Association between composite dietary antioxidant index and metabolic dysfunction associated steatotic liver disease: result from NHANES, 2017-2020 - PubMed (original) (raw)

Association between composite dietary antioxidant index and metabolic dysfunction associated steatotic liver disease: result from NHANES, 2017-2020

Zhaofu Zhang et al. Front Nutr. 2024.

Abstract

Background: The development of metabolic dysfunction associated steatotic liver disease (MASLD) has been associated with lipid accumulation, oxidative stress, endoplasmic reticulum stress, and lipotoxicity. The Composite Dietary Antioxidant Index (CDAI) is a comprehensive score representing an individual intake of various dietary antioxidants, including vitamin A, vitamin C, vitamin E, selenium, zinc, and carotenoids. This study investigated the association between CDAI and MASLD.

Materials and methods: Clinical and demographic data, as well as ultrasound transient elastography measurements at baseline, were collected from the National Health and Nutrition Examination Survey 2017-2020 (NHANES 2017-2020). The controlled attenuation parameter was utilized to diagnose the presence of hepatic steatosis and to categorize individuals into those with and without MASLD. Liver stiffness was measured by ultrasound transient elastography, and subjects were classified as those with and without advanced liver fibrosis.

Results: This study included 5,884 adults, of whom 3,433 were diagnosed with MASLD, resulting in a weighted prevalence of 57.3%. After adjusting for covariates, the odds ratios for MASLD were 0.96 (95% CI: 0.82, 1.12) in the second quartile, 0.80 (95% CI: 0.68, 0.95) in the third quartile and 0.60 (95% CI: 0.49, 0.73) in the fourth quartile, respectively. CDAI, however, was not significantly associated with advanced liver fibrosis.

Conclusion: These findings suggested that scores on the CDAI were linearly and negatively associated with the prevalence of MASLD in the United States adults.

Keywords: composite dietary antioxidant index; liver stiffness; metabolic dysfunction associated steatotic liver disease; oxidative stress; restricted cubic spline.

Copyright © 2024 Zhang, Wang and Chen.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1

Figure 1

Flowchart of participant selection. NHANES, National Health and Nutrition Examination Survey; CAP, controlled attenuation parameter; CDAI, composite dietary antioxidant index; MASLD, metabolic dysfunction associated steatotic liver disease.

Figure 2

Figure 2

Forest plot for analyzing the relationship between each component of composite dietary antioxidant index and metabolic dysfunction associated steatotic liver disease. OR, odds ratio; CI, confidence interval.

Figure 3

Figure 3

Restricted cubic spine model of the odds ratio of metabolic dysfunction associated steatotic liver disease with composite dietary antioxidant index. All were adjusted for age, sex, race, marital status, education level, poverty income ratio, alcohol intake, smoking, physical activity, and energy intake. CI, confidence interval.

Figure 4

Figure 4

Forest plot of stratified analyses of the relationship between composite dietary antioxidant index and metabolic dysfunction associated steatotic liver disease. Analyses were adjusted for covariates age, gender, race, marital status, education level, poverty income ratio, alcohol intake, smoking, physical activity, and energy intake, when they were not the strata variables. OR, odds ratio; CI, confidence interval.

References

    1. Rinella ME, Neuschwander-Tetri BA, Siddiqui MS, Abdelmalek MF, Caldwell S, Barb D, et al. Aasld practice guidance on the clinical assessment and management of nonalcoholic fatty liver disease. Hepatology. (2023) 77:1797–835. doi: 10.1097/hep.0000000000000323 - DOI - PMC - PubMed
    1. Chalasani N, Younossi Z, Lavine JE, Charlton M, Cusi K, Rinella M, et al. The diagnosis and Management of Nonalcoholic Fatty Liver Disease: practice guidance from the American Association for the Study of Liver Diseases. Hepatology. (2018) 67:328–57. doi: 10.1002/hep.29367 - DOI - PubMed
    1. Harrison SA, Bedossa P, Guy CD, Schattenberg JM, Loomba R, Taub R, et al. A phase 3, randomized, controlled trial of Resmetirom in Nash with liver fibrosis. N Engl J Med. (2024) 390:497–509. doi: 10.1056/NEJMoa2309000 - DOI - PubMed
    1. Karim G, Bansal MB. Resmetirom: an orally administered, Smallmolecule, liver-directed, Β-selective Thr agonist for the treatment of non-alcoholic fatty liver disease and non-alcoholic Steatohepatitis. touchREV Endocrinol. (2023) 19:60–70. doi: 10.17925/ee.2023.19.1.60 - DOI - PMC - PubMed
    1. Long MT, Noureddin M, Lim JK. Aga clinical practice update: diagnosis and management of nonalcoholic fatty liver disease in lean individuals: expert review. Gastroenterology. (2022) 163:764–774.e1. doi: 10.1053/j.gastro.2022.06.023 - DOI - PMC - PubMed

LinkOut - more resources