Endocrinology and Metabolism Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
BMC Public Health. 2023 May 26;23(1):973. doi: 10.1186/s12889-023-15816-3.
The combined role of important environmental factors as a single lifestyle index in predicting non-alcoholic fatty liver disease (NAFLD) risk is not fully assessed. Therefore, we aimed to investigate the association of healthy lifestyle factor score (HLS) with the odds of NAFLD in Iranian adults.
This case-control study was conducted on 675 participants, aged ≥ 20-60 years, including 225 new NAFLD cases and 450 controls. We measured dietary intake information using a validated food frequency questionnaire and determined diet quality based on the alternate healthy eating index-2010(AHEI-2010). The score of HLS was calculated based on four lifestyle factors, including a healthy diet, normal body weight, non-smoking, and high physical activity. An ultrasound scan of the liver was used to detect NAFLD in participants of the case group. Logistic regression models were used to determine the odds ratios(ORs) and 95% confidence interval(CI) of NAFLD across tertiles of HLS and AHEI.
Mean ± SD age of the participants were 38.13 ± 8.85 years. The Mean ± SD HLS in the case and control groups was 1.55 ± 0.67 and 2.53 ± 0.87, respectively. Also, the Mean ± SD AHEI in the case and control groups was 48.8 ± 7.7 and 54.1 ± 8.1, respectively. Based on the age and sex-adjusted model, the odds of NAFLD were decreased across tertiles of AHEI (OR:0.18;95%CI:0.16-0.29,P<0.001) and HLS(OR:0.03;95%CI:0.01-0.05,P<0.001). Also, in the multivariable model, the odds of NAFLD were decreased across tertiles AHEI (OR:0.12;95%CI:0.06-0.24,P<0.001) and HLS(OR:0.02;95%CI:0.01-0.04,P<0.001).
Our findings reported that higher adherence to lifestyle with a higher score of HLS was associated with decreased odds of NAFLD. Also, a diet with a high AHEI score can reduce the risk of NAFLD in the adult population.
将重要环境因素的综合作用作为单一生活方式指数来预测非酒精性脂肪性肝病（NAFLD）风险的情况尚未完全评估。因此，我们旨在研究伊朗成年人中健康生活方式因素评分（HLS）与 NAFLD 患病几率之间的关联。
这项病例对照研究纳入了 675 名年龄≥20-60 岁的参与者，包括 225 名新确诊的 NAFLD 病例和 450 名对照。我们使用经过验证的食物频率问卷来测量饮食摄入信息，并根据替代健康饮食指数-2010（AHEI-2010）来确定饮食质量。HLS 评分是基于 4 种生活方式因素计算得出的，包括健康饮食、正常体重、不吸烟和高身体活动水平。对病例组的参与者进行肝脏超声检查以检测 NAFLD。使用逻辑回归模型确定 HLS 和 AHEI 三分位数与 NAFLD 之间的比值比（OR）和 95%置信区间（CI）。
参与者的平均年龄±标准差为 38.13±8.85 岁。病例组和对照组的 HLS 平均年龄±标准差分别为 1.55±0.67 和 2.53±0.87，AHEI 分别为 48.8±7.7 和 54.1±8.1。在调整年龄和性别后，AHEI 的三分位数与 NAFLD 的几率呈下降趋势（OR：0.18；95%CI：0.16-0.29，P<0.001）和 HLS（OR：0.03；95%CI：0.01-0.05，P<0.001）。此外，在多变量模型中，AHEI 的三分位数与 NAFLD 的几率呈下降趋势（OR：0.12；95%CI：0.06-0.24，P<0.001）和 HLS（OR：0.02；95%CI：0.01-0.04，P<0.001）。
我们的研究结果表明，较高的 HLS 评分与较低的 NAFLD 患病几率相关，而 AHEI 评分较高的饮食可以降低成年人患 NAFLD 的风险。
