Sekkarie Ahlia, Welsh Jean A, Northstone Kate, Stein Aryeh D, Ramakrishnan Usha, Vos Miriam B
Nutrition and Health Sciences Program, Laney Graduate School, Emory University, Atlanta, GA 30322, USA.
Department of Pediatrics, Emory School of Medicine, Atlanta, GA 30322, USA.
Children (Basel). 2021 Apr 8;8(4):290. doi: 10.3390/children8040290.
(1) Background: High sugar intake is prevalent among children and is associated with non-alcoholic fatty liver disease (NAFLD). The purpose of this study is to determine if a high intake of free sugars and sugary beverages (SB) in childhood is associated with NAFLD in adulthood; (2) Methods: At 24 years, 3095 participants were assessed for severe hepatic steatosis (controlled attenuation parameter >280 dB/m) and had dietary data collected via a food frequency questionnaire at age three years. Multiple logistic regression models adjusted for total energy intake, potential confounders, and a mediator (offspring body mass index (BMI) at 24 years); (3) Results: Per quintile increase of free sugar intake association with severe hepatic steatosis at 24 years after adjusting for total energy was odds ratio (OR):1.07 (95% CL: 0.99-1.17). Comparing the lowest vs. the highest free sugar consumers, the association was OR:1.28 (95% CL: 0.88-1.85) and 1.14 (0.72, 1.82) after full adjustment. The OR for high SB consumption (>2/day) compared to <1/day was 1.23 (95% CL: 0.82-1.84) and OR: 0.98 (95% CL: 0.60-1.60) after full adjustment; (4) Conclusions: High free sugar and SB intake at three years were positively but weakly associated with severe hepatic steatosis at 24 years. These associations were completely attenuated after adjusting for confounders and 24-year BMI.
(1)背景:高糖摄入在儿童中很普遍,且与非酒精性脂肪性肝病(NAFLD)相关。本研究的目的是确定儿童期高游离糖和含糖饮料(SB)摄入量是否与成年期NAFLD相关;(2)方法:在24岁时,对3095名参与者进行了严重肝脂肪变性评估(控制衰减参数>280 dB/m),并通过三岁时的食物频率问卷收集了饮食数据。采用多因素logistic回归模型,对总能量摄入、潜在混杂因素和中介变量(24岁时子代体重指数(BMI))进行了校正;(3)结果:在校正总能量后,游离糖摄入量每增加一个五分位数与24岁时严重肝脂肪变性的关联的比值比(OR)为1.07(95%可信区间:0.99 - 1.17)。比较游离糖摄入量最低与最高的人群,在完全校正后,关联的OR为1.28(95%可信区间:0.88 - 1.85)和1.14(0.72,1.82)。与每天饮用<1杯相比,高SB摄入量(>2杯/天)的OR为1.23(95%可信区间:0.82 - 1.84),在完全校正后OR为0.98(95%可信区间:0.60 - 1.60);(4)结论:三岁时高游离糖和SB摄入量与24岁时严重肝脂肪变性呈正相关但关联较弱。在校正混杂因素和24岁时的BMI后,这些关联完全减弱。