Nikparast Ali, Razavi Maryam, Sohouli Mohammad Hassan, Hekmatdoost Azita, Dehghan Pooneh, Tohidi Maryam, Rouhani Pejman, Asghari Golaleh
Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Pediatric Gastroenterology and Hepatology Research Center Pediatrics Centre of Excellence Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
J Diabetes Metab Disord. 2024 Dec 20;24(1):19. doi: 10.1007/s40200-024-01516-1. eCollection 2025 Jun.
Dietary supplementation with branched-chain amino acids (BCAAs), including leucine, isoleucine, and valine, has shown potential benefits for the metabolic profile. However, emerging population-based studies suggest that BCAAs may mediate pathways related to cardiometabolic risk factors, possibly due to their involvement in the dysregulation of insulin metabolic pathways. This study aimed to investigate the association between BCAAs intake and the odds of nonalcoholic fatty liver disease (NAFLD) in children and adolescents with overweight and obesity.
This cross-sectional study encompassed individuals aged 6 to 18 years with WHO body mass index (BMI)-for-age z-score ≥ 1. NAFLD diagnosis was done using an ultrasonography scan of the liver and gastroenterologist confirmation. Dietary BCAAs intake was assessed using a validated 147-item food frequency questionnaire. Logistic regression models, adjusted for potential confounders, were used to estimate the odds ratios (OR) and 95% confidence interval (CI) of NAFLD across quartiles of BCAAs intake.
A total of 505 (52.9% boys) with mean ± SD age and BMI-for-age-Z-score of 10.0 ± 2.3 and 2.70 ± 1.01, respectively, were enrolled. After adjusting for potential confounders, participants in the highest quartile of total dietary BCAAs (OR: 1.87;95%CI:1.06-3.28) and leucine (OR: 1.84;95%CI:1.03-3.29) intake had greater odds of developing NAFLD compared with those in the lowest quartile. There was no significant association between dietary valine and isoleucine intake and the odds of NAFLD.
The study findings suggest that increased dietary intake of BCAAs, particularly leucine, may have detrimental effects on the development of NAFLD.
补充包括亮氨酸、异亮氨酸和缬氨酸在内的支链氨基酸（BCAAs）已显示出对代谢状况有潜在益处。然而，新出现的基于人群的研究表明，BCAAs可能介导与心脏代谢危险因素相关的途径，这可能是由于它们参与了胰岛素代谢途径的失调。本研究旨在调查超重和肥胖儿童及青少年的BCAAs摄入量与非酒精性脂肪性肝病（NAFLD）发生几率之间的关联。
这项横断面研究纳入了6至18岁、世界卫生组织（WHO）年龄别体重指数（BMI）z评分≥1的个体。通过肝脏超声扫描和胃肠病学家确认来诊断NAFLD。使用经过验证的147项食物频率问卷评估饮食中BCAAs的摄入量。采用经潜在混杂因素调整的逻辑回归模型，估计BCAAs摄入量四分位数组中NAFLD的比值比（OR）和95%置信区间（CI）。
共纳入505名参与者（52.9%为男孩），平均年龄±标准差为10.0±2.3岁，年龄别BMI-Z评分为2.70±1.01。在调整潜在混杂因素后，与最低四分位数组相比，总饮食BCAAs（OR：1.87；95%CI：1.06-3.28）和亮氨酸（OR：1.84；95%CI：1.03-3.29）摄入量最高四分位数组的参与者发生NAFLD的几率更高。饮食中缬氨酸和异亮氨酸摄入量与NAFLD发生几率之间无显著关联。
研究结果表明，饮食中BCAAs摄入量增加，尤其是亮氨酸，可能对NAFLD的发展产生不利影响。
