收稿日期: 2023-12-28
网络出版日期: 2024-04-08
基金资助
江苏省研究计划面上项目(BK20211004)
The association between vitamin intake and the progression of metabolic dysfunction⁃associated fatty liver disease
Received date: 2023-12-28
Online published: 2024-04-08
目的 探讨膳食多种维生素摄入量与代谢相关脂肪性肝病（metabolic dysfunction-associated fatty liver disease， MAFLD）个体肝纤维化风险及全因死亡率之间的相关性。 方法 从美国第三次国家健康和营养检查调查（National Health and Nutrition Examination Surveys，NHANES）中获取相关数据，并采用24 h饮食回顾法评估膳食维生素摄入情况，包括维生素A、维生素B1、维生素B6、维生素B12、维生素C、维生素D、核黄素、叶酸和α-生育酚。非酒精性脂肪性肝病纤维化评分（non-alcoholic fatty liver disease fibrosis score， NFS） < -1.455被定义为非高级别纤维化，NFS ≥ -1.455被定义为高级别纤维化。 结果 共纳入3 844例MAFLD个体，中位随访时间为25年10个月，其中1 739例（45.3%）个体在随访期间死亡。非高级别纤维化个体的维生素B1、核黄素、α-生育酚、VB6和VB12摄入量显著高于对照组（P < 0.05）。调整风险因素后，α-生育酚摄入量最高四分位数组（> 11.5 mg/d）的纤维化风险明显低于摄入量最低四分位数组（P = 0.031）。与VC摄入量最低四分位数组相比，最高四分位数组（> 130 mg/d）的死亡率降低了0.34倍（HR： 0.66， 95% CI： 0.51 ~ 0.85， P = 0.001）。 结论 摄入更多α-生育酚可减轻MAFLD个体的纤维化，摄入更多VC可降低MAFLD个体的全因死亡率。
姚仁玲 , 朱艺璇 , 黄睿 , 李婕 . 维生素摄入量与代谢相关脂肪性肝病进程的相关性分析[J]. 实用医学杂志, 2024 , 40(6) : 820 -826 . DOI: 10.3969/j.issn.1006-5725.2024.06.015
Objective There is a Few studies explored the association between vitamin intake and metabolic dysfunction?associated fatty liver disease （MAFLD）， while the existing results were still contradictory. This study aimed to investigate the association between dietary vitamins and all?cause mortality as well as fibrosis risk in patients with MAFLD. Methods The data were extracted from the third National Health and Nutrition Examination Surveys 1988-1994. Dietary vitamins was assessed using a 24 h diet recall， including vitamin A， vitamin B6， vitamin B12， vitamin C， vitamin D， thiamin， riboflavin， folic acid and α?tocopherol. The non?alcoholic fatty liver disease fibrosis score （NFS） < -1.455 was considered as non?advanced fibrosis， while NFS ≥ -1.455 was considered as advanced fibrosis. Results A total of 3844 MAFLD participants were included in this study. The median time of follow?up was 310 months. 1739 participants （45.3%） were deceased during the follow?up. The intake of thiamin， riboflavin， α?tocopherol， VB6， and VB12 were significantly higher in patients with NFS?determined non?advanced fibrosis （P < 0.05）. After adjusting， a significantly lower risk of fibrosis was found in patients with the highest quartile （> 11.5 mg/d） of α?tocopherol intake compared to the lowest intake group （P = 0.031）. Compared to the lowest quartile group， the risk of mortality was reduced by 0.34 folds in the group consuming the highest quartile amount （> 130 mg/d） of VC （HRs： 0.66， 95% CI： 0.51 ~ 0.85， P = 0.001）. Conclusions More α?tocopherol intake reduced fibrosis grade in MAFLD patients. VC intake may reduce all?cause mortality in patients with MAFLD.
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