Xu Yurou, Wang Youyi, Zhao Qi, Chen Bo, Wang Na, Zhang Tiejun, Jiang Yonggen, Wu Yiling, He Na, Zhao Genming, Liu Xing
The Key Laboratory of Public Health Safety of Ministry of Education, Department of Epidemiology, School of Public Health, Fudan University, Shanghai, 200032, China.
Songjiang District Center for Disease Control and Prevention, Shanghai, 201600, China.
Hepatol Int. 2024 Apr;18(2):529-539. doi: 10.1007/s12072-024-10638-w. Epub 2024 Feb 26.
Non-alcoholic fatty liver disease (NAFLD) is a growing public health concern. Modifiable factors such as diet and lifestyle are of research interest in preventing or reversing the disease. The relationship between dairy products and NAFLD remains unclear.
In this cohort study, 36,122 participants aged 20-74 were enrolled by multi-stage, stratified, randomized cluster sampling from 2016 to 2017. A total of 25,085 participants finished at least one follow-up visit from 2019 to 2023. Dairy intake was collected by food frequency questionnaire at baseline. NAFLD was defined as fatty liver diagnosed by ultrasonography with excessive alcohol drink excluded. Logistic regression and Cox proportional hazard models were used to analyze the association between dairy intake and NAFLD.
A total of 34,040 participants were included in the baseline analysis. The prevalence of NAFLD was inversely associated with dairy intake (OR = 0.91, 95% CI 0.84-0.98; OR = 0.95, 95% CI 0.92-0.99). 20,460 participants entered the follow-up analysis. Among 12,204 without NAFLD at baseline, 4,470 developed NAFLD after a median time of 4.3 years. The incidence of NAFLD was inversely associated with dairy intake (HR = 0.89, 95% CI 0.81-0.98; HR = 0.94, 95% CI 0.89-0.99). Among 8256 with NAFLD at baseline, 3,885 recovered after 4.2-year follow-up. Total dairy intake did not show significant associations with recovery of NAFLD, and the HRs (95% CI) were 0.96 (0.87-1.06) for > 7 servings/week and 0.98 (0.93-1.03) for per serving/day increase.
Dairy product intake of more than one serving per day was associated with a lower prevalence and incidence of NAFLD in Chinese population. However, total dairy intake did not show significant association in NAFLD reversal.
非酒精性脂肪性肝病（NAFLD）是一个日益引起公众健康关注的问题。饮食和生活方式等可改变因素在预防或逆转该疾病方面具有研究意义。乳制品与NAFLD之间的关系仍不明确。
在这项队列研究中，2016年至2017年通过多阶段、分层、随机整群抽样纳入了36122名年龄在20 - 74岁的参与者。2019年至2023年共有25085名参与者完成了至少一次随访。在基线时通过食物频率问卷收集乳制品摄入量。NAFLD被定义为经超声诊断的脂肪肝，排除大量饮酒者。采用逻辑回归和Cox比例风险模型分析乳制品摄入量与NAFLD之间的关联。
共有34040名参与者纳入基线分析。NAFLD的患病率与乳制品摄入量呈负相关（OR = 0.91，95%CI 0.84 - 0.98；OR = 0.95，95%CI 0.92 - 0.99）。20460名参与者进入随访分析。在基线时无NAFLD的12204名参与者中，4470名在中位时间4.3年后发生了NAFLD。NAFLD的发病率与乳制品摄入量呈负相关（HR = 0.89，95%CI 0.81 - 0.98；HR = 0.94，95%CI 0.89 - 0.99）。在基线时有NAFLD的8256名参与者中，3885名在4.2年的随访后恢复。总乳制品摄入量与NAFLD的恢复未显示出显著关联，每周摄入超过7份的HR（95%CI）为0.96（0.87 - 1.06），每天每份增加的HR（95%CI）为0.98（0.93 - 1.03）。
在中国人群中，每天摄入超过一份的乳制品与较低的NAFLD患病率和发病率相关。然而，总乳制品摄入量在NAFLD逆转方面未显示出显著关联。
