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Abstract：
BACKGROUND: Although several epidemiological studies have identified an inverse association between healthy dietary patterns and metabolic dysfunction-associated steatotic liver disease (MASLD)/non-alcoholic fatty liver disease (NAFLD), little is known about the contribution of the food component to MASLD risk and the association between dietary patterns and severity of MASLD. This study aimed to investigate the association between healthy eating patterns and MASLD risk and severity of MASLD.
METHODS: A case-control study including 228 patients diagnosed with MASLD and 228 controls was conducted. The modified Alternate Healthy Eating Index (AHEI), Dietary Approaches to Stop Hypertension (DASH) score, and Alternative Mediterranean Diet (AMED) score were evaluated based on information collected via a validated food-frequency questionnaire. MASLD was confirmed if participants presented with ultrasound-diagnosed fatty liver diseases along with at least one of five cardiometabolic risk factors and no other discernible cause. The logistic regression models were applied to estimate the odds ratio (OR) and 95% confidence interval (95% CI) of MASLD for dietary scores.
RESULTS: Compared with participants in the lowest tertile, those in the highest tertile of AHEI had a 60% reduced risk of MASLD (OR: 0.40; 95% CI: 0.25-0.66). Similar associations were also observed for DASH and AMED, with ORs comparing extreme tertiles of 0.38 (95% CI: 0.22-0.66) and 0.46 (95% CI: 0.28-0.73), respectively. Further Stratified analysis revealed that the inverse associations between AHEI and DASH with MASLD risks were stronger among women than men, and the inverse associations between AMED and MASLD risks were more pronounced among participants with normal weight (OR: 0.22; 95% CI: 0.09-0.49). For components within the dietary score, every one-point increase in vegetable score and whole grain score within the AHEI was associated with an 11% (95% CI: 5-16%) and a 6% (95% CI: 0-12%) lower MASLD risk, respectively. Similar inverse associations with those scores were observed for the DASH and AMED.
CONCLUSIONS: Greater adherence to healthy eating patterns was associated with reduced risk of MASLD, with vegetables and whole grains predominately contributing to these associations. These findings suggested that healthy eating patterns should be recommended for the prevention of MASLD.
METHODS: A case-control study including 228 patients diagnosed with MASLD and 228 controls was conducted. The modified Alternate Healthy Eating Index (AHEI), Dietary Approaches to Stop Hypertension (DASH) score, and Alternative Mediterranean Diet (AMED) score were evaluated based on information collected via a validated food-frequency questionnaire. MASLD was confirmed if participants presented with ultrasound-diagnosed fatty liver diseases along with at least one of five cardiometabolic risk factors and no other discernible cause. The logistic regression models were applied to estimate the odds ratio (OR) and 95% confidence interval (95% CI) of MASLD for dietary scores.
RESULTS: Compared with participants in the lowest tertile, those in the highest tertile of AHEI had a 60% reduced risk of MASLD (OR: 0.40; 95% CI: 0.25-0.66). Similar associations were also observed for DASH and AMED, with ORs comparing extreme tertiles of 0.38 (95% CI: 0.22-0.66) and 0.46 (95% CI: 0.28-0.73), respectively. Further Stratified analysis revealed that the inverse associations between AHEI and DASH with MASLD risks were stronger among women than men, and the inverse associations between AMED and MASLD risks were more pronounced among participants with normal weight (OR: 0.22; 95% CI: 0.09-0.49). For components within the dietary score, every one-point increase in vegetable score and whole grain score within the AHEI was associated with an 11% (95% CI: 5-16%) and a 6% (95% CI: 0-12%) lower MASLD risk, respectively. Similar inverse associations with those scores were observed for the DASH and AMED.
CONCLUSIONS: Greater adherence to healthy eating patterns was associated with reduced risk of MASLD, with vegetables and whole grains predominately contributing to these associations. These findings suggested that healthy eating patterns should be recommended for the prevention of MASLD.
摘要：
背景：尽管一些流行病学研究已经确定了健康饮食模式与代谢功能障碍相关的脂肪变性肝病（MASLD）/非酒精性脂肪性肝病（NAFLD）之间的负相关，关于食物成分对MASLD风险的影响以及饮食模式与MASLD严重程度之间的关系知之甚少。本研究旨在调查健康饮食模式与MASLD风险和MASLD严重程度之间的关系。
方法：进行病例对照研究，包括228例诊断为MASLD的患者和228例对照。修改后的替代健康饮食指数(AHEI)，停止高血压的饮食方法（DASH）评分，和替代地中海饮食（AMED）评分基于通过经过验证的食物频率问卷收集的信息进行评估。如果参与者出现超声诊断的脂肪肝疾病以及至少五个心脏代谢危险因素之一并且没有其他可辨别的原因，则确认MASLD。逻辑回归模型用于估计饮食评分的MASLD的比值比（OR）和95％置信区间（95％CI）。
结果：与最低三分位数的参与者相比，AHEI最高三分位数的患者的MASLD风险降低了60%(OR:0.40;95%CI:0.25~0.66).DASH和AMED也观察到类似的关联，OR比较极端三元率为0.38(95%CI：0.22-0.66)和0.46(95%CI：0.28-0.73)，分别。进一步的分层分析表明，AHEI和DASH与MASLD风险之间的负相关在女性中比男性更强，在体重正常的参与者中,AMED和MASLD风险之间的负相关更为明显(OR:0.22;95%CI:0.09~0.49).对于饮食评分中的成分，AHEI内蔬菜评分和全麦评分每增加1分，MASLD风险降低11%（95%CI：5-16%）和6%（95%CI：0-12%），分别。对于DASH和AMED,观察到与这些分数类似的逆关联。
结论：更坚持健康饮食模式与降低MASLD风险相关，蔬菜和全谷物主要促成了这些联系。这些发现表明，应推荐健康的饮食模式来预防MASLD。
方法：进行病例对照研究，包括228例诊断为MASLD的患者和228例对照。修改后的替代健康饮食指数(AHEI)，停止高血压的饮食方法（DASH）评分，和替代地中海饮食（AMED）评分基于通过经过验证的食物频率问卷收集的信息进行评估。如果参与者出现超声诊断的脂肪肝疾病以及至少五个心脏代谢危险因素之一并且没有其他可辨别的原因，则确认MASLD。逻辑回归模型用于估计饮食评分的MASLD的比值比（OR）和95％置信区间（95％CI）。
结果：与最低三分位数的参与者相比，AHEI最高三分位数的患者的MASLD风险降低了60%(OR:0.40;95%CI:0.25~0.66).DASH和AMED也观察到类似的关联，OR比较极端三元率为0.38(95%CI：0.22-0.66)和0.46(95%CI：0.28-0.73)，分别。进一步的分层分析表明，AHEI和DASH与MASLD风险之间的负相关在女性中比男性更强，在体重正常的参与者中,AMED和MASLD风险之间的负相关更为明显(OR:0.22;95%CI:0.09~0.49).对于饮食评分中的成分，AHEI内蔬菜评分和全麦评分每增加1分，MASLD风险降低11%（95%CI：5-16%）和6%（95%CI：0-12%），分别。对于DASH和AMED,观察到与这些分数类似的逆关联。
结论：更坚持健康饮食模式与降低MASLD风险相关，蔬菜和全谷物主要促成了这些联系。这些发现表明，应推荐健康的饮食模式来预防MASLD。
