Zhang Shunming, Li Huiping, Meng Ge, Zhang Qing, Liu Li, Wu Hongmei, Gu Yeqing, Zhang Tingjing, Wang Xuena, Zhang Juanjuan, Dong Jun, Zheng Xiaoxi, Cao Zhixia, Zhang Xu, Dong Xinrong, Sun Shaomei, Wang Xing, Zhou Ming, Jia Qiyu, Song Kun, Borné Yan, Sonestedt Emily, Qi Lu, Niu Kaijun
Nutrition and Radiation Epidemiology Research Center, Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, People's Republic of China.
Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, People's Republic of China.
Br J Nutr. 2023 Jun 28;129(12):2094-2101. doi: 10.1017/S000711452200277X. Epub 2022 Sep 26.
It has been suggested that added sugar intake is associated with non-alcoholic fatty liver disease (NAFLD). However, previous studies only focused on sugar-sweetened beverages; the evidence for associations with total added sugars and their sources is scarce. This study aimed to examine the associations of total added sugars, their physical forms (liquid . solid) and food sources with risk of NAFLD among adults in Tianjin, China. We used data from 15 538 participants, free of NAFLD, other liver diseases, CVD, cancer or diabetes at baseline (2013-2018 years). Added sugar intake was estimated from a validated 100-item FFQ. NAFLD was diagnosed by ultrasonography after exclusion of other causes of liver diseases. Multivariable Cox proportional hazards models were fitted to calculate hazard ratios (HR) and corresponding 95 % CI for NAFLD risk with added sugar intake. During a median follow-up of 4·2 years, 3476 incident NAFLD cases were documented. After adjusting for age, sex, BMI and its change from baseline to follow-up, lifestyle factors, personal and family medical history and overall diet quality, the multivariable HR of NAFLD risk were 1·18 (95 % CI 1·06, 1·32) for total added sugars, 1·20 (95 % CI 1·08, 1·33) for liquid added sugars and 0·96 (95 % CI 0·86, 1·07) for solid added sugars when comparing the highest quartiles of intake with the lowest quartiles of intake. In this prospective cohort of Chinese adults, higher intakes of total added sugars and liquid added sugars, but not solid added sugars, were associated with a higher risk of NAFLD.
有人提出，添加糖的摄入量与非酒精性脂肪性肝病（NAFLD）有关。然而，以往的研究仅关注含糖饮料；关于与总添加糖及其来源之间关联的证据很少。本研究旨在探讨中国天津成年人中总添加糖、其物理形态（液体、固体）和食物来源与NAFLD风险之间的关联。我们使用了15538名参与者的数据，这些参与者在基线时（2013 - 2018年）没有NAFLD、其他肝脏疾病、心血管疾病、癌症或糖尿病。添加糖的摄入量通过经过验证的100项食物频率问卷进行估计。在排除其他肝脏疾病原因后，通过超声检查诊断NAFLD。采用多变量Cox比例风险模型来计算添加糖摄入量与NAFLD风险的风险比（HR）及相应的95%置信区间（CI）。在中位随访4.2年期间，记录了3476例新发NAFLD病例。在调整了年龄、性别、BMI及其从基线到随访的变化、生活方式因素、个人和家族病史以及总体饮食质量后，将摄入量最高四分位数与最低四分位数进行比较时，NAFLD风险的多变量HR分别为：总添加糖为1.18（95%CI 1.06，1.32），液体添加糖为1.20（95%CI 1.08，1.33），固体添加糖为0.96（95%CI 0.86，1.07）。在这个中国成年人前瞻性队列中，较高的总添加糖和液体添加糖摄入量，但不是固体添加糖摄入量，与更高的NAFLD风险相关。
