Institute of Nutrition and Food Sciences, Nutritional Epidemiology, University of Bonn, Bonn53115, Germany.
Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
Br J Nutr. 2023 Feb 14;129(3):513-522. doi: 10.1017/S0007114522001313. Epub 2022 May 2.
A healthy lifestyle during adolescence is associated with insulin sensitivity or liver enzyme levels and thus might contribute to the prevention of non-alcoholic fatty liver disease (NAFLD). Therefore, we examined the association between adherence to a hypothesis-based lifestyle score including dietary intake, physical activity, sedentary behaviour, sleep duration and BMI in adolescence and fatty liver indices in early adulthood. Overall, 240 participants of the DOrtmund Nutritional and Anthropometric Longitudinally Designed study completed repeated measurements of lifestyle score factors during adolescence (females: 8·5-15·5 years, males: 9·5-16·5 years). Multivariable linear regression models were used to investigate the association between adolescent lifestyle scores and NAFLD risk (hepatic steatosis index (HSI) and fatty liver index (FLI)) in early adulthood (18-30 years). Participants visited the study centre 4·9 times during adolescence and achieved on average 2·8 (min: 0·6, max: 5) out of five lifestyle score points. Inverse associations were observed between the lifestyle score and fatty liver indices (HSI: ß=-5·8 % (95 % CI -8·3, -3·1), < 0·0001, FLI: ß=-32·4 % (95 % CI -42·9, -20·0), < 0·0001) in the overall study population. Sex-stratified analysis confirmed these results in men, while inverse but non-significant associations were observed in women ( > 0·05). A higher lifestyle score was associated with lower HSI and FLI values, suggesting that a healthy lifestyle during adolescence might contribute to NAFLD prevention, predominantly in men. Our findings on repeatedly measured lifestyle scores in adolescents and their association with NAFLD risk in early adulthood warrant confirmation in larger study populations.
青少年时期的健康生活方式与胰岛素敏感性或肝酶水平相关，因此可能有助于预防非酒精性脂肪肝疾病 (NAFLD)。因此，我们研究了青少年时期基于假设的生活方式评分（包括饮食摄入、体力活动、久坐行为、睡眠持续时间和 BMI）与成年早期脂肪肝指数之间的关联。总体而言，DOrtmund 营养和人体测量纵向设计研究的 240 名参与者在青少年时期完成了生活方式评分因素的多次测量（女性：8.5-15.5 岁，男性：9.5-16.5 岁）。多变量线性回归模型用于研究青少年生活方式评分与成年早期（18-30 岁）NAFLD 风险（肝脂肪变性指数 (HSI) 和脂肪肝指数 (FLI)) 之间的关联。参与者在青少年时期平均 4.9 次访问研究中心，平均获得 5 个生活方式评分点中的 2.8 个（最低：0.6，最高：5）。生活方式评分与脂肪肝指数呈负相关（HSI：β=-5.8%（95%CI：-8.3，-3.1），<0.0001，FLI：β=-32.4%（95%CI：-42.9，-20.0），<0.0001）在整个研究人群中。性别分层分析在男性中证实了这些结果，而在女性中则观察到相反但无统计学意义的关联（>0.05）。较高的生活方式评分与较低的 HSI 和 FLI 值相关，表明青少年时期健康的生活方式可能有助于预防 NAFLD，主要在男性中。我们在青少年时期多次测量的生活方式评分及其与成年早期 NAFLD 风险之间的关联结果需要在更大的研究人群中得到证实。
