Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, China.
Eur J Nutr. 2019 Mar;58(2):721-730. doi: 10.1007/s00394-018-1678-1. Epub 2018 Mar 29.
Previous studies have suggested that serum carotenoids might be inversely associated with non-alcoholic fatty liver disease (NAFLD), but little data came from longitudinal studies. We prospectively examined the associations between serum-carotenoid levels and NAFLD severity and the intermediary effects of retinol-binding protein 4 (RBP4), HOMA insulin-resistance index (HOMA-IR), body mass index (BMI), and serum triglycerides in middle-aged and elderly Chinese adults.
This prospective study included 3336 Chinese adults (40-75 years). We assessed serum concentrations of carotenoids at baseline and determined serum RBP4, triglycerides, and HOMA-IR levels at year 3. Abdominal ultrasonography was conducted to assess the presence and degree of NAFLD at years 3 and 6.
The 2687 subjects who completed both NAFLD tests were classified into stable, improved and progressed groups according to changes in the degree of NAFLD between two visits. Analyses of covariance showed that ln-transformed serum concentrations of α-carotene, β-cryptoxanthin, β-carotene, lycopene, lutein/zeaxanthin, and total carotenoids were positively associated with NAFLD improvement (all p-trend < 0.05). After multivariable adjustment, mean differences in serum carotenoids were higher by 29.6% (β-carotene), 18.2% (α-carotene), 15.6% (β-cryptoxanthin), 11.5% (lycopene), 8.9% (lutein/zeaxanthin), and 16.6% (total carotenoids) in the improved vs. progressed subjects. Path analyses indicated the carotenoid-NAFLD association was mediated by lowering serum RBP4, triglycerides, HOMA-IR, and BMI, which were positively associated with the prevalence and progression of NAFLD.
In middle-aged and elderly adults, higher serum-carotenoid concentrations were favorably associated with NAFLD improvement, mediated by reducing serum RBP4, triglycerides, HOMA-IR, and BMI.
This study has been registered at http://www.clinicaltrials.gov as NCT03179657.
先前的研究表明，血清类胡萝卜素可能与非酒精性脂肪性肝病（NAFLD）呈负相关，但来自纵向研究的数据很少。我们前瞻性地研究了血清类胡萝卜素水平与 NAFLD 严重程度之间的关系，并研究了视黄醇结合蛋白 4（RBP4）、胰岛素抵抗指数（HOMA-IR）、体重指数（BMI）和血清甘油三酯在中年和老年中国成年人中的中介作用。
这项前瞻性研究包括 3336 名中国成年人（40-75 岁）。我们在基线时评估了血清类胡萝卜素浓度，并在第 3 年时测定了血清 RBP4、甘油三酯和 HOMA-IR 水平。腹部超声检查用于评估第 3 年和第 6 年 NAFLD 的存在和程度。
完成两次 NAFLD 检查的 2687 名受试者根据两次就诊之间 NAFLD 程度的变化分为稳定、改善和进展组。协方差分析显示，ln 转化的血清 α-胡萝卜素、β-隐黄质、β-胡萝卜素、番茄红素、叶黄素/玉米黄质和总类胡萝卜素浓度与 NAFLD 改善呈正相关（所有 p 趋势<0.05）。经过多变量调整后，与进展组相比，改善组血清类胡萝卜素的平均差异分别高出 29.6%（β-胡萝卜素）、18.2%（α-胡萝卜素）、15.6%（β-隐黄质）、11.5%（番茄红素）、8.9%（叶黄素/玉米黄质）和 16.6%（总类胡萝卜素）。路径分析表明，类胡萝卜素与 NAFLD 的关联是通过降低血清 RBP4、甘油三酯、HOMA-IR 和 BMI 来介导的，这些因素与 NAFLD 的患病率和进展呈正相关。
在中年和老年成年人中，较高的血清类胡萝卜素浓度与 NAFLD 的改善呈正相关，这是通过降低血清 RBP4、甘油三酯、HOMA-IR 和 BMI 来介导的。
本研究已在 http://www.clinicaltrials.gov 注册，注册号为 NCT03179657。
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