A flavonoid-rich diet is associated with lower risk and improved imaging biomarkers of nonalcoholic fatty liver disease: a prospective cohort study

IF 6.9 1区医学 Q1 NUTRITION & DIETETICS American Journal of Clinical Nutrition Pub Date : 2024-12-01 Epub Date: 2024-09-26 DOI:10.1016/j.ajcnut.2024.09.022

William Bell , Amy Jennings , Alysha S Thompson , Nicola P Bondonno , Anna Tresserra-Rimbau , Tilman Kühn , Aedín Cassidy

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引用次数: 0

Abstract

Background

Mechanistic studies and short-term randomized trials suggest higher intakes of dietary flavonoids may protect against nonalcoholic fatty liver disease (NAFLD).

Objectives

We aimed to perform the first population-based study with long-term follow-up on flavonoid consumption, incident NAFLD, and validated NAFLD biomarkers.

Methods

In a prospective study, we assessed the associations between flavonoid intake based on ≥2 24-h dietary assessments and NAFLD risk among 121,064 adults aged 40–69 y by multivariable Cox regression analyses. We further assessed the associations between flavonoid intake and magnetic resonance imaging-derived liver fat (a subset of n = 11,435) and liver-corrected T1 values (cT1; a subset of n = 9570), a marker of steatosis, more sensitive to inflammatory pathology.

Results

Over 10 y of follow-up, 1081 cases of NAFLD were identified. Participants in the highest quartile (Q4) of the flavodiet score reflecting the consumption of foods high in flavonoids, had a 19% lower risk of NAFLD compared to the lowest quartile (Q1) [hazard ratio (HR) (95% confidence interval (CI): 0.81 (0.67, 0.97), P-trend = 0.02)]. Moreover, participants in the Q4 of the flavodiet score had lower liver fat and cT1 values than those in Q1 (liver fat: relative difference Q1 compared with Q4: –5.28%, P-trend = <0.001; cT1: relative difference Q1 compared with Q4: –1.73%, P-trend = <0.001). When compared to low intakes, high intakes of apples and tea were associated with lower NAFLD risk [apples: HR (95% CI): 0.78 (0.67, 0.92), P-trend = <0.01; tea: HR (95% CI): 0.86 (0.72, 1.02), P-trend = 0.03)]. Additionally, when compared to low intakes, high apple, tea, and dark chocolate intakes were significantly associated with lower liver fat values, whereas high tea and red pepper intakes were significantly associated with lower cT1 values.

Conclusions

The consumption of flavonoid-rich foods was associated with a reduced risk of NAFLD among middle-aged adults.

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富含类黄酮的饮食与降低非酒精性脂肪肝风险和改善成像生物标志物有关：一项前瞻性队列研究。

背景和目的：机理研究和短期随机试验表明，摄入较多的膳食类黄酮可预防非酒精性脂肪肝（NAFLD）：我们旨在开展首个基于人群的研究，长期跟踪类黄酮的摄入量、非酒精性脂肪肝的发病率以及非酒精性脂肪肝的有效生物标志物：在一项前瞻性研究中，我们通过多变量考克斯回归分析评估了121,064名年龄在40至69岁之间的成年人类黄酮摄入量与非酒精性脂肪肝风险之间的关系。我们进一步评估了类黄酮摄入量与核磁共振成像肝脏脂肪（子集，n = 11,435）和肝脏校正T1值（cT1，子集，n = 9,570）之间的关系，肝脏校正T1值是脂肪变性的标志物，对炎症病理更敏感：在10年的随访中，共发现1081例非酒精性脂肪肝病例。黄酮饮食评分（FDS）最高四分位数（Q4）的参与者与最低四分位数（Q1）的参与者相比，患非酒精性脂肪肝的风险降低了19%（HR (95%CI): 0.81 (0.67, 0.97)，P=0.02）。此外，与第一季度的参与者相比，FDS 第四季度参与者的肝脏脂肪和 cT1 值更低（肝脏脂肪：Q1 与 Q4 的相对差异：-5.28%，P 趋势 = 结论：与第一季度的参与者相比，FDS 第四季度参与者的肝脏脂肪和 cT1 值更低（肝脏脂肪：Q1 与 Q4 的相对差异：-5.28%，P 趋势 =）：食用富含类黄酮的食物与中年人非酒精性脂肪肝风险的降低有关。

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来源期刊

American Journal of Clinical Nutrition 医学-营养学

CiteScore

12.40

自引率

4.20%

发文量

332

审稿时长

38 days

期刊介绍： American Journal of Clinical Nutrition is recognized as the most highly rated peer-reviewed, primary research journal in nutrition and dietetics.It focuses on publishing the latest research on various topics in nutrition, including but not limited to obesity, vitamins and minerals, nutrition and disease, and energy metabolism. Purpose: The purpose of AJCN is to: Publish original research studies relevant to human and clinical nutrition. Consider well-controlled clinical studies describing scientific mechanisms, efficacy, and safety of dietary interventions in the context of disease prevention or health benefits. Encourage public health and epidemiologic studies relevant to human nutrition. Promote innovative investigations of nutritional questions employing epigenetic, genomic, proteomic, and metabolomic approaches. Include solicited editorials, book reviews, solicited or unsolicited review articles, invited controversy position papers, and letters to the Editor related to prior AJCN articles. Peer Review Process: All submitted material with scientific content undergoes peer review by the Editors or their designees before acceptance for publication.