Department of Biology and Biological Engineering, Food and Nutrition Science, Chalmers University of Technology, SE-41296 Gothenburg, Sweden.
Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece.
Int J Cardiol. 2018 Dec 1;272:316-322. doi: 10.1016/j.ijcard.2018.07.061. Epub 2018 Jul 30.
The prevalence of non-alcoholic fatty liver disease (NAFLD) is rising. This increase may be associated with obesity. It has been suggested that trans-fatty acids (TFAs) play an important role in non-communicable diseases.
We examined the link between liver tests, fatty liver index (FLI) and plasma TFAs. Furthermore, we evaluated the impact of adiposity on this link.
The National Health and Nutrition Examination Survey (NHANES) was used to obtain the data on TFAs and liver function biomarkers. We took account of complex NHANES data, masked variance and weighting methodology.
Of the 4252 participants, 46.4% were men. The mean age was 50.6 years overall; 51.3 years for men and 49.8 years for women (p = 0.206). In a fully adjusted model (demographic and clinical factors), FLI increased as trans-9-hexadecenoic acid and trans-11-octadecenoic acid levels increased; FLI was 38.1 and 42.3 for the first quarter (Q1) of trans-9-hexadecenoic acid and trans-11-octadecenoic acid, respectively, reaching 65.1 and 69.3 for the highest quarters (Q4) (p < 0.001 for all comparisons). Multivariable logistic regression showed for all four studied TFAs, the likelihood of NAFLD (determined by FLI) increased with increasing TFAs levels (quartiles) in a stepwise manner (p < 0.001 for all comparisons). Based on moderation analysis, a strong impact of body mass index (BMI) on the link between FLI and TFAs was observed.
Our results suggest a direct significant association between plasma TFAs, liver tests and NAFLD (assessed by FLI). Furthermore, BMI was shown to mediate this relationship. These findings highlight the importance of avoiding TFAs consumption in order to minimize cardiometabolic risk.
非酒精性脂肪性肝病（NAFLD）的患病率正在上升。这种增加可能与肥胖有关。有人认为反式脂肪酸（TFAs）在非传染性疾病中发挥重要作用。
我们研究了肝酶、脂肪肝指数（FLI）和血浆 TFAs 之间的联系。此外，我们评估了肥胖对此联系的影响。
我们使用国家健康和营养检查调查（NHANES）来获取 TFAs 和肝功能生物标志物的数据。我们考虑了复杂的 NHANES 数据、掩盖方差和加权方法。
在 4252 名参与者中，46.4%为男性。总体平均年龄为 50.6 岁；男性为 51.3 岁，女性为 49.8 岁（p=0.206）。在完全调整的模型（人口统计学和临床因素）中，随着反式-9-十六碳烯酸和反式-11-十八碳烯酸水平的升高，FLI 增加；反式-9-十六碳烯酸和反式-11-十八碳烯酸的第一季度（Q1）FLI 分别为 38.1 和 42.3，最高季度（Q4）分别为 65.1 和 69.3（所有比较均 p<0.001）。多变量逻辑回归显示，对于所有四种研究的 TFAs，随着 TFAs 水平（四分位）的增加，NAFLD（由 FLI 确定）的可能性呈逐步增加（所有比较均 p<0.001）。基于调节分析，观察到 BMI 对 FLI 和 TFAs 之间联系的强烈影响。
我们的研究结果表明，血浆 TFAs、肝酶和 NAFLD（由 FLI 评估）之间存在直接显著的关联。此外，BMI 显示出介导这种关系的作用。这些发现强调了避免 TFAs 摄入以最大程度降低心血管代谢风险的重要性。
