METHODS: Cross-sectional data from 23,130 participants aged ≥20 years were obtained from the National Health and Nutrition Examination Survey, 2005-2018. Vegetarian status was classified based on two 24-h dietary recalls. We examined the association between vegetarian diets and the risk of NAFLD using the propensity score weighting method.
RESULTS: Vegetarian diets were significantly associated with decreases in hepatic steatosis index (HSI), US fatty liver index and nonalcoholic fatty liver disease fibrosis score with mean differences of -2.70 (95% confidence interval [CI]: -3.69, -1.70), -3.03 (95% CI: -7.15, -0.91) and -0.12 (95% CI: -0.26, -0.01), respectively. While modelling the risk of NAFLD, we estimated that vegetarians were 53% less likely to have NAFLD assessed by HSI (odds ratios [OR]: 0.47; 95% CI: 0.34, 0.65). The effect of vegetarian diets was higher among individuals with lower waist circumferences (OR: 0.20) than among those with higher waist circumferences (OR: 0.53, p interaction ${p}_{\\text{interaction}}\\,$ = 0.004). However, the association was largely attenuated after adjusting for body mass index and diabetes status. No significant association was identified between vegetarian diets and advanced fibrosis.
CONCLUSIONS: Vegetarian diets were associated with a lower prevalence of NAFLD among US adults, and the association appeared to be stronger in people with lower waist circumferences. Further studies are warranted to replicate our findings.
方法:来自23,130名年龄≥20岁的参与者的横截面数据来自国家健康和营养检查调查,2005-2018。根据两次24小时饮食回忆对素食状态进行分类。我们使用倾向评分加权方法检查了素食饮食与NAFLD风险之间的关系。
结果:素食与肝脏脂肪变性指数(HSI)的降低显着相关,美国脂肪肝指数和非酒精性脂肪肝疾病纤维化评分平均差异为-2.70(95%置信区间[CI]:-3.69,-1.70),-3.03(95%CI:-7.15,-0.91)和-0.12(95%CI:-0.26,-0.01),分别。在模拟NAFLD的风险时,我们估计,通过HSI评估,素食者患NAFLD的可能性降低了53%(比值比[OR]:0.47;95%CI:0.34,0.65).在腰围较低(OR:0.20)的个体中,素食的效果要高于腰围较高的个体(OR:0.53,p交互作用${p}_{\\text{交互作用}}\\,$=0.004)。然而,在校正体重指数和糖尿病状态后,这种关联在很大程度上减弱.在素食饮食和晚期纤维化之间没有发现显着关联。
结论:在美国成年人中,素食与较低的NAFLD患病率相关,在腰围较低的人群中,这种关联似乎更强。需要进一步的研究来复制我们的发现。