成年人膳食模式与代谢相关脂肪性肝病亚型的关联性

Relationship between dietary patterns and metabolism-associated fatty liver disease subtype in adult

目的探讨不同膳食模式与代谢相关脂肪性肝病(metabolic associated fatty liver disease, MAFLD)亚型的相关性。方法选取2022年1月至2023年3月在大连医科大学附属第二医院健康管理中心的6 022名体检人群作为研究对象。将MAFLD分为超重/肥胖型、代谢紊乱型、糖尿病型三种亚型。采用因子分析法进行膳食模式的提取。使用logistic回归分析膳食模式对MAFLD患病的影响, 构建摄入膳食模式与年龄、性别及身体锻炼分层的乘积项模型。结果因子分析后根据特征排序提取4种膳食模式, 分别命名为优质蛋白模式、果蔬模式、蛋类水产模式、加工腌熏模式。未调整模型的回归分析显示优质蛋白模式和超重/肥胖型及糖尿病型MAFLD呈负相关, 经模型调整后的回归分析发现加工腌熏模式与MAFLD各分型风险呈正相关, 果蔬模式与超重/肥胖型MAFLD呈正相关(P<0.05)。亚组分析结果提示高摄入加工腌熏模式的女性(OR=1.55, 95%CI 1.14~2.15)比男性(OR=1.18, 95%CI 1.02~1.49)更容易发生超重/肥胖型MAFLD。结论研究提示优质蛋白模式与MAFLD呈负相关, 果蔬模式和加工腌熏模式与MAFLD呈正相关, 高摄入加工腌熏模式下女性相比男性更易发生超重/肥胖型MAFLD。建议MAFLD患者都应减少加工腌制品和高果糖食物的摄入, 适当食用优质蛋白食物, 均衡膳食方式。

Objective To investigate the association between different dietary patterns and subtypes of metabolic associated fatty liver disease(MAFLD).Methods A total of 6022 check-ups at the health management center of the Second Hospital of Dalian Medical University from January 2022 to March 2023 were selected as study subjects.MAFLD was categorised into three subtypes:overweight/obese type,metabolic disorder type,and diabetic type.Factor analysis was used to extract dietary patterns.Logistic regression was used to assess the impact of dietary patterns on MAFLD occurrence,constructing interaction models between dietary patterns intake and age,gender,and physical exercise levels.Results Four dietary patterns were extracted based on feature sorting after factor analysis and were named as the high-quality protein pattern,the fruit-vegetable pattern,egg-aquatic pattern,and the processed meat pattern.Regression analysis of the unadjusted model showed that overweight/obese and diabetic types of MAFLD were negatively associated with the high-quality protein mode,while model-adjusted regression analysis showed that the processed meat pattern was positively associated with the risk of MAFLD,and fruit-vegetable pattern was positively associated with overweight/obese MAFLD(P<0.05).The results of subgroup analyses suggested that female(OR=1.55,95%CI 1.14-2.15)with a high intake of pickle pattern had a higher risk of overweight/obese MAFLD than male(OR=1.18,95%CI 1.02-1.49).Conclusion High-quality protein pattern was negatively correlated with MAFLD,whereas fruit-vegetable pattern and processed meat pattern were positively correlated with MAFLD.Female with high consumption of processed meat pattern are more likely to develop overweight/obesity MAFLD compared with male.It is recommended that people with MAFLD reduce their intake of processed products and high-fructose food,and consume adequate amounts of high-quality protein food to maintain a balanced diet.