The associations between dairy intake and chronic liver disease mortality and liver cancer incidence: a prospective cohort study

IF 6.5 1区医学 Q1 NUTRITION & DIETETICS

American Journal of Clinical Nutrition Pub Date : 2025-07-01 DOI:10.1016/j.ajcnut.2025.04.028

Xing Liu , Xinyuan Zhang , Longgang Zhao , Jessica L Petrick , Linda M Liao , Weibing Wang , Na He , Edward Giovannucci , Zuo-Feng Zhang , Katherine A McGlynn , Xuehong Zhang

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引用次数: 0

Abstract

Background

The incidence and prevalence of chronic liver diseases (CLD) and liver cancer are increasing worldwide.

Objectives

This study aimed to evaluate the associations between the intake levels of high-fat and low-fat dairy products and CLD mortality and liver cancer incidence.

Methods

This study included eligible participants from the NIH–American Association of Retired Persons Diet and Health Study cohort established between 1995 and 1996. Epidemiological data, including dietary factors, were collected using a self-administered validated questionnaire. Portion size and frequency of intake of dairy products were recorded. Cox proportional hazard models were used to examine the associations.

Results

A total of 485,931 eligible participants, 59.8% male, with an average age of 61.5 y (SD = 5.4 y) at baseline were included in this analysis after excluding those with pre-existing cancer diagnoses or extreme caloric intakes. During a median follow-up of 15.5 y, 993 deaths from CLD and 940 incident liver cancer cases occurred. CLD mortality was positively associated with intake of high-fat dairy [hazard ratio (HR)_{21+ compared with 0–<3.5 serv/wk} = 1.51, 95% confidence interval (CI): 1.24, 1.84, P_trend = 0.009] and high-fat milk (HR_{14+ compared with 0 serv/wk} = 2.03, 95% CI: 1.31, 3.14, P_trend <0.001), and was inversely associated with low-fat dairy (HR_{21+ compared with 0–<3.5 serv/wk} =0.62, 95% CI: 0.46, 0.84, P_trend = 0.002), low-fat milk (HR_{14+ compared with 0 serv/wk} =0.54, 95% CI: 0.41, 0.70, P_trend = 0.028) and yogurt (HR_{4+ compared with 0 serv/wk} = 0.60, 95% CI: 0.37, 0.97, P_trend = 0.057). Total dairy intake (HR_{21–<28 compared with 0–<7 serv/wk} = 1.26, 95% CI: 0.99, 1.59, P_trend = 0.040) and high-fat dairy (HR_{14–<21 compared with 0–<3.5 serv/wk} = 1.35, 95% CI: 1.07, 1.70, P_trend = 0.14) showed marginally positive association with liver cancer risk. Milk intake was positively associated with risk of hepatocellular carcinoma (HCC).

Conclusions

High-fat dairy intake is positively associated with CLD mortality, and low-fat dairy shows an inverse association. Total dairy intake is marginally positively associated with liver cancer, and milk intake is positively associated with HCC.

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乳制品摄入量与慢性肝病死亡率和肝癌发病率之间的关系：一项前瞻性队列研究

背景：慢性肝病（CLD）和肝癌的发病率和患病率在世界范围内呈上升趋势。目的：本研究旨在评估高脂和低脂乳制品摄入水平与CLD死亡率和肝癌发病率之间的关系。方法：本研究纳入了1995-1996年建立的美国国立卫生研究院(NIH)-美国退休人员协会（AARP）饮食与健康研究队列的合格参与者。流行病学数据，包括饮食因素，采用自我管理的有效问卷收集。记录了乳制品的摄入量和频率。采用Cox比例风险模型检验相关性。结果：共有485,931名符合条件的参与者，其中59.8%为男性，基线时平均年龄为61.5岁（SD=5.4岁），排除了已有癌症诊断或极端热量摄入的参与者。在15.5年的中位随访期间，发生了993例CLD死亡和940例肝癌。CLD死亡率与摄入高脂乳制品（HR 21+与0-相比=1.51,95% CI: 1.24, 1.84, Ptrend=0.009）、高脂牛奶（HR14+与0-相比=2.03,95% CI: 1.31, 3.14， Ptrend21+与0-相比=0.62,95% CI: 0.46, 0.84, Ptrend=0.002）、低脂牛奶（HR14+与0-相比=0.54,95% CI: 0.41, 0.70, Ptrend=0.028）和酸奶（HR4+与0-相比=0.60,95% CI: 0.37, 0.97, Ptrend=0.057）呈正相关。总乳制品摄入量（HR21-=1.26, 95% CI: 0.99, 1.59， p趋势=0.040）和高脂乳制品（HR14-=1.35, 95% CI: 1.07, 1.70， p趋势=0.14）与肝癌风险呈微正相关。牛奶摄入量与肝细胞癌（HCC）的风险呈正相关。结论：高脂乳制品与CLD死亡率呈正相关，低脂乳制品与CLD死亡率呈负相关。总乳制品摄入量与肝癌呈微弱正相关，牛奶摄入量与HCC呈正相关。

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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.