膳食n-3多不饱和脂肪酸对非酒精性脂肪性肝病的影响

The association of dietary intake of n-3 polyunsaturated fatty acids and non-alcoholic fatty liver disease

目的探讨广州社区居民膳食n-3多不饱和脂肪酸(n-3 PUFAs)对非酒精性脂肪性肝病(NAFLD)的影响。方法 3 049例研究对象来自"广州居民营养与健康队列研究",其中NAFLD患者1 517人,正常组1 532人。采用膳食频率问卷收集膳食n-3 PUFAs包括二十二碳六烯酸(DHA),二十碳五烯酸(EPA),α-亚麻酸(ALA))的摄入水平,采用多普勒超声仪对肝脏进行超声检查并按中华医学会肝病学分会诊断标准进行NAFLD的诊断。结果 Logistic回归分析显示DHA、DHA+EPA摄入水平与NAFLD呈负相关关系,与最低四分位相比,最高四分位OR值分别为0.70(0.49~0.96)、0.75(0.52~1.00),差异有统计学意义(P<0.05)。随着患病程度的加重,DHA、EPA、DHA+EPA百分比浓度呈下降趋势(P<0.05),与正常组比中重度脂肪肝浓度分别下降了26.8%、22.8%和25.3%。结论膳食n-3 PUFAs是NAFLD的保护因素,对于NAFLD患者,可通过指导富含n-3 PUFA特别是DHA的膳食,从而改善NAFLD。

Objective To investigate the association between dietary intake of n-3 polyunsaturated fatty acids （n-3 PUFAs） and non-alcoholic fatty liver disease （NAFLD） among Chinese adults. Methods Subjects were derived from Guangzhou Nutrition and Health Study （GNHS）. The dietary intake of n-3 PUFAs of the subjects were surveyed with food frequency questionnaire, and NAFLD was examined by ultrasound. Results 3 049 subjects were included in this study. After adjusting for potential confounders, inverse association between dietary intake of DHA, DHA＋EPA and NAFLD was observed. The adjusted OR （95%C1） of NAFLD for the highest （vs. lowest） quatile were 0.70 （0.49-0.96） for DHA, 0.？5 （0.52-1.00） for DHA＋EPA （ all P〈O.05 ）. The mean weight percentages of DHA, EPA, DHA＋EPA significantly were decreased with the increased severity of NAFLD （all P trend 〈0.05）. And compared with the normal group, the weight percentages of moderate and severe group were decreased by 26.8%, 22.8% and 25.3%, respectively. Conclusions Dietary intake of n-3 PUFAs was protective factor for NAFLD. Dietary guidance on intaking food rich in n-3 PUFAs could improve NAFLD.