Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Behafarin St., Karimkhan Ave., Vali-Asr Sq, 1449614535, Tehran, Iran.
Centre for Intelligent Healthcare, Coventry University, Coventry, CV1 5FB, UK.
Sci Rep. 2022 Feb 8;12(1):2131. doi: 10.1038/s41598-022-06035-8.
Nonalcoholic fatty liver disease (NAFLD) is an emerging cause of chronic liver diseases and a major health problem worldwide. Dietary patterns may play a critical role in controlling and preventing this disease, but the available evidence is scarce. The current study aims to ascertain the association of adherence to the Dietary Approach to Stop Hypertension (DASH) diet and Mediterranean diet (MeD) with nonalcoholic fatty liver disease (NAFLD) among Iranian adults of the Amol Cohort Study (AmolCS). In a cross-sectional analysis among 3220 adults (55.3% men), age ≥ 18 years (46.96 ± 14.67), we measured usual dietary intake with a validated food frequency questionnaire (FFQ) and then calculated dietary pattern scores for DASH and MeD. Sociodemographic and lifestyle factors were collected by a structured questionnaire. The presence and degree of NAFLD were also determined by abdominal sonography. Multiple regression models were used to estimate NAFLD odds across tertiles of DASH and Mediterranean dietary scores. Dietary DASH and Mediterranean components were adjusted for total energy intake, based on the residual methods. After adjusting for multiple potential confounders, we found an inverse association of DASH and MeD with NAFLD (Ptrend = 0.02, and Ptrend = 0.002, respectively). Those in the highest tertiles of adherence to the DASH and MeD had the lowest risk for NAFLD (OR = 0.80, 95%CI = 0.66-0.96, OR = 0.64, 95%CI = 0.52-0.78, respectively). The results of logistic analysis of MeD, stratified by gender and abdominal obesity, revealed the favorable association was more pronounced in women (OR = 0.42, 95%CI = 0.29-0.61, Ptrend = 0.004), and in participants with or without abdominal obesity (OR = 0.62, 95% CI = 0.47-0.81, Ptrend = 0.03, OR = 0.64, 95%CI = 0.475-0.91, Ptrend = 0.04, respectively). Similar results were obtained for the adherence to DASH diet score with the prevalence of NAFLD patients with abdominal obesity (OR = 0.75, 95% CI = 0.57-0.97, Ptrend = 0.04). The findings suggested the favorable association between DASH and MeD with NAFLD in Iranian adults, especially women and subjects with or without abdominal obesity. Further prospective investigations are needed to confirm the integrity of our findings.
非酒精性脂肪性肝病（NAFLD）是一种新兴的慢性肝病病因，也是全球主要的健康问题。饮食模式可能在控制和预防这种疾病方面发挥关键作用，但现有证据有限。本研究旨在确定伊朗阿摩尔队列研究（AmolCS）中成年人对停止高血压的饮食方法（DASH）和地中海饮食（MeD）的依从性与非酒精性脂肪性肝病（NAFLD）之间的关联。在一项横断面分析中，我们对 3220 名成年人（55.3%为男性），年龄≥18 岁（46.96±14.67）进行了分析，使用经过验证的食物频率问卷（FFQ）测量了他们的常规饮食摄入量，然后计算了 DASH 和 MeD 的饮食模式得分。通过结构化问卷收集社会人口统计学和生活方式因素。通过腹部超声确定 NAFLD 的存在和严重程度。使用多元回归模型估计 DASH 和地中海饮食评分三分位数的 NAFLD 比值。根据残差法，基于总能量摄入调整饮食 DASH 和地中海成分。在调整了多个潜在混杂因素后，我们发现 DASH 和 MeD 与 NAFLD 呈负相关（Ptrend=0.02，Ptrend=0.002）。DASH 和 MeD 依从性最高三分位的人患 NAFLD 的风险最低（OR=0.80，95%CI=0.66-0.96，OR=0.64，95%CI=0.52-0.78）。按性别和腹部肥胖分层的 MeD 逻辑分析的结果表明，女性（OR=0.42，95%CI=0.29-0.61，Ptrend=0.004）和有或没有腹部肥胖的参与者（OR=0.62，95%CI=0.47-0.81，Ptrend=0.03，OR=0.64，95%CI=0.475-0.91，Ptrend=0.04）中这种有利的关联更为明显。对于 DASH 饮食评分与腹部肥胖的 NAFLD 患者的患病率之间的关系，也得到了类似的结果（OR=0.75，95%CI=0.57-0.97，Ptrend=0.04）。研究结果表明，DASH 和 MeD 与伊朗成年人的 NAFLD 之间存在有利关联，尤其是女性和有或没有腹部肥胖的人群。需要进一步的前瞻性研究来证实我们研究结果的完整性。
