He Yijia, Ye Miaomin, Xia Yin, Zhong Ziyi, Li Qian
Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
Eur J Gastroenterol Hepatol. 2025 Feb 1;37(2):230-239. doi: 10.1097/MEG.0000000000002898. Epub 2024 Dec 2.
The link between antioxidants and metabolic dysfunction-associated steatotic liver disease (MASLD) is a topic of considerable discussion in the field of observational studies, with the exact causal connections still being unclear.
In this investigation, a cohort consisting of 17 061 participants from the National Health and Nutrition Examination Surveys was studied. Initially, a cross-sectional analysis was carried out to examine the relationship between the CDAI and MASLD. Further, Mendelian randomization (MR) was utilized to assess the possible causal links between antioxidant levels in the bloodstream and MASLD.
The association between the CDAI and MASLD was found to be significant in the fully adjusted logistic regression model, showing an OR of 0.95 [95% confidence interval (CI): 0.94-0.97; P < 0.001]. The use of restricted cubic spline regression revealed no significant nonlinear association between the CDAI and the occurrence of MASLD ( Pnonlinearity = 0.321). Additionally, MR findings did not suggest any causal connections between circulating levels of various antioxidants and MASLD. These antioxidants included vitamin A (retinol) (IVW: OR: 0.67, 95% CI: 0.33-1.36, P = 0.272), vitamin C (ascorbate) (IVW: OR: 0.61, 95% CI: 0.34-1.09, P = 0.094), vitamin E (α-tocopherol) (IVW: OR: 0.55, 95% CI: 0.13-2.25, P = 0.407), vitamin E (γ-tocopherol) (IVW: OR: 0.89, 95% CI: 0.36-2.23, P = 0.806), zinc (IVW: OR: 0.95, 95% CI: 0.82-1.09, P = 0.449), selenium (IVW: OR: 0.98, 95% CI: 0.84-1.16, P = 0.855), and carotene (IVW: OR: 0.80, 95% CI: 0.36-1.81, P = 0.596).
The findings highlight a significant negative linear relationship between CDAI and MASLD prevalence in the observational component of the study. However, the MR analysis did not indicate any causal effects of circulating antioxidant levels on MASLD.
抗氧化剂与代谢功能障碍相关脂肪性肝病（MASLD）之间的联系是观察性研究领域中一个备受讨论的话题，确切的因果关系仍不明确。
在本调查中，对来自国家健康与营养检查调查的17061名参与者组成的队列进行了研究。首先，进行横断面分析以检查CDAI与MASLD之间的关系。此外，利用孟德尔随机化（MR）来评估血液中抗氧化剂水平与MASLD之间可能的因果联系。
在完全调整的逻辑回归模型中，发现CDAI与MASLD之间的关联具有显著性，OR为0.95[95%置信区间（CI）：0.94 - 0.97；P < 0.001]。使用受限立方样条回归显示CDAI与MASLD的发生之间无显著非线性关联（P非线性 = 0.321）。此外，MR结果未表明各种抗氧化剂的循环水平与MASLD之间存在任何因果联系。这些抗氧化剂包括维生素A（视黄醇）（逆方差加权法：OR：0.67，95%CI：0.33 - 1.36，P = 0.272）、维生素C（抗坏血酸）（逆方差加权法：OR：0.61，95%CI：0.34 - 1.09，P = 0.094）、维生素E（α - 生育酚）（逆方差加权法：OR：0.55，95%CI：0.13 - 2.25，P = 0.407）、维生素E（γ - 生育酚）（逆方差加权法：OR：0.89；95%CI：0.36 - 2.23，P = 0.806）、锌（逆方差加权法：OR：0.95，95%CI：0.82 - 1.09，P = 0.449）、硒（逆方差加权法：OR：0.98，95%CI：（0.84 - 1.16），P = 0.855）和胡萝卜素（逆方差加权法：OR：0.80，95%CI：0.36 - 1.81，P = 0.596）。
研究结果突出了在研究的观察部分中CDAI与MASLD患病率之间存在显著的负线性关系。然而，MR分析未表明循环抗氧化剂水平对MASLD有任何因果效应。
