根据过去 25 年平均快餐摄入量评估中年腹部脂肪组织水平与代谢相关脂肪性肝病（MAFLD）的关系：CARDIA 研究。
Levels of abdominal adipose tissue and metabolic-associated fatty liver disease (MAFLD) in middle age according to average fast-food intake over the preceding 25 years: the CARDIA Study.
机构信息
Department of Epidemiology and Biostatistics, University of California, Irvine, CA, USA.
Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA.
出版信息
Am J Clin Nutr. 2022 Jul 6;116(1):255-262. doi: 10.1093/ajcn/nqac079.
BACKGROUND
Higher levels of intra-abdominal adipose tissue (IAAT) comprising visceral adipose tissue (VAT), intermuscular adipose tissue (IMAT), and liver fat are posited drivers of obesity-related chronic disease risk. Fast food is hypothesized to contribute to IAAT patterns.
OBJECTIVES
We quantified levels of abdominal subcutaneous adipose tissue (SAT), IAAT, and odds of metabolic-associated fatty liver disease (MAFLD) in middle age according to average fast-food intake over the preceding 25 y.
METHODS
We analyzed data from the Coronary Artery Risk Development in Young Adults (CARDIA) study. Participants underwent 6 clinical exams and measurements over 25 y with computed tomography-measured VAT, SAT, and IMAT (n = 3156), plus MAFLD defined by liver attenuation (≤40 Hounsfield units) and 1 metabolic abnormality at year 25 (2010, n = 3001, n cases = 302). We estimated means of VAT, SAT, IMAT, and liver attenuation at the year 25 exam according to categories of average fast-food intake over the previous 25 y adjusted for sociodemographic and lifestyle factors and logistic regression to estimate the odds ratio of MAFLD at year 25.
RESULTS
With higher average fast-food intake over 25 y (categorized as follows: never-1×/mo, >1×-3×/mo, 1-<2×/wk, 2-<3×/wk, ≥3×/wk), there were monotonic higher levels of VAT (98.5, 127.6, 134.5, 142.0, 145.5 cm3), P-trend < 0.0001, which were consistent across anthropometrically classified obesity categories. There was a similar pattern with liver fat. There were higher levels of IMAT and SAT with higher fast-food intake (P-trend = 0.003, 0.0002, respectively), with amounts leveling off at ≥2×/wk. In addition, compared with participants who ate fast food never-1×/mo, there were monotonic higher odds of having MAFLD at year 25 with higher average fast-food intake, with participants who ate fast food ≥3×/wk having an OR of MAFLD = 5.18 (95% CI: 2.87, 9.37).
CONCLUSIONS
There were monotonic higher levels of VAT, liver fat, and odds of having MAFLD in middle age according to higher average fast-food intake over the preceding 25 y.
背景
内脏脂肪组织（VAT）、肌肉间脂肪组织（IMAT）和肝脂肪等腹部内脏脂肪组织（IAAT）水平升高被认为是与肥胖相关的慢性疾病风险的驱动因素。快餐被认为是导致 IAAT 模式的因素之一。
目的
我们根据过去 25 年中平均快餐摄入量，量化了中年人的腹部皮下脂肪组织（SAT）、IAAT 和代谢相关脂肪性肝病（MAFLD）的患病几率。
方法
我们分析了来自冠状动脉风险发展在年轻人（CARDIA）研究的数据。参与者在 25 年内进行了 6 次临床检查和测量，通过计算机断层扫描测量了 VAT、SAT 和 IMAT（n=3156），以及在第 25 年（2010 年）通过肝脏衰减（≤40 亨氏单位）和 1 项代谢异常定义的 MAFLD（n=3001，n 病例=302）。我们根据过去 25 年中平均快餐摄入量的类别，估计了第 25 年检查中 VAT、SAT、IMAT 和肝脏衰减的平均值，调整了社会人口统计学和生活方式因素，并进行了逻辑回归，以估计第 25 年 MAFLD 的比值比。
结果
随着过去 25 年中平均快餐摄入量的增加（分为以下几类：从不-1 次/月，>1-3 次/月，1-<2 次/周，2-<3 次/周，≥3 次/周），VAT 水平呈单调递增趋势（98.5、127.6、134.5、142.0、145.5cm3），P-趋势<0.0001，并且在按人体测量学分类的肥胖类别中均保持一致。肝脂肪也呈现出类似的模式。随着快餐摄入量的增加，IMAT 和 SAT 的水平也更高（P-趋势=0.003，0.0002），但在每周≥2 次后趋于平稳。此外，与每月吃快餐不超过 1 次的参与者相比，随着过去 25 年中平均快餐摄入量的增加，有 MAFLD 的参与者的 MAFLD 患病几率呈单调递增趋势，每周吃快餐≥3 次的参与者患 MAFLD 的 OR 为 5.18（95%CI：2.87，9.37）。
结论
根据过去 25 年中平均快餐摄入量，中年人的 VAT、肝脂肪和 MAFLD 患病几率呈单调递增趋势。
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