Song Yancheng, Guo Wencong, Wang Junke, Liu Shuguang, Li Zhaopeng, Li Yu
Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China.
Department of Colorectal Surgery, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Front Nutr. 2024 Apr 8;11:1334935. doi: 10.3389/fnut.2024.1334935. eCollection 2024.
Recent research showed that probiotics treatment may reduce insulin resistance, regulate lipid metabolism, raise liver enzyme levels, and ameliorate inflammation in individuals with metabolic associated fatty liver disease (MAFLD). However, the possible effects of probiotic use on the progression of hepatic steatosis (HS) have not been identified. The purpose of this study was to investigate this in a large population database.
The cross-sectional research was conducted among adults with complete data on probiotic yogurt consumption and HS in the 2011-2016 National Health and Nutrition Examination Survey (NHANES). Probiotic yogurt consumption was assessed using a dietary supplement questionnaire, while HS was evaluated with HS index (HSI). To explore their relationship, weighted univariate regression analysis, subgroup analysis, and interaction analysis were conducted. To evaluate the causal association between yogurt consumption and NAFLD, mendelian randomization analysis (MR) were performed. A restricted cubic spline (RCS) was used to analyze the relationship curve between the leves of yogurt consumption and hepatic steatosis.
A total of 7,891 participants were included in the study represented 146.7 million non-institutionalized residents of the United States, of whom 4,322 (54.77%) were diagnosed with HS. Multivariable logistic regression showed probiotic yogurt consumption had significantly inverse relationship for HS (OR = 0.84, 95% CI: 0.72-0.97, = 0.02) after adjusting for all covariates. Once more, the independent relationship between probiotic yogurt consumption and HS was verified by subgroup analysis and interaction analysis. The MR analysis results indicate that there is no causal relationship between yogurt consumption and NAFLD. The RCS model demonstrated a robust J-shaped link between yogurt consumption and HS, revealing a significant decrease in risk within the lower range of yogurt consumption, which attained the lowest risk close to 0.4 cup.
According to the NHANES data, the consumption of probiotics and yogurt has a beneficial effect on HS, whereas the MR results indicated it was not related to NAFLD. The RCS analysis indicates a J-shaped relationship between yogurt consumption and HS, which may account for the inconsistency in the results. Based on these findings, we recommend that adults take half a cup of yogurt daily.
近期研究表明，益生菌治疗可能会降低胰岛素抵抗、调节脂质代谢、提高肝酶水平，并改善代谢相关脂肪性肝病（MAFLD）患者的炎症。然而，益生菌使用对肝脂肪变性（HS）进展的可能影响尚未明确。本研究的目的是在一个大型人群数据库中对此进行调查。
在2011 - 2016年美国国家健康与营养检查调查（NHANES）中，对有关于益生菌酸奶消费和HS完整数据的成年人进行横断面研究。使用膳食补充问卷评估益生菌酸奶的消费情况，同时用HS指数（HSI）评估HS。为探究它们之间的关系，进行了加权单变量回归分析、亚组分析和交互分析。为评估酸奶消费与非酒精性脂肪性肝病（NAFLD）之间的因果关联，进行了孟德尔随机化分析（MR）。使用受限立方样条（RCS）分析酸奶消费水平与肝脂肪变性之间的关系曲线。
本研究共纳入7891名参与者，代表了美国1.467亿非机构化居民，其中4322人（54.77%）被诊断为HS。多变量逻辑回归显示，在调整所有协变量后，益生菌酸奶消费与HS呈显著负相关（OR = 0.84，95% CI：0.72 - 0.97，P = 0.02）。亚组分析和交互分析再次验证了益生菌酸奶消费与HS之间的独立关系。MR分析结果表明酸奶消费与NAFLD之间不存在因果关系。RCS模型显示酸奶消费与HS之间存在稳健的J形关联，表明在较低酸奶消费范围内风险显著降低，在接近0.4杯时达到最低风险。
根据NHANES数据，益生菌和酸奶的消费对HS有有益影响，而MR结果表明其与NAFLD无关。RCS分析表明酸奶消费与HS之间存在J形关系，这可能解释了结果的不一致性。基于这些发现，我们建议成年人每天饮用半杯酸奶。
