Department of Gastroenterology, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuhan 430060, China.
Department of Ophthalmology, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuhan 430060, China.
Nutrients. 2023 Nov 27;15(23):4931. doi: 10.3390/nu15234931.
Most studies have primarily focused on assessing the association between diet or exercise patterns and metabolic dysfunction-associated steatotic liver disease (MASLD). This study adopted a more comprehensive approach by introducing the oxidative balance score (OBS) to evaluate the combined effects of diet and lifestyle on the body's antioxidant ability. Our main objective was to investigate the association between OBS and the burden of MASLD in the United States.
Participants with complete information from 2001 to 2018 were included. In the absence of other definite liver injury factors, the United States fatty liver index (us-FLI) ≥ 30 was used as the diagnostic criterion for MASLD. We first calculated the weighted prevalence for each cycle and stratified it according to demographic and metabolic-related disease characteristics. Subsequently, weighted multiple logistic regression was used to evaluate the relationship between OBS and MASLD. In addition, we explored the body's inflammatory state and the level of insulin resistance (IR) in mediating OBS and MASLD.
From 2001 to 2018, the prevalence of MASLD in the U.S. population as a whole increased from 29.76% to 36.04%, and the rate was higher in people with metabolic-related diseases. Notably, OBS exhibited a negative correlation with MASLD. Participants in the highest tertile of OBS had a significantly lower prevalence of MASLD compared to those in the lowest tertile [OR: 0.72, 95%CI: (0.57, 0.92), < 0.001]. Moreover, a high OBS is associated with a lower inflammatory state and level of IR. The body's inflammatory state and IR level mediated the association between OBS and MASLD by 5.2% and 39.7%, respectively (both < 0.001).
In this study, we observed an increasing prevalence of MASLD over the years. A higher OBS was associated with a lower risk of MASLD, especially when OBS ≥ 25. The body's inflammatory state and IR level mediate the association between OBS and MASLD, but the mechanism needs to be further investigated.
大多数研究主要集中在评估饮食或运动模式与代谢功能障碍相关脂肪性肝病（MASLD）之间的关联。本研究采用了更全面的方法，引入氧化平衡评分（OBS）来评估饮食和生活方式对身体抗氧化能力的综合影响。我们的主要目的是研究 OBS 与美国 MASLD 负担之间的关联。
纳入了 2001 年至 2018 年期间信息完整的参与者。在没有其他明确的肝损伤因素的情况下，采用美国脂肪肝指数（us-FLI）≥30 作为 MASLD 的诊断标准。我们首先计算了每个周期的加权患病率，并根据人口统计学和代谢相关疾病特征进行分层。随后，采用加权多因素 logistic 回归评估 OBS 与 MASLD 之间的关系。此外，我们还探讨了 OBS 与 MASLD 之间的中介作用，即机体的炎症状态和胰岛素抵抗（IR）水平。
2001 年至 2018 年期间，美国人群 MASLD 的总体患病率从 29.76%上升至 36.04%，代谢相关疾病患者的患病率更高。值得注意的是，OBS 与 MASLD 呈负相关。与最低 OBS 三分位组相比，OBS 最高三分位组 MASLD 的患病率显著降低[OR：0.72，95%CI：（0.57，0.92）， < 0.001]。此外，较高的 OBS 与较低的炎症状态和 IR 水平相关。机体的炎症状态和 IR 水平分别介导了 OBS 与 MASLD 之间 5.2%和 39.7%的关联（均<0.001）。
本研究观察到 MASLD 的患病率在过去几年中呈上升趋势。较高的 OBS 与 MASLD 的风险降低相关，尤其是 OBS≥25 时。机体的炎症状态和 IR 水平介导了 OBS 与 MASLD 之间的关联，但具体机制需要进一步研究。
