膳食和生活方式炎症评分与伊朗成年人代谢相关脂肪性肝病呈负相关：一项巢式病例对照研究。

Dietary and Lifestyle Inflammation Scores Are Inversely Associated with Metabolic-Associated Fatty Liver Disease among Iranian Adults: A Nested Case-Control Study.

机构信息

Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Science, Tehran, Iran.

Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA.

出版信息

J Nutr. 2022 Feb 8;152(2):559-567. doi: 10.1093/jn/nxab391.

DOI:10.1093/jn/nxab391

PMID:34791370

Abstract

BACKGROUND

Diet and lifestyle may affect risk for metabolic-associated fatty liver disease (MAFLD) by chronically elevating systemic inflammation.

OBJECTIVES

In this study we investigated the separate and joint associations of dietary and lifestyle inflammation scores (DIS and LIS, respectively) with MAFLD risk.

METHODS

For this nested case-control study we identified and recruited 968 patients with MAFLD (defined as having a fatty liver index ≥60 plus ≥1 of the following conditions: overweight or obese, type II diabetes mellitus, evidence of metabolic dysregulation) and 964 controls from among 35-70-y-old men and women in the baseline phase of the Sabzevar Persian Cohort Study. We collected demographic, lifestyle, anthropometric, biochemical, and dietary intake information (via a validated FFQ) from which we calculated a circulating inflammation biomarker-weighted, predominantly whole foods and beverages-based, 19-component DIS and a 3-component LIS. We estimated DIS- and LIS-MAFLD associations using multivariable unconditional logistic regression. We also calculated equal-weight DIS and LIS to capture all potential mechanisms (inflammation plus other mechanisms) for associations of diet and lifestyle with MAFLD risk.

RESULTS

Among those in the highest relative to the lowest DIS and LIS tertiles, the multivariable-adjusted ORs and their 95% CIs were OR: 1.84; 95% CI: 1.61, 2.07; Ptrend < 0.001, and OR: 1.96; 95% CI: 1.69, 2.21; Ptrend < 0.001, respectively. For those in the highest relative to the lowest joint DIS and LIS tertile, the values were OR: 2.56; 95% CI: 2.19, 2.93; Pinteraction < 0.001. The findings were similar by sex. The third tertile values for the equal-weight DIS- and LIS-MAFLD associations were OR: 1.87; 95% CI: 1.41, 2.34; and OR: 2.16; 95% CI: 1.85, 2.46, respectively.

CONCLUSIONS

Our results suggest that higher balances of pro- relative to anti-inflammatory dietary and lifestyle exposures, separately and especially jointly, may be associated with higher MAFLD risk among adults. Also, inflammation may be the primary mechanism through which diet affects MAFLD risk.

摘要

背景

饮食和生活方式可能通过长期升高全身炎症来影响代谢相关脂肪性肝病（MAFLD）的风险。

目的

在这项研究中，我们调查了饮食和生活方式炎症评分（分别为 DIS 和 LIS）与 MAFLD 风险的单独和联合关联。

方法

本巢式病例对照研究从 35-70 岁的男性和女性中确定并招募了 968 名 MAFLD 患者（定义为肝脂肪指数≥60 加上以下情况之一：超重或肥胖、2 型糖尿病、代谢失调的证据）和 964 名对照Sabzevar 波斯队列研究的基线阶段。我们收集了人口统计学、生活方式、人体测量、生化和饮食摄入信息（通过验证的 FFQ），从中计算了一个循环炎症生物标志物加权的、主要基于全食物和饮料的 19 成分 DIS 和一个 3 成分 LIS。我们使用多变量无条件逻辑回归估计了 DIS 和 LIS-MAFLD 之间的关联。我们还计算了等权重的 DIS 和 LIS，以捕捉饮食和生活方式与 MAFLD 风险相关的所有潜在机制（炎症加其他机制）。

结果

在最高相对最低 DIS 和 LIS 三分位数的人群中，多变量调整后的 OR 和 95%CI 分别为 OR：1.84；95%CI：1.61，2.07；Ptrend<0.001 和 OR：1.96；95%CI：1.69，2.21；Ptrend<0.001。对于最高相对最低联合 DIS 和 LIS 三分位数的人群，比值为 OR：2.56；95%CI：2.19，2.93；Pinteration<0.001。按性别划分，结果相似。等权重 DIS 和 LIS-MAFLD 关联的第三三分位数值分别为 OR：1.87；95%CI：1.41，2.34；和 OR：2.16；95%CI：1.85，2.46。