Yu Hao, Wang Di, Yan Yan, Jiao Lirui, Zhang Jinjin, Gu Yeqing, Zhang Shunming, Zhang Qing, Liu Li, Meng Ge, Wu Hongmei, Wu Xuehui, Zhu Dandan, Fu Liyuan, Chen Yinxiao, Wang Dongli, Wang Yaxiao, Geng Hao, Sun Shaomei, Wang Xing, Jia Qiyu, Song Kun, Zheng Yunliang, Yu Ming, Chen Yu-Ming, Niu Kaijun
School of Public Health, Tianjin Medical University, Tianjin, 300070, China.
School of Public Health, Tianjin University of Traditional Chinese Medicine, 10 Poyanghu Road, West Area, Tuanbo New Town, Jinghai District, Tianjin, 301617, China.
Eur J Nutr. 2025 May 26;64(5):188. doi: 10.1007/s00394-025-03708-8.
Manganese (Mn) is an essential nutrient that plays a crucial role in maintaining normal physiological functions of the human body. However, overexposure to Mn often leads to adverse health outcomes and contributes to the development of a variety of diseases. Several studies have explored the relationship between dietary Mn and metabolic dysfunction-associated steatotic liver disease (MASLD) risk. Two UK Biobank (UKB)-based studies suggested that Mn, as a key nutrient, may be associated with a reduced risk of MASLD. Another study found an association between the dietary antioxidant index and the onset of non-alcoholic fatty liver disease (NAFLD), highlighting the importance of nutritional factors (including Mn) in liver health. However, the relationship between dietary Mn intake and MASLD in the Chinese population remains unexplored, and further research is needed to elucidate its underlying mechanisms.
This prospective multi-cohort study had 1,137 adults from the Guangzhou Nutrition and Health Study (GNHS) cohort and 17,649 people from the Tianjin Chronic Low-grade Systemic Inflammation and Health (TCLSIH) cohort. We measured dietary intake using a validated and standardized food frequency questionnaire. Annual abdominal ultrasound was used to diagnose new-onset MASLD. We used multivariable Cox regression models to assess the relationship between dietary Mn intake and the risk of MASLD.
In the TCLSIH cohort, 3640 MASLD cases were observed with a follow-up time of 60,190 person-years. After taking into account possible confounding factors, the multivariable HRs (95% CIs) for MASLD across the quartiles of dietary Mn intake in males were 1.00 (reference), 1.08 (0.96-1.21), 1.12 (0.99-1.26), and 1.16 (1.02-1.31), with a P for trend = 0.02; for females, the HRs (95% CIs) for MASLD across the quartiles of dietary Mn intake were 1.00, 1.11 (0.95-1.31), 1.08 (0.91-1.28), and 0.97 (0.81-1.16), with a P for trend = 0.58. After adjustment for proteins, lipids, and carbohydrates, the HRs (95% CIs) for MASLD across the quartiles of dietary Mn intake in males were 1.00 (reference), 1.11 (0.97-1.26), 1.14 (1.00-1.31), and 1.16 (1.00-1.34), with a P for trend = 0.045. For females, the HRs (95% CIs) for MASLD across the quartiles of dietary Mn intake were 1.00 (reference), 1.08 (0.91-1.30), 1.06 (0.88-1.27), and 0.93 (0.76-1.13), with a P for trend = 0.39. In the GNHS cohort, 624 MASLD cases were observed with a follow-up time of 6454 person-years. After adjusting for relevant confounders, the HRs (95% CIs) for males comparing T3 versus T1 of dietary Mn intake were 1.04 (0.65-1.60); the HRs (95% CIs) for females comparing T3 versus T1 of dietary Mn intake were 1.00 (0.78-1.29).
In males, higher dietary Mn intake is associated with a higher incidence of MASLD.
锰（Mn）是一种必需营养素，在维持人体正常生理功能中起着关键作用。然而，过度接触锰往往会导致不良健康后果，并促使多种疾病的发展。多项研究探讨了膳食锰与代谢功能障碍相关脂肪性肝病（MASLD）风险之间的关系。两项基于英国生物银行（UKB）的研究表明，锰作为一种关键营养素，可能与降低MASLD风险有关。另一项研究发现膳食抗氧化指数与非酒精性脂肪性肝病（NAFLD）的发病之间存在关联，突出了营养因素（包括锰）对肝脏健康的重要性。然而，中国人群中膳食锰摄入量与MASLD之间的关系仍未得到探索，需要进一步研究以阐明其潜在机制。
这项前瞻性多队列研究纳入了来自广州营养与健康研究（GNHS）队列的1137名成年人以及来自天津慢性低度全身炎症与健康（TCLSIH）队列的17649人。我们使用经过验证和标准化的食物频率问卷来测量膳食摄入量。每年进行腹部超声检查以诊断新发的MASLD。我们使用多变量Cox回归模型来评估膳食锰摄入量与MASLD风险之间的关系。
在TCLSIH队列中，观察到3640例MASLD病例，随访时间为60190人年。在考虑了可能的混杂因素后，男性膳食锰摄入量四分位数对应的MASLD多变量HR（95%CI）分别为1.00（参考值）、1.08（0.96 - 1.21）、1.12（0.99 - 1.26）和1.16（1.02 - 1.31），趋势P值 = 0.02；女性膳食锰摄入量四分位数对应的MASLD的HR（95%CI）分别为1.00、1.11（0.95 - 1.31）、1.08（0.91 - 1.28）和0.97（0.81 - 1.16），趋势P值 = 0.58。在调整蛋白质、脂质和碳水化合物后，男性膳食锰摄入量四分位数对应的MASLD的HR（95%CI）分别为1.00（参考值）、1.11（0.97 - 1.26）、1.14（1.00 - 1.31）和1.16（1.00 - 1.34），趋势P值 = 0.045。女性膳食锰摄入量四分位数对应的MASLD的HR（95%CI）分别为1.00（参考值）、1.08（0.91 - 1.30）、1.06（0.88 - 1.27）和0.93（0.76 - 1.13），趋势P值 = 0.39。在GNHS队列中，观察到624例MASLD病例，随访时间为6454人年。在调整相关混杂因素后，男性膳食锰摄入量T3与T1相比的HR（95%CI）为1.04（0.65 - 1.60）；女性膳食锰摄入量T3与T1相比的HR（95%CI）为1.00（0.78 - 1.29）。
在男性中，较高的膳食锰摄入量与较高的MASLD发病率相关。
