Dietary inflammatory index and risk of non-alcoholic fatty liver disease and advanced hepatic fibrosis in US adults

Zhongmian Zhang; Lan Wang; Zili Lin; Weitian Yan; Jiaqin Chen; Xiyan Zhang; Wangyu Ye; Jian Li; Zhihong Li

doi:10.3389/fnut.2023.1102660

Dietary inflammatory index and risk of non-alcoholic fatty liver disease and advanced hepatic fibrosis in US adults

Front Nutr. 2023 Jan 25:10:1102660. doi: 10.3389/fnut.2023.1102660. eCollection 2023.

Authors

Zhongmian Zhang¹, Lan Wang¹, Zili Lin¹, Weitian Yan², Jiaqin Chen¹, Xiyan Zhang¹, Wangyu Ye¹, Jian Li³, Zhihong Li¹

Affiliations

¹ Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
² The First Affiliated Hospital of Yunnan University of Chinese Medicine, Kunming, Yunnan, China.
³ Department of Histology and Embryology, Beijing University of Chinese Medicine, Beijing, China.

Abstract

Background and aims: This study aims to investigate whether the Dietary Inflammatory Index (DII) is associated with non-alcoholic fatty liver disease (NAFLD) and advanced hepatic fibrosis (AHF) among non-institutionalized adults in the United States.

Methods: Utilizing data from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2016, a total of 10,052 adults aged ≥18 years were included in the analysis. We used multivariable analysis, controlling for demographic variables, to evaluate the association between DII and NAFLD and AHF, a restricted cubic spline (RCS) was used to model the non-linear relationship between DII and NAFLD.

Results: For 10,052 participants, DII ranges from -4.63 to 5.47. Compared with quartile 1, higher DII group were associated with higher levels of female, separated/divorced, lower education level, heavy alcohol use, current smoke status, BMI, poverty income ratio, and waist circumference. DII also showed a significantly positive correlation with ALT, AST. In the fully adjusted multivariable model, DII was positively associated with the presence of NAFLD (OR 1.09, 1.06-1.13 CI, p trend <0.0001), and AHF (OR 1.15, 1.07-1.23 CI, p trend <0.001). The association remained statistically significant after stratified by gender in terms of NAFLD, but in case of AHF only in males (Q4 vs. Q1: OR 2.68, 1.63-4.41 CI, p trend <0.0001) was statistically significant. In the RCS models, the relation of DII and NAFLD started increase rapidly until around 1.80 and then started relatively flat afterward.

Conclusion: Higher pro-inflammatory level was associated with higher risk of NAFLD in males and females, and with higher risk of AHF in males but not in females. Therefore, strategies to promote an Zhang anti-inflammatory diet should be considered to prevent and ameliorate NAFLD and AHF in adults.

Keywords: NHANES; advanced hepatic fibrosis; dietary inflammatory index; non-alcoholic fatty liver disease; population-based study.

Grants and funding

This project was supported by the National Natural Science Foundation of China (Grants Number: 82074187).