The relationship between nutrient intake, lifestyle, and non-alcoholic fatty liver disease in patients with type 2 diabetes mellitus: Results from the National Health and Nutrition Examination Surveys 2007–2018

IF 2.9 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2025-02-22 DOI:10.1016/j.clnesp.2025.02.008

Liangyuanhui Sun , Zhiqing He , Yanbin Li , Zijun Huo , Liehua Liu

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引用次数: 0

Abstract

Objective

More than half of the individuals with type 2 diabetes mellitus (T2DM) are accompanied by Non-alcoholic fatty liver disease (NAFLD). This study aimed to explore the relationship between nutrient intake, lifestyle, and the risk NAFLD in patients with T2DM.

Methods

This study comprised 2110 adult patients with diabetes from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018. We employed weighted logistic regression to assess the associations between nutrient intake, lifestyle and NAFLD, while exploring potential non-linear relationships using restrictive cubic spline analysis. Additionally, we validated our findings through subgroup analyses and sensitivity analyses to ensure the robustness and reliability of our results.

Result

Out of 2110 diabetes patients, 1743 were diagnosed with NAFLD, and 53.43 % of them were male. After adjusting for potential confounders, we found a negative correlation between Vitamin K intake and the occurrence of NAFLD in patients with T2DM (OR = 0.885 [0.829, 0.959]). This dose–response relationship was further validated through stratification analysis by tertiles of vitamin K intake. Lycopene intake is identified as a risk factor for NAFLD in patients with T2DM. Specifically, for every 100 μg of lycopene ingested, there was a 0.2 % higher likelihood of NAFLD (OR = 1.002 [1.0001, 1.005], p < 0.05). Conversely, a 0.5 % reduction in NAFLD risk was observed with the same amount of lutein intake (OR = 0.995 [0.992, 0.999], p < 0.05). Furthermore, we also found that a high-quality diet can reduce the risk of NAFLD in patients with T2DM, with an odds ratio of 0.208 (0.101, 0.430).

Conclusion

Increasing intake of Vitamin K and lutein, reducing intake of lycopene, and improving dietary quality may lower the risk of NAFLD in patients with T2DM.

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2型糖尿病患者营养摄入、生活方式与非酒精性脂肪性肝病的关系：2007-2018年全国健康与营养调查结果

目的：超过一半的2型糖尿病（T2DM）患者伴有非酒精性脂肪性肝病（NAFLD）。本研究旨在探讨2型糖尿病患者营养摄入、生活方式与NAFLD风险之间的关系。方法：本研究纳入了2007年至2018年国家健康与营养调查（NHANES）的2110名成年糖尿病患者。我们采用加权逻辑回归来评估营养摄入、生活方式和NAFLD之间的关系，同时使用限制性三次样条分析探索潜在的非线性关系。此外，我们通过亚组分析和敏感性分析验证了我们的发现，以确保我们的结果的稳健性和可靠性。结果：2110例糖尿病患者中有1743例确诊为NAFLD，男性占53.43%。在对潜在混杂因素进行校正后，我们发现维生素K摄入量与T2DM患者NAFLD的发生呈负相关（OR = 0.885[0.829, 0.959]）。通过维生素K摄入量的分位数分层分析，进一步验证了这种剂量-反应关系。番茄红素摄入量被确定为T2DM患者NAFLD的危险因素。具体而言，每摄入100 μg番茄红素，NAFLD的可能性增加0.2% （OR = 1.002 [1.0001, 1.005], p < 0.05）。相反，摄入相同量的叶黄素可使NAFLD风险降低0.5% （OR = 0.995 [0.992, 0.999], p < 0.05）。此外，我们还发现，高质量的饮食可以降低T2DM患者NAFLD的风险，优势比为0.208（0.101,0.430）。结论：增加维生素K和叶黄素的摄入，减少番茄红素的摄入，改善饮食质量可降低T2DM患者NAFLD的发生风险。

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

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.