Evaluating the impact of the Dietary Approaches to Stop Hypertension diet versus a calorie-restricted diet on metabolic dysfunction-associated steatotic liver disease: A meta-analysis of randomized controlled trials

IF 3.4 3区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Hepatology Research Pub Date : 2024-12-26 DOI:10.1111/hepr.14155

Fariha Hasan, Avneet Singh, Alexander Garcia, Syeda Hafsa Qadri, Hina Sattar, Rimmel Ali, Hassam Ali, Tommy Nguyen, Babu P. Mohan, Krysta Contino

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Abstract

Aim

Metabolic dysfunction-associated steatotic liver disease (MASLD) can lead to increased morbidity and mortality. Diets high in refined carbohydrates and saturated fats elevate MASLD risk. The Dietary Approaches to Stop Hypertension (DASH) diet has shown metabolic benefits. This meta-analysis evaluates the impact of the DASH diet on MASLD progression.

Methods

A systematic search from 2016 to 2023 across PubMed, Embase, Web of Science, and Cochrane databases was conducted to identify studies reporting on the role of the DASH diet in MASLD. Standard meta-analysis methods were employed using a random-effects model. Heterogeneity was assessed by I² statistics.

Results

We identified five randomized controlled trials meeting inclusion criteria, involving 280 participants (140 in the DASH group and 140 in the control group). Mean ages were approximately 41 years, and the proportions of women were similar between groups. Compared with controls, the DASH diet group had a significantly reduced risk of grade 0 and 1 liver fibrosis (RR 1.21, 95% CI 1.04–1.41, p = 0.01). They also showed lower levels of aspartate aminotransferase (MD −4.81, 95% CI −6.98 to −2.64, p < 0.0001), alanine aminotransferase (MD −10.31, 95% CI −13.82 to −6.80, p < 0.00001), body mass index (MD −0.74, 95% CI −1.45 to −0.03, p = 0.04), and cholesterol-to-high-density lipoprotein ratio (MD −0.40, 95% CI −0.68 to −0.11, p = 0.006). No significant differences were found for weight, waist and hip circumference, total cholesterol, low-density lipoprotein, or high-density lipoprotein levels. Heterogeneity was low for most outcomes (I² = 0%).

Conclusion

Based on our meta-analysis of five randomized controlled trials, the DASH diet may reduce MASLD progression. These findings suggest it could be an effective dietary intervention for MASLD management.

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评估停止高血压饮食与限制热量饮食对代谢功能障碍相关脂肪变性肝病的影响：随机对照试验的荟萃分析

目的代谢功能障碍相关脂肪变性肝病（MASLD）可导致发病率和死亡率增高。高精制碳水化合物和饱和脂肪的饮食会增加MASLD的风险。饮食方法停止高血压（DASH）饮食已显示出代谢益处。本荟萃分析评估DASH饮食对MASLD进展的影响。方法系统检索2016年至2023年PubMed、Embase、Web of Science和Cochrane数据库，以确定有关DASH饮食在MASLD中作用的研究。采用随机效应模型的标准荟萃分析方法。采用I2统计量评估异质性。结果我们确定了5个符合纳入标准的随机对照试验，涉及280名参与者（140名在DASH组，140名在对照组）。平均年龄约为41岁，两组女性的比例相似。与对照组相比，DASH饮食组显著降低了0级和1级肝纤维化的风险（RR 1.21, 95% CI 1.04-1.41, p = 0.01）。他们也表现出较低的天冬氨酸转氨酶水平(MD - 4.81, 95% CI - 6.98 ~ - 2.64, p <；0.0001)，丙氨酸转氨酶(MD - 10.31, 95% CI - 13.82 ~ - 6.80, p <；0.00001)、体重指数（MD - 0.74, 95% CI - 1.45至- 0.03,p = 0.04）和胆固醇与高密度脂蛋白比值（MD - 0.40, 95% CI - 0.68至- 0.11,p = 0.006）。体重、腰围和臀围、总胆固醇、低密度脂蛋白和高密度脂蛋白水平均无显著差异。大多数结果的异质性较低（I2 = 0%）。结论：根据我们对五项随机对照试验的荟萃分析，DASH饮食可能会减少MASLD的进展。这些发现表明，它可能是对MASLD管理有效的饮食干预。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hepatology Research 医学-胃肠肝病学

CiteScore

8.30

自引率

14.30%

发文量

124

审稿时长

1 months

期刊介绍： Hepatology Research (formerly International Hepatology Communications) is the official journal of the Japan Society of Hepatology, and publishes original articles, reviews and short comunications dealing with hepatology. Reviews or mini-reviews are especially welcomed from those areas within hepatology undergoing rapid changes. Short communications should contain concise definitive information.