Department of Endocrine and Metabolic Diseases, 1st Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.
School of Public Health and Management, Wenzhou Medical University, Chashan University Town, Wenzhou 325015, China.
Nutrients. 2022 Oct 29;14(21):4559. doi: 10.3390/nu14214559.
We aimed to investigate the association of fruit and vegetable consumption with nonalcoholic fatty liver disease (NAFLD) in Chinese patients with type 2 diabetes mellitus (T2DM). This cross-sectional study included 2667 Chinese patients with T2DM aged 18 to 76 years from March 2017 to October 2021. Dietary intake was assessed using a food frequency questionnaire, and prevalent NAFLD was diagnosed with abdominal ultrasonography. High fruit−vegetable consumption was determined using ≥500 g/day consumption of both fruit and vegetable, and both fruit and vegetable consumption were divided into three categories of <200 g/day (low), 200−400 g/day (median) and >400 g (high). The primary outcome measurement was multivariate-adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for the prevalence of NAFLD in relation to the highest fruit and (or) vegetable intake compared with the lowest. Secondary analyses were conducted to assess the effects of either fruit or vegetable intake on the fatty liver index (FLI) using multivariable linear regressions. There were 1694 men and 973 women in this study, and 1445 (54.06%) participants had prevalent NAFLD. Patients with high fruit−vegetable intake had a lower prevalence of NAFLD than those with low fruit−vegetable intake (52.04% vs. 56.48%), but this difference was not statistically significant (p = 0.065). Vegetable intake had a significantly inverse association with NAFLD (OR: 0.68, 95% CI: 0.52−0.90), but this association was not pronounced with fruit intake (OR: 1.23, 95% CI: 0.89−1.69) or fruit−vegetable intake (OR: 0.90, 95% CI: 0.73−1.10). Additional analyses showed that an increase in vegetable intake was linearly associated with a significant reduction in FLI (β: −1.028, 95% CI: −1.836, −0.219). In conclusion, higher vegetable consumption was associated with lower odds of NAFLD in Chinese patients with T2DM, which suggested that increased vegetable intake might protect patients with diabetes against NAFLD.
本研究旨在探讨中国 2 型糖尿病（T2DM）患者中水果和蔬菜摄入与非酒精性脂肪性肝病（NAFLD）的相关性。这项横断面研究纳入了 2017 年 3 月至 2021 年 10 月期间年龄在 18 至 76 岁的 2667 名中国 T2DM 患者。采用食物频率问卷评估饮食摄入情况，采用腹部超声诊断现患 NAFLD。高水果-蔬菜摄入量定义为每天摄入水果和蔬菜均≥500g，水果和蔬菜摄入量分为<200g/天（低）、200-400g/天（中）和>400g/天（高）三个类别。主要结局测量指标是与最低水果和（或）蔬菜摄入量相比，最高水果和（或）蔬菜摄入量与 NAFLD 患病率相关的多变量校正比值比（OR）及其 95%置信区间（CI）。进行了二次分析，采用多变量线性回归评估水果或蔬菜摄入量对脂肪性肝病指数（FLI）的影响。本研究共纳入 1694 名男性和 973 名女性患者，其中 1445 名（54.06%）患者患有现患 NAFLD。与低水果-蔬菜摄入量相比，高水果-蔬菜摄入量患者的 NAFLD 患病率较低（52.04% vs. 56.48%），但差异无统计学意义（p=0.065）。蔬菜摄入量与 NAFLD 呈显著负相关（OR：0.68，95%CI：0.52-0.90），但与水果摄入量（OR：1.23，95%CI：0.89-1.69）或水果-蔬菜摄入量（OR：0.90，95%CI：0.73-1.10）无关。进一步分析显示，蔬菜摄入量的增加与 FLI 的显著降低呈线性相关（β：-1.028，95%CI：-1.836，-0.219）。总之，较高的蔬菜摄入量与中国 T2DM 患者发生 NAFLD 的几率较低相关，这表明增加蔬菜摄入量可能有助于保护糖尿病患者免受 NAFLD 的侵害。
