Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking, Union Medical College, Beijing, China.
Department of Cardiology, Kailuan General Hospital, Tangshan, China.
Liver Int. 2022 Apr;42(4):809-819. doi: 10.1111/liv.15156. Epub 2022 Jan 17.
The evidence of the relationship between dietary approaches to stop hypertension (DASH) and non-alcoholic fatty liver disease (NAFLD) is limited. Thus, we conducted a cohort-based case-control study to examine whether adherence to the DASH diet was associated with lower NAFLD risk in China.
We included 11 888 participants (2529 incident NAFLD and 9359 non-NAFLD) from the Kailuan cohort with no history of hepatitis B/C infection and alcohol drinking. DASH score was calculated based on the energy-adjusted consumption of vegetables, fruits, dairy, beans, grains, meats, fat, sodium and beverage, collected by a validated food frequency questionnaire. We used Logistic regression analysis to determine the NAFLD's risk according to the DASH score.
Higher DASH score was associated with lower risk of NAFLD. Compared with the lowest quintile of DASH score, the highest DASH quintile had a lower risk of occurring NAFLD, with odds ratio (OR) of 0.82 (95% confidence interval [CI]: 0.70-0.96) in the multivariate model. Stratified analysis showed that the inverse association was only observed in women (OR = 0.67, 95% CI: 0.48-0.94), and participants with overweight/obesity (OR = 0.79, 95% CI: 0.66-0.94), fasting blood glucose <6.1 mmol/L (OR = 0.80, 95%: 0.67-0.96), low density lipoprotein ≥3.4 mmol/L (OR = 0.71, 95% CI: 0.53-0.96), high density lipoprotein ≥1.0 mmol/L (OR = 0.81, 95% CI: 0.69-0.96), ALT < 40 U/L (OR = 0.79, 95% CI:0.67-0.93) and C-reactive protein ≥2.0 mg/L (OR = 0.56, 95% CI: 0.40-0.78).
Adherence to the DASH diet was inversely associated with a lower risk of NAFLD in the Chinese population. DASH diet should be highly recommended, especially for women and people with overweight/obesity and a high CRP level.
关于饮食方法防治高血压(DASH)与非酒精性脂肪性肝病(NAFLD)之间关系的证据有限。因此,我们开展了一项基于队列的病例对照研究,以探讨在中国人群中,DASH 饮食的依从性与较低的 NAFLD 风险是否相关。
我们纳入了无乙型肝炎/丙型肝炎感染和饮酒史的开滦队列中 11888 名参与者(2529 例新发 NAFLD 和 9359 例非 NAFLD)。DASH 评分基于经能量校正的蔬菜、水果、乳制品、豆类、谷物、肉类、脂肪、钠和饮料的摄入量,通过验证的食物频率问卷进行收集。我们使用 Logistic 回归分析来确定 DASH 评分与 NAFLD 风险之间的关系。
较高的 DASH 评分与较低的 NAFLD 风险相关。与 DASH 评分最低的五分位数相比,DASH 评分最高的五分位数发生 NAFLD 的风险较低,多变量模型中的比值比(OR)为 0.82(95%置信区间[CI]:0.70-0.96)。分层分析显示,这种负相关仅在女性中观察到(OR=0.67,95%CI:0.48-0.94),以及超重/肥胖(OR=0.79,95%CI:0.66-0.94)、空腹血糖<6.1mmol/L(OR=0.80,95%CI:0.67-0.96)、低密度脂蛋白≥3.4mmol/L(OR=0.71,95%CI:0.53-0.96)、高密度脂蛋白≥1.0mmol/L(OR=0.81,95%CI:0.69-0.96)、丙氨酸氨基转移酶(ALT)<40U/L(OR=0.79,95%CI:0.67-0.93)和 C 反应蛋白(CRP)≥2.0mg/L(OR=0.56,95%CI:0.40-0.78)。
在中国人群中,DASH 饮食的依从性与较低的 NAFLD 风险呈负相关。DASH 饮食应高度推荐,尤其是对女性、超重/肥胖和 CRP 水平较高的人群。