Division of Human Nutrition and Health, Wageningen University and Research, Stippeneng 4, P.O. Box 17, 6700 AA, Wageningen, The Netherlands.
Eur J Nutr. 2024 Aug;63(5):1847-1856. doi: 10.1007/s00394-024-03431-w. Epub 2024 Jun 12.
A healthy diet reduces the risk of non-alcoholic fatty liver disease (NAFLD) in the general population, especially in individuals who are genetically predisposed to NAFLD. Little is known in patients who suffered from a myocardial infarction (MI). We examined the interaction between diet quality and genetic predisposition in relation to NAFLD in post-MI patients.
We included 3437 post-MI patients from the Alpha Omega Cohort. Diet quality was assessed with adherence to the Dutch Healthy Diet index 2015 (DHD15-index). A weighted genetic risk score (GRS) for NAFLD was computed using 39 genetic variants. NAFLD prevalence was predicted using the Fatty Liver Index. Prevalence ratios (PR) with 95% confidence intervals of DHD15-index and GRS in relation to NAFLD were obtained with multivariable Cox proportional hazards models. The interaction between DHD15-index and GRS in relation to NAFLD was assessed on an additive and multiplicative scale.
Patients had a mean age of 69 (± 5.5) years, 77% was male and 20% had diabetes. The DHD15-index ranged from 28 to 120 with a mean of 73. Patients with higher diet quality were less likely to suffer from NAFLD, with a PR of 0.76 (0.62, 0.92) for the upper vs lower quintile of DHD15-index. No association between the GRS and NAFLD prevalence was found (PR of 0.92 [0.76, 1.11]). No statistically significant interaction between the DHD15-index and GRS was observed.
In Dutch post-MI patients, adherence to the Dutch dietary guidelines was associated with a lower prevalence of NAFLD, as assessed by the FLI. This association was present regardless of genetic predisposition in this older aged cohort.
健康的饮食可降低普通人群中非酒精性脂肪性肝病（NAFLD）的风险，尤其在那些遗传易患 NAFLD 的人群中。然而，在心肌梗死（MI）患者中，这种关联知之甚少。我们研究了饮食质量与遗传易感性之间的相互作用与 MI 后患者 NAFLD 的关系。
我们纳入了来自 Alpha Omega 队列的 3437 例 MI 后患者。采用 2015 年荷兰健康饮食指数（DHD15-index）评估饮食质量。使用 39 个遗传变异计算 NAFLD 的加权遗传风险评分（GRS）。采用 Fatty Liver Index 预测 NAFLD 的患病率。采用多变量 Cox 比例风险模型获得 DHD15-index 和 GRS 与 NAFLD 之间的比值比（PR）及其 95%置信区间。在加性和乘法尺度上评估 DHD15-index 和 GRS 与 NAFLD 之间的相互作用。
患者的平均年龄为 69（±5.5）岁，77%为男性，20%患有糖尿病。DHD15-index 范围为 28 至 120，平均为 73。饮食质量较高的患者发生 NAFLD 的可能性较低，与 DHD15-index 最低五分位相比，上五分位的 PR 为 0.76（0.62，0.92）。未发现 GRS 与 NAFLD 患病率之间存在关联（PR 为 0.92[0.76，1.11]）。未观察到 DHD15-index 和 GRS 之间存在统计学显著的交互作用。
在荷兰 MI 后患者中，采用荷兰饮食指南与 FLI 评估的 NAFLD 患病率降低相关。在这个年龄较大的队列中，这种关联存在于遗传易感性的患者中。
