Research On The Association Between Dietary Patterns And Non-Alcoholic Fatty Liver Disease In Tianjin Middle-Aged And Elderly Population

Objective Non-alcoholic fatty liver disease(NAFLD)plays a principal role in the middle-aged and elderly population in China and is related to diet.The purpose of this study was to investigate the relationship between dietary patterns and NAFLD in the middle-aged and elderly population in Tianjin,and to provide scientific basis and theoretical support for the prevention and treatment of NAFLD.Methods The study population was obtained from the "Tianjin Chronic Low Grade Inflammation and Health Cohort" from May 2013 to December 2019.Participants completed a routine health examination as well as a questionnaire,and non-alcoholic fatty liver disease was diagnosed by abdominal ultrasound and self-report of alcohol intake.Continuous variables were exs rates or percentages.Analysis of covariance and logistic regression were used to describe differences in baseline characteristics of the population across dietary pattern scores and onset status of NAFLD.The main dietary patterns of the middle-aged and elderly population in Tianjin were extracted using exploratory factor analysis.Cox risk regression models were used to appressed as geometric means(95% confidence intervals)and categorical variables were expressed analyse the association between different dietary patterns and the risk of developing NAFLD.Stratified analysis was conducted according to the gender of the participants to explore the risk of dietary patterns and the development of NAFLD under different genders.Data were analysed using SAS 9.3.Results(1)A total of 5679 middle-aged and older adults were included in this study,2741(48.27%)were males and 2938(51.73%)were females.The median follow-up year was 5.00 years and the total prevalence of non-alcoholic fatty liver disease was 85.00/1000person-years,109.88/1000 person-years for men and 64.03/1000 person-years for women.A total of 3 main dietary patterns were sampled,namely vegetable dietary pattern,sweet and fruit dietary pattern,and animal food dietary pattern.(2)A comparison of the basic characteristics of middle-aged and elderly people showed that a higher proportion of men than women had non-alcoholic fatty liver disease.Socio-demographics showed that an older age group and a higher proportion of managers were involved in the development of NAFLD.Physical examination and biochemical indicators showed higher levels of body mass index,waist circumference,total cholesterol,triglycerides,LDL cholesterol,fasting glucose,alanine aminotransferase,ultrasensitive C-reactive protein,systolic blood pressure,diastolic blood pressure and lower HDL cholesterol levels in patients with NAFLD.Lifestyle habits showed higher levels of physical activity and total energy intake in patients with NAFLD,a higher proportion of never smokers and former smokers and a lower proportion of current smokers,and a higher proportion of occasional drinkers and a lower proportion of non-drinkers.Past medical history showed a high proportion of patients with hypertension,hyperlipidaemia and diabetes mellitus who developed NAFLD.Family history showed a higher prevalence of coronary heart disease,hypertension and diabetes mellitus in those with NAFLD(P values<0.05).The remaining variables were not statistically different(P values >0.05).(3)After multifactorial adjustment,the risk ratios(95% confidence intervals)for the development of non-alcoholic fatty liver disease were 0.91(0.8,1.05),0.8(0.69,0.93),0.98(0.84,1.16)(P for trend = 0.001)for those in tertiles 2,3 and 4,respectively,compared to those in tertiles 1for vegetable dietary pattern intake,with vegetable dietary pattern scores at tertile 3 was negatively associated with the risk of developing NAFLD.The risk ratios(95% confidence intervals)for NAFLD in tertiles 2,3 and 4 were 0.96(0.83,1.1),1.02(0.89,1.17),1.07(0.93,1.23)respectively(P for trend =0.267)compared to tertiles 1 for the sweet and fruit dietary pattern,with no association between the sweet and fruit dietary pattern and the risk of NAFLD.There was no correlation between the dietary pattern of sweets and fruit and the risk of NAFLD.The risk ratios(95% confidence intervals)for NAFLD in quartiles 2,3 and 4compared to quartile 1 of the animal food dietary pattern were 1.08(0.93,1.24),1.13(0.98,1.3),1.21(1.05,1.39)respectively(P for trend=0.007),with a positive association between the animal food dietary pattern and the risk of NAFLD.The risk of NAFLD was positively correlated.Conclusion A vegetable dietary pattern score in the 3rd quartile was negatively associated with the risk of NAFLD,and when stratified by gender,there was still a negative association among men and no statistical association among women.There was no statistically significant association between dietary patterns of sweets and fruit and the risk of NAFLD.There was a positive association between dietary patterns of animal foods and the risk of NAFLD,which remained positive in men but not in women when stratified by gender.