Sex Differences in the Association Between the Korean Healthy Eating Index and Liver Enzymes Among Korean Adults.

BACKGROUND/OBJECTIVES: Dietary quality plays a crucial role in maintaining liver function. In this study, we examined sex differences in the association between dietary quality and elevated liver enzyme levels in Korean adults.

METHODS

This study included a nationwide sample of 15,997 males and 22,300 females in South Korea. Dietary assessment was performed using the Korean Healthy Eating Index (KHEI), an evidence-based dietary quality index that quantitatively reflects adherence to Korean dietary guidelines (range 0-100). Serum levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were measured, with individuals classified as having elevated AST or ALT levels when values were ≥40 IU/L or ≥35 IU/L, respectively. Logistic regression analysis was performed to examine the association between the KHEI and elevated AST or ALT levels stratified by sex. Odds ratios (ORs) and 95% confidence intervals (CIs) were determined.

RESULTS

Among the males, a 10-point increase in the KHEI score was inversely associated with the likelihood of having elevated AST (OR: 0.90; 95% CI: 0.85-0.96) and ALT (OR: 0.96; 95% CI: 0.92-1.00) levels, respectively. Among the females, there was no clear association between the KHEI and elevated AST (OR: 0.98; 95% CI: 0.91-1.05) or ALT (OR: 1.00; 95% CI: 0.95-1.05) levels.

CONCLUSION

Further research is warranted to elucidate the underlying mechanisms of the observed sex-specific associations and guide the development of targeted dietary interventions for liver health in males and females.