Department of Nutrition, School of Public Health, Anhui Medical University, Hefei, China.
Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, Hefei, China.
Obesity (Silver Spring). 2022 Nov;30(11):2317-2328. doi: 10.1002/oby.23551. Epub 2022 Sep 4.
This study assessed the cross-sectional associations of low-carbohydrate diets (LCDs) and low-fat diets (LFDs) with hepatic steatosis in the National Health and Nutrition Examination Survey.
Diet was measured using the 24-hour recalls. Hepatic steatosis was defined by vibration-controlled transient elastography. The odds ratios (OR) and 95% confidence intervals (CI) were estimated using logistic regression. Substitution analysis was performed using the leave-one-out model.
Participants with higher adherence scores (comparing extreme tertiles) for an overall (OR = 0.76, 95% CI: 0.61-0.96, p = 0.049) or a healthful LCD (OR = 0.61, 95% CI: 0.43-0.87, p < 0.001) exhibited lower odds of steatosis. Replacing 5% of the energy from carbohydrates with total fat and protein (OR = 0.91, 95% CI: 0.83-0.99) or unsaturated fat and plant protein (OR = 0.89, 95% CI: 0.84-0.94) was associated with lower steatosis prevalence. High overall (OR = 1.65, 95% CI: 1.13-2.40, p = 0.006) or unhealthful (OR = 1.41, 95% CI: 1.10-1.80, p < 0.001) LFD scores were associated with increased likelihood of steatosis.
These findings suggest that the associations between LCDs and LFDs and steatosis may depend on the quality and food sources of the macronutrients.
本研究评估了国家健康与营养调查中低碳水化合物饮食（LCDs）和低脂肪饮食（LFDs）与肝脂肪变性的横断面关联。
饮食通过 24 小时回顾法进行测量。肝脂肪变性通过振动控制瞬态弹性成像进行定义。使用逻辑回归估计比值比（OR）和 95%置信区间（CI）。采用留一法进行替代分析。
总体上（比较极端三分位，OR=0.76，95%CI：0.61-0.96，p=0.049）或健康的 LCD（OR=0.61，95%CI：0.43-0.87，p<0.001）中，高依从性得分的参与者发生脂肪变性的几率较低。用总脂肪和蛋白质（OR=0.91，95%CI：0.83-0.99）或不饱和脂肪和植物蛋白（OR=0.89，95%CI：0.84-0.94）替代碳水化合物能量的 5%与较低的脂肪变性患病率相关。总体上（OR=1.65，95%CI：1.13-2.40，p=0.006）或不健康的（OR=1.41，95%CI：1.10-1.80，p<0.001）LFD 评分与脂肪变性的可能性增加相关。
这些发现表明，LCDs 和 LFDs 与脂肪变性之间的关联可能取决于宏量营养素的质量和食物来源。
