad076. [PMID: 38264763 PMCID: PMC10805339 DOI: 10.1093/gastro/goad076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 11/09/2023] [Accepted: 12/10/2023] [Indexed: 01/25/2024] Open
Abstract
Background Recent studies have found that thyroid function may be associated with the occurrence and development of advanced liver fibrosis in patients with metabolic dysfunction-associated fatty liver disease (MAFLD). However, the majority of such research has consisted of cross-sectional studies. This retrospective cohort study aimed to investigate the effect of low-normal thyroid function on advanced liver fibrosis in MAFLD patients over a 5-year period. Methods This retrospective cohort study enrolled 825 outpatients and inpatients with MAFLD who attended the Third Affiliated Hospital of Sun Yat-sen University (Guangzhou, China) between January 2011 and December 2018. Based on plasma thyroid hormone and thyroid-stimulating hormone levels, these patients were divided into two groups, namely a low-normal thyroid function group and a strict-normal thyroid function group. The fibrosis-4 score was used to assess advanced liver fibrosis. A chi-square test was conducted to compare the occurrence of advanced fibrosis between the groups. Results Among the 825 MAFLD patients, 117 and 708 were defined as having low-normal thyroid function and strict-normal thyroid function, respectively. Follow-up data were available for 767 patients (93.0%) during a 5-year period. Eight (7.5%) MAFLD patients with low-normal thyroid function and 26 (3.9%) with strict-normal thyroid function developed advanced liver fibrosis and the cumulative incidence was not significantly different (P = 0.163). Stratification analysis showed that the lean MAFLD patients (body mass index ≤ 23 kg/m2) with low-normal thyroid function had a higher risk of advanced liver fibrosis than the lean MAFLD patients with strict-normal thyroid function (P < 0.05). Conclusion Low-normal thyroid function is associated with advanced liver fibrosis among lean MAFLD patients.
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Affiliation(s)
- Zixuan Li
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, P. R. China
| | - Xiaoying Wu
- Department of Gastroenterology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, P. R. China
| | - Zebin Chen
- Center of Hepato-Pancreatico-Biliary Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, P. R. China
| | - Xiuqing Wei
- Department of Gastroenterology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, P. R. China
| | - Weiqing Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, P. R. China
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25
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Tan Z, Wu Y, Meng Y, Liu C, Deng B, Zhen J, Dong W. Trends in Oxidative Balance Score and Prevalence of Metabolic Dysfunction-Associated Steatotic Liver Disease in the United States: National Health and Nutrition Examination Survey 2001 to 2018. Nutrients 2023; 15:4931. [PMID: 38068789 PMCID: PMC10708172 DOI: 10.3390/nu15234931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 11/01/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Most studies have primarily focused on assessing the association between diet or exercise patterns and metabolic dysfunction-associated steatotic liver disease (MASLD). This study adopted a more comprehensive approach by introducing the oxidative balance score (OBS) to evaluate the combined effects of diet and lifestyle on the body's antioxidant ability. Our main objective was to investigate the association between OBS and the burden of MASLD in the United States. METHODS Participants with complete information from 2001 to 2018 were included. In the absence of other definite liver injury factors, the United States fatty liver index (us-FLI) ≥ 30 was used as the diagnostic criterion for MASLD. We first calculated the weighted prevalence for each cycle and stratified it according to demographic and metabolic-related disease characteristics. Subsequently, weighted multiple logistic regression was used to evaluate the relationship between OBS and MASLD. In addition, we explored the body's inflammatory state and the level of insulin resistance (IR) in mediating OBS and MASLD. RESULTS From 2001 to 2018, the prevalence of MASLD in the U.S. population as a whole increased from 29.76% to 36.04%, and the rate was higher in people with metabolic-related diseases. Notably, OBS exhibited a negative correlation with MASLD. Participants in the highest tertile of OBS had a significantly lower prevalence of MASLD compared to those in the lowest tertile [OR: 0.72, 95%CI: (0.57, 0.92), p < 0.001]. Moreover, a high OBS is associated with a lower inflammatory state and level of IR. The body's inflammatory state and IR level mediated the association between OBS and MASLD by 5.2% and 39.7%, respectively (both p < 0.001). CONCLUSIONS In this study, we observed an increasing prevalence of MASLD over the years. A higher OBS was associated with a lower risk of MASLD, especially when OBS ≥ 25. The body's inflammatory state and IR level mediate the association between OBS and MASLD, but the mechanism needs to be further investigated.
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Affiliation(s)
- Zongbiao Tan
- Department of Gastroenterology, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuhan 430060, China
| | - Yanrui Wu
- Department of Gastroenterology, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuhan 430060, China
| | - Yang Meng
- Department of Ophthalmology, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuhan 430060, China
| | - Chuan Liu
- Department of Gastroenterology, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuhan 430060, China
| | - Beiying Deng
- Department of Gastroenterology, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuhan 430060, China
| | - Junhai Zhen
- Department of General Practice, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuhan 430060, China
| | - Weiguo Dong
- Department of Gastroenterology, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuhan 430060, China
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Hou JZ, Wu QW, Zhang L. Association between micronutrients intake and metabolic-associated fatty liver disease: a cross-sectional study based on the National Health and Nutrition Examination Survey. J Nutr Sci 2023; 12:e117. [PMID: 38033509 PMCID: PMC10685258 DOI: 10.1017/jns.2023.99] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 10/13/2023] [Indexed: 12/02/2023] Open
Abstract
Metabolic-associated fatty liver disease (MAFLD) has been proposed to replace the term non-alcoholic fatty liver disease (NAFLD) in 2020. The association between micronutrients and MAFLD has not been reported. Therefore, this study aims to explore the association between micronutrients intake and MAFLD. This was a cross-section study based on the National Health and Nutrition Examination Survey (NHANES). The dietary intake of copper, zinc, iron, and selenium was evaluated using the 24-h dietary recall interview. Logistic regression analysis was used to explore the association between micronutrients and MAFLD, and the results were shown as odds ratio (OR) with 95 % confidence intervals (CIs). A total of 5976 participants were finally included for analysis, with 3437 participants in the MAFLD group. After adjusting potential confounders, copper intake at quartile Q3 (OR = 0⋅68, 95 % CI 0⋅50, 0⋅93) and Q4 (OR = 0⋅60, 95 % CI 0⋅45, 0⋅80) was found to be associated with lower odds of MAFLD. Iron intake at Q2 (OR = 0⋅64, 95 % CI 0⋅45, 0⋅92) and Q3 (OR = 0⋅61, 95 % CI 0⋅41, 0⋅91) was associated with the lower odds of MAFLD. Our findings found that high intake of copper and adequate intake of iron were associated with MAFLD, which may provide guidance for the management of MAFLD.
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Affiliation(s)
- Jun-zhen Hou
- Department of Gastroenterology, Shijingshan Teaching Hospital of Capital Medical University, Beijing Shijingshan Hospital, Beijing, China
| | - Qi-wei Wu
- Department of Gastroenterology, Shijingshan Teaching Hospital of Capital Medical University, Beijing Shijingshan Hospital, Beijing, China
| | - Li Zhang
- Department of Gastroenterology, Shijingshan Teaching Hospital of Capital Medical University, Beijing Shijingshan Hospital, Beijing, China
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27
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Hu C, Huang R, Li R, Ning N, He Y, Zhang J, Wang Y, Ma Y, Jin L. Low-Carbohydrate and Low-Fat Diet with Metabolic-Dysfunction-Associated Fatty Liver Disease. Nutrients 2023; 15:4763. [PMID: 38004162 PMCID: PMC10674227 DOI: 10.3390/nu15224763] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/08/2023] [Accepted: 11/11/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND This observational cross-sectional study was designed to explore the effects of a low-carbohydrate diet (LCD) and a low-fat diet (LFD) on metabolic-dysfunction-associated fatty liver disease (MAFLD). METHODS This study involved 3961 adults. The associations between LCD/LFD scores and MAFLD were evaluated utilizing a multivariable logistic regression model. Additionally, a leave-one-out model was applied to assess the effect of isocaloric substitution of specific macronutrients. RESULTS Participants within the highest tertile of healthy LCD scores (0.63; 95% confidence interval [CI], 0.45-0.89) or with a healthy LFD score (0.64; 95%CI, 0.48-0.86) faced a lower MAFLD risk. Furthermore, compared with tertile 1, individuals with unhealthy LFD scores in terile 2 or tertile 3 had 49% (95%CI, 1.17-1.90) and 77% (95%CI, 1.19-2.63) higher risk levels for MAFLD, respectively. CONCLUSIONS Healthy LCD and healthy LFD are protective against MAFLD, while unhealthy LFD can increase the risk of MAFLD. Both the quantity and quality of macronutrients might have significant influences on MAFLD.
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Affiliation(s)
- Chengxiang Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China; (C.H.); (R.L.); (Y.H.); (J.Z.); (Y.W.)
| | - Rong Huang
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang 110122, China; (R.H.); (N.N.)
| | - Runhong Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China; (C.H.); (R.L.); (Y.H.); (J.Z.); (Y.W.)
| | - Ning Ning
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang 110122, China; (R.H.); (N.N.)
| | - Yue He
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China; (C.H.); (R.L.); (Y.H.); (J.Z.); (Y.W.)
| | - Jiaqi Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China; (C.H.); (R.L.); (Y.H.); (J.Z.); (Y.W.)
| | - Yingxin Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China; (C.H.); (R.L.); (Y.H.); (J.Z.); (Y.W.)
| | - Yanan Ma
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang 110122, China; (R.H.); (N.N.)
| | - Lina Jin
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China; (C.H.); (R.L.); (Y.H.); (J.Z.); (Y.W.)
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28
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Li H, Cao Z, Li J, King L, Zhang Z, Zhao Y, Zhang S, Song Y, Zhang Q, Chen L, Tang Y, Dai L, Yao P. Associations of Combined Lifestyle Factors with MAFLD and the Specific Subtypes in Middle-Aged and Elderly Adults: The Dongfeng-Tongji Cohort Study. Nutrients 2023; 15:4588. [PMID: 37960242 PMCID: PMC10650607 DOI: 10.3390/nu15214588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/23/2023] [Accepted: 10/25/2023] [Indexed: 11/15/2023] Open
Abstract
Metabolic dysfunction-associated fatty liver disease (MAFLD) is the crucial pathogenesis for intra-hepatic and extra-hepatic diseases, especially in elderly adults. Lifestyle management may be a modifiable cost-effective measure for MAFLD prevention, but the evidence is limited. A total of 23,408 middle-aged and elderly individuals were included in a longitudinal study from 2008 to 2018. Combined lifestyle scores (range 0-6) were evaluated by BMI, smoking, drinking, diet, physical activity, and sleep. Logistic regression models were used to calculate ORs for the risks of MAFLD and specific subtypes. The mean age of participants was 61.7 years, and 44.5% were men. Compared with poor lifestyle (scores 0-2), ORs (95% CIs) of the ideal lifestyle (scores 5-6) were 0.62 (0.57-0.68) for MAFLD, 0.31 (0.28-0.34) for MAFLD with excess weight and obesity, 0.97 (0.75-1.26) for MAFLD with diabetes, and 0.56 (0.51-0.62) for MAFLD with metabolic dysregulation. Additionally, lifestyle improvement was associated with lower risks of MAFLD (OR, 0.76; 95% CI, 0.68-0.86), MAFLD with excess weight and obesity (OR, 0.72; 95% CI, 0.63-0.81), MAFLD with diabetes (OR, 0.74; 95% CI, 0.54-1.02) and MAFLD with metabolic dysregulation (OR, 0.49; 95% CI, 0.43-0.55), respectively. Our findings suggest that adherence to a combined healthy lifestyle was associated with lower risks of MAFLD, particularly in excess weight/obese individuals or those with metabolic dysregulation.
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Affiliation(s)
- Hongxia Li
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China; (H.L.); (Z.C.); (J.L.); (L.K.); (Z.Z.); (Y.Z.); (S.Z.); (Y.S.); (Q.Z.); (L.C.); (Y.T.)
- Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China
| | - Zhiqiang Cao
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China; (H.L.); (Z.C.); (J.L.); (L.K.); (Z.Z.); (Y.Z.); (S.Z.); (Y.S.); (Q.Z.); (L.C.); (Y.T.)
- Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China
| | - Jingxi Li
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China; (H.L.); (Z.C.); (J.L.); (L.K.); (Z.Z.); (Y.Z.); (S.Z.); (Y.S.); (Q.Z.); (L.C.); (Y.T.)
- Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China
| | - Lei King
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China; (H.L.); (Z.C.); (J.L.); (L.K.); (Z.Z.); (Y.Z.); (S.Z.); (Y.S.); (Q.Z.); (L.C.); (Y.T.)
- Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China
| | - Zhuangyu Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China; (H.L.); (Z.C.); (J.L.); (L.K.); (Z.Z.); (Y.Z.); (S.Z.); (Y.S.); (Q.Z.); (L.C.); (Y.T.)
- Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China
| | - Ying Zhao
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China; (H.L.); (Z.C.); (J.L.); (L.K.); (Z.Z.); (Y.Z.); (S.Z.); (Y.S.); (Q.Z.); (L.C.); (Y.T.)
- Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China
| | - Siyi Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China; (H.L.); (Z.C.); (J.L.); (L.K.); (Z.Z.); (Y.Z.); (S.Z.); (Y.S.); (Q.Z.); (L.C.); (Y.T.)
- Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China
| | - Yajing Song
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China; (H.L.); (Z.C.); (J.L.); (L.K.); (Z.Z.); (Y.Z.); (S.Z.); (Y.S.); (Q.Z.); (L.C.); (Y.T.)
- Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China
| | - Qian Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China; (H.L.); (Z.C.); (J.L.); (L.K.); (Z.Z.); (Y.Z.); (S.Z.); (Y.S.); (Q.Z.); (L.C.); (Y.T.)
- Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China
| | - Liangkai Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China; (H.L.); (Z.C.); (J.L.); (L.K.); (Z.Z.); (Y.Z.); (S.Z.); (Y.S.); (Q.Z.); (L.C.); (Y.T.)
- Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China
| | - Yuhan Tang
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China; (H.L.); (Z.C.); (J.L.); (L.K.); (Z.Z.); (Y.Z.); (S.Z.); (Y.S.); (Q.Z.); (L.C.); (Y.T.)
- Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China
| | - Lingling Dai
- Experimental Teaching Center of Preventive Medicine, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China
| | - Ping Yao
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China; (H.L.); (Z.C.); (J.L.); (L.K.); (Z.Z.); (Y.Z.); (S.Z.); (Y.S.); (Q.Z.); (L.C.); (Y.T.)
- Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China
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Liu Y, Chen M. Dietary and lifestyle oxidative balance scores are independently and jointly associated with nonalcoholic fatty liver disease: a 20 years nationally representative cross-sectional study. Front Nutr 2023; 10:1276940. [PMID: 37920290 PMCID: PMC10619002 DOI: 10.3389/fnut.2023.1276940] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 10/06/2023] [Indexed: 11/04/2023] Open
Abstract
Background Oxidative stress is an important contributor to the progression of nonalcoholic fatty liver disease (NAFLD), but whether dietary and lifestyle pro- and antioxidants may have combined or independent effects on NAFLD, and advanced liver fibrosis (AHF) remains unclear. We aimed to elucidate the relationship between a well-established oxidative balance score (OBS) and NAFLD/AHF. Methods This was a cross-sectional study. We included adult participants with complete data from the National Health and Nutrition Examination Survey 1999-2018. Survey-weighted adjusted multivariate regression analyses were used to examine the association of all OBS with NAFLD/AHF. A combination of restricted cubic splines, mediation analysis, stratified analysis, and sensitivity analysis were used to further elucidate these associations. Results We included 6,341 eligible adult participants with prevalence of NAFLD and AHF of 30.2 and 13.9%, respectively. In the fully adjusted model, the highest quartile of OBS, dietary OBS, and lifestyle OBS were associated with 65, 55, and 77% reduced risk of NAFLD, respectively, compared with the reference population, respectively. However, all OBS were not associated with the risk of AHF. All OBS were nonlinearly associated with risk of NAFLD and had a more pronounced reduced risk for OBS, dietary OBS, and lifestyle OBS after exceeding 26, 21, and 5 points, respectively. OBS may exert a protective effect indirectly through inflammation, oxidative stress, and glycolipid metabolism markers. Stratification and sensitivity analyses demonstrate the robustness of our findings. Conclusion All OBS were nonlinearly and negatively associated with NAFLD risk. These effects may exert indirectly through inflammation, oxidative stress, and glycolipid metabolism markers.
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Affiliation(s)
| | - Mingkai Chen
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China
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Chi Z, Teng Y, Liu Y, Gao L, Yang J, Zhang Z. Association between klotho and non-alcoholic fatty liver disease and liver fibrosis based on the NHANES 2007-2016. Ann Hepatol 2023; 28:101125. [PMID: 37286168 DOI: 10.1016/j.aohep.2023.101125] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 05/24/2023] [Accepted: 05/29/2023] [Indexed: 06/09/2023]
Abstract
INTRODUCTION AND OBJECTIVES This study aims to explore the association between Klotho and Non-Alcoholic Fatty Liver Disease (NAFLD), a condition affecting millions worldwide. Klotho may have a protective effect against NAFLD mechanisms like inflammation, oxidative stress, and fibrosis. The study will use FLI and FIB-4 score to diagnose NAFLD in a large population for investigating the link between Klotho and NAFLD. MATERIALS AND METHODS The study aimed to explore the association between Klotho and NAFLD by measuring the α-Klotho protein levels in the participants' blood using ELISA. Patients with underlying chronic liver diseases were excluded. The severity of NAFLD was evaluated using FLI and FIB-4, and logistic regression models were used to analyze the data obtained from NHANES. Subgroup analyses were conducted to study Klotho's effect on hepatic steatosis and fibrosis in diverse subpopulations. RESULTS The study found that low levels of α-Klotho were associated with NAFLD, with ORs ranging from 0.72 to 0.83. However, high levels of α-Klotho were associated with NAFLD-related fibrosis. The Q4 group showed significant results in individuals aged 51 years or younger and in females. Non-Hispanic White ethnicity, education level of high school or above, non-smoking, non-hypertension, and non-diabetic groups showed negative correlations. CONCLUSIONS Our study suggests a potential correlation between α-Klotho levels in the blood and NAFLD in adult patients, especially among younger individuals, females and Non-Hispanic Whites. Elevated α-Klotho levels may have therapeutic benefits in treating NAFLD. Further research is required to validate these findings, but they provide new insights for managing this condition.
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Affiliation(s)
- Zhenfei Chi
- Liaoning University of Traditional Chinese Medicine, PR China
| | - Yun Teng
- Liaoning University of Traditional Chinese Medicine, PR China
| | - Yuting Liu
- Liaoning University of Traditional Chinese Medicine, PR China
| | - Lu Gao
- Liaoning University of Traditional Chinese Medicine, PR China
| | - Junhan Yang
- Liaoning University of Traditional Chinese Medicine, PR China
| | - Zhe Zhang
- Liaoning University of Traditional Chinese Medicine, PR China.
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Chen W, Xiong B, Liao Z, Xiao M, Chen W. Association between dietary inflammatory index and low muscle mass in diabetes/prediabetes patients. Exp Gerontol 2023; 179:112258. [PMID: 37460025 DOI: 10.1016/j.exger.2023.112258] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 07/14/2023] [Accepted: 07/14/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND Growing evidence has increasingly validated that individuals with diabetes/prediabetes have a higher prevalence of low skeletal muscle mass and function compared to healthy individuals. The anti-inflammatory diet is considered a promising and modifiable approach to optimize skeletal muscle quality. However, current evidence on the relation of dietary inflammatory potential with low muscle mass among diabetic/prediabetic patients is limited. METHODS Dietary consumption was determined by trained staff using the 24-hour diet recall method, and the Dietary Inflammatory Index (DII) was scored based on a previously validated approach that included 26 food parameters. Dual-energy X-ray absorptiometry was used to assess the mass of skeletal muscle and low muscle mass was defined based on the sarcopenia index. Logistic regression was conducted to calculate odds ratios (ORs) and 95 % confidence intervals (CIs). Restricted cubic spline (RCS) analysis was also performed to visually represent the relationship between DII and low muscle mass. Furthermore, sensitivity and subgroup analyses were conducted. RESULTS In this study, a total of 4269 eligible participants were registered, comprising 1975 (46.26 %) females and 2294 (53.74 %) males. The mean age was 49.98 ± 0.31 years old, and the mean DII score was 1.53 ± 0.04. Among them, 934 (21.88 %) patients were defined as having low muscle mass, while 3335 (78.12 %) were without low muscle mass. The highest tertile (T3) of DII had an 61 % increased risk of low muscle mass (OR = 1.61, 95%CI: 1.19-2.17, p for trend = 0.004) compared to the lowest tertile. The RCS curve displayed a linear dose-response relationship between DII score and low muscle mass risk in patients with diabetes/prediabetes. Subgroup and sensitivity analyses provided robustness to our results. CONCLUSIONS Our results indicated that a higher DII score was associated with an increased risk of low muscle mass among diabetes/prediabetes patients. These findings provided a nutritional strategy for diabetes/prediabetes patients to prevent skeletal muscle mass loss.
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Affiliation(s)
- Wei Chen
- Department of Emergency Medicine, The First Affiliated Hospital of Chongqing Medical University, Friendship Road 1, Yuan Jiagang, 400016 Chongqing, China
| | - Bingquan Xiong
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Linjiang Road 76, Yuzhong District, 400010 Chongqing, China
| | - Zhiyin Liao
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Linjiang Road 76, Yuzhong District, 400010 Chongqing, China
| | - Minghan Xiao
- Department of Cardiology, Chongqing Hospital of Chinese Academy of Sciences, No.118, Xingguang Avenue, Liangjiang New Area, 401147 Chongqing, China
| | - Wei Chen
- Department of Emergency Medicine, The First Affiliated Hospital of Chongqing Medical University, Friendship Road 1, Yuan Jiagang, 400016 Chongqing, China.
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Fan L, Zhao S, Shi H, Zhang S. Role of BMI in the relationship between dietary inflammatory index and non-alcoholic fatty liver disease: an intermediary analysis. Scand J Gastroenterol 2023; 58:1159-1165. [PMID: 37211749 DOI: 10.1080/00365521.2023.2213791] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 05/07/2023] [Indexed: 05/23/2023]
Abstract
OBJECTIVE Previous studies have indicated that a pro-inflammatory diet is associated with non-alcoholic fatty liver disease (NAFLD), but the role of BMI remains ambiguous. We aim to study the intermediary effect of BMI on the relationship between dietary inflammatory properties and NAFLD. METHODS A total of 19536 adult participants from the National Health and Nutrition Examination Surveys (NHANES) were included. Dietary inflammatory index (DII) was used to evaluate the dietary inflammatory properties and NAFLD was diagnosed by non-invasive biomarkers. Weighted multivariable logistic regression models estimated ORs and 95% CIs between DII and incidence of NAFLD. Interaction effect between DII and BMI on NAFLD was tested and the mediation analysis of BMI was performed. RESULTS Higher DII scores, representing higher inflammatory potential of diet, were positively associated with a higher risk of NAFLD. Compared with the first quartile of DII, people from the second quartile (OR: 1.23 [95% CI: 1.04, 1.46]) to the fourth quartile (OR: 1.59 [95% CI: 1.31, 1.94]) have a higher risk of NAFLD before adjustment for BMI. The overall association was completely mediated by BMI (89.19%). CONCLUSIONS Our findings suggested that a higher pro-inflammatory potential diet was associated with a higher prevalence of NAFLD, and this association might be mediated by BMI.
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Affiliation(s)
- Liqiaona Fan
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Diseases, Beijing, China
- Digestive Disease Center, Beijing Key Laboratory for Precancerous Lesion of Digestive Diseases, Beijing, China
| | - Songfeng Zhao
- Department of Neurosurgery, Third Xiangya Hospital, Central South University, Hunan, China
| | - Haiyun Shi
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Diseases, Beijing, China
- Digestive Disease Center, Beijing Key Laboratory for Precancerous Lesion of Digestive Diseases, Beijing, China
| | - Shutian Zhang
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Diseases, Beijing, China
- Digestive Disease Center, Beijing Key Laboratory for Precancerous Lesion of Digestive Diseases, Beijing, China
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Gao V, Long MT, Singh SR, Kim Y, Zhang X, Rogers G, Jacques PF, Levy D, Ma J. A Healthy Diet is Associated with a Lower Risk of Hepatic Fibrosis. J Nutr 2023; 153:1587-1596. [PMID: 37023964 PMCID: PMC10273161 DOI: 10.1016/j.tjnut.2023.03.038] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 03/13/2023] [Accepted: 03/31/2023] [Indexed: 04/07/2023] Open
Abstract
BACKGROUND Higher diet quality is associated with a lower risk of NAFLD. OBJECTIVES We examined the relationship between diet quality and hepatic fibrosis. METHODS We analyzed cross-sectional associations between 3 a priori diet quality scores-the Dietary Approaches to Stop Hypertension (DASH) score, the Alternative Healthy Eating Index (AHEI), and a modified Mediterranean-style Diet Score (MDS)-and hepatic fat [controlled attenuation parameter (CAP)] and fibrosis [liver stiffness measurement (LSM)] measured by vibration-controlled transient elastography (VCTE) in 2532 Framingham Heart Study (FHS) participants and 3295 participants of the National Health and Nutrition Examination Survey (NHANES). RESULTS Higher diet quality scores were associated with lower LSM in both FHS and NHANES after adjustment for demographic and lifestyle factors. Additional adjustment for CAP or BMI attenuated the observed associations. Association strength was similar across all 3 diet quality scores. Fixed-effect meta-analysis demonstrated that, under CAP-adjusted models, the LSM decreases associated with 1-SD increase of the DASH, AHEI, and MDS scores were 2% (95% CI: 0.7%, 3.3%; P = 0.002), 2% (95% CI: 0.7%, 3.3%; P = 0.003), and 1.7% (95% CI: 0.7%, 2.6%; P = 0.001), respectively, whereas in the meta-analysis of BMI-adjusted models, LSM reductions associated with 1-SD increase of the DASH, AHEI, and MDS scores were 2.2% (95% CI: -0.1%, 2.2%; P = 0.07), 1.5% (95% CI: 0.3%, 2.7%; P = 0.02), and 0.9 (95% CI: -0.1%, 1.9%; P = 0.07), respectively. CONCLUSIONS We demonstrated associations of higher diet quality with favorable hepatic fat and fibrosis measures. Our data suggest that a healthy diet may reduce the likelihood of obesity and hepatic steatosis as well as the progression of steatosis to fibrosis.
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Affiliation(s)
- Vincent Gao
- Emory College of Arts and Sciences, Emory University, Atlanta, GA, United States
| | - Michelle T Long
- Section of Gastroenterology, Boston Medical Center, Boston University School of Medicine, Boston, MA, United States
| | - Shridhar R Singh
- Department of Ophthalmology and Visual Sciences, UMass Chan Medical School, Worcester, MA, United States
| | - Youjin Kim
- Division of Nutrition Epidemiology and Data Science, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Xuehong Zhang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Gail Rogers
- Epidemiology, Jean Mayer USDA Human Nutrition Research Center on Aging, Boston, MA, United States
| | - Paul F Jacques
- Nutritional Epidemiology, Jean Mayer USDA Human Nutrition Research Center on Aging, Boston, MA, United States
| | - Daniel Levy
- Population Sciences Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, and the Framingham Heart Study, Framingham, MA, United States
| | - Jiantao Ma
- Division of Nutrition Epidemiology and Data Science, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States.
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Xie R, Ning Z, Xiao M, Li L, Liu M, Zhang Y. Dietary inflammatory potential and biological aging among US adults: a population-based study. Aging Clin Exp Res 2023; 35:1273-1281. [PMID: 37186209 DOI: 10.1007/s40520-023-02410-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 04/10/2023] [Indexed: 05/17/2023]
Abstract
OBJECTIVES The rate of biological aging is influenced by various factors such as genetics, environment, and diet. The dietary inflammatory index (DII) is strongly associated with various chronic diseases. The aim of this study was to investigate the association between DII and biological aging in US adults using quantitative indicators. METHODS Based on data from the National Health and Nutrition Examination Survey (NHANES) 1999-2018, weighted multiple linear regression models, generalized weighted models, and smoothed fitted curves were used to investigate the linear and nonlinear relationships of DII with four biological markers of aging (biological age, phenotypic age, telomere length, and serum klotho concentration). RESULTS A total of 35,575 adult participants with complete data were included in the study. After adjusting for all confounders, significant positive correlations were found between DII with biological age [0.070 (0.045, 0.095)] and phenotypic age [0.421 (0.371, 0.471)], with an increase of 0.07 and 0.42 years in biological age and phenotypic age, respectively, for each increase in DII score. The negative correlations between DII with telomere length [ - 0.005 ( - 0.008, - 0.002)] and klotho [ - 3.874 ( - 7.409, - 0.338)] were significant only in partially adjusted models and differed across subgroups. CONCLUSIONS In the current study, higher DII scores (greater pro-inflammatory dietary potential) were associated with biological aging. These findings may contribute to the development of aging prevention strategies through dietary interventions.
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Affiliation(s)
- Ruijie Xie
- Department of Hand & Microsurgery, Hengyang Medical School, The Affiliated Nanhua Hospital, University of South China, Hengyang, 421002, China
| | - Zhongxing Ning
- Department of Intensive Care Unit, The People's Hospital of Guangxi Zhuang Autonomous Region & Research Center of Intensive Care Unit, Nanning, 530021, China
| | - Mengde Xiao
- Department of Quality Evaluation Office, Hengyang Medical School, The Affiliated Nanhua Hospital, University of South China, Hengyang, 421002, China
| | - Lihong Li
- Department of Gland Surgery, Hengyang Medical School, The Affiliated Nanhua Hospital, University of South China, Hengyang, 421002, China
| | - Mingjiang Liu
- Department of Hand & Microsurgery, Hengyang Medical School, The Affiliated Nanhua Hospital, University of South China, Hengyang, 421002, China.
| | - Ya Zhang
- Department of Gland Surgery, Hengyang Medical School, The Affiliated Nanhua Hospital, University of South China, Hengyang, 421002, China.
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Ma TC, Zhou J, Wang CX, Lin ZZ, Gao F. Associations between the Healthy Eating Index-2015 and S-Klotho plasma levels: A cross-sectional analysis in middle-to-older aged adults. Front Nutr 2023; 9:904745. [PMID: 36712541 PMCID: PMC9875035 DOI: 10.3389/fnut.2022.904745] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 12/21/2022] [Indexed: 01/13/2023] Open
Abstract
Background and aim The Healthy Eating Index (HEI) is a dietary index developed by the United States Department of Agriculture (USDA) to determine whether a diet adheres to US dietary guidelines. Soluble Klotho (S-Klotho) is a protein with essential anti-aging properties. However, whether HEI is linked to S-Klotho plasma levels is still debatable. This study aimed to assess the association between HEI-2015 and S-Klotho in middle-to-older aged adults in the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2016. Methods The study included 8456 middle-to-older aged (40-79 years old) participants. Multivariate regression models were used to estimate the correlation between HEI-2015 and S-Klotho concentrations. General additive models and two-piece-wise regression models were used to investigate the possible non-linear relationships between HEI-2015 and S-Klotho concentrations. Moreover, a stratified analysis of potential influencing factors was performed. Results A positive correlation was observed between HEI-2015 and S-Klotho plasma levels (β = 0.74, 95% CI: 0.21, 1.27, P = 0.0067). According to the two-piece-wise regression, the turning point of HEI-2015 was 45.15. When the range of HEI-2015 was from 0 to 45.15, the relationship between HEI and S-Klotho was insignificant (β = -0.87, 95% CI: -2.47, 0.73, P = 0.2858). However, when the range of HEI-2015 was from 45.15 to 100, HEI-2015 increased by 1 unit, the S-Klotho increased by 1.30 pg/ml (β = 1.30, 95% CI: 0.55, 2.05, P = 0.0007), suggesting a dose-response relationship. Furthermore, the stratified analysis showed that the association between HEI-2015 and S-Klotho concentrations was more significant in people with normal body mass index (P-interaction = 0.0161). Conclusion There is a dose-response relationship between the HEI-2015 and S-Klotho in the middle-to-older aged adults. This relationship suggests that adherence to healthy dietary patterns may benefit the prevention of aging and health maintenance. The underlying mechanisms require further investigation.
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