Abstract

Background: Vitamins and carotenoids may be involved in the pathogenesis of non-alcoholic fatty liver disease (NAFLD). Previously related publications mainly focused on vitamin D and vitamin E, and studies on other vitamins and carotenoids and NAFLD are scarce.Methods: This study aimed to explore the clinical relevance of vitamin A, B vitamins (vitamin B1, vitamin B2, niacin, vitamin B6, folate, vitamin B12, and choline), vitamin C and carotenoids (α-carotene, β-carotene, β-cryptoxanthin, lycopene, lutein + zeaxanthin) with liver steatosis and fibrosis in the 2017–2018 NHANES (N = 4,352). Liver steatosis and fibrosis were detected by transient elastography. Logistic regression, linear regression and restricted cubic splines were adopted to explore the non-linear dose-response relationships.Results: Higher intakes of vitamin C [0.68 (0.50–0.93)] and β-carotene [0.71 (0.54–0.93)] were inversely associated with liver steatosis. Higher levels of serum vitamin C [0.45 (0.32–0.62)] were inversely associated with liver fibrosis, while higher intakes of choline [1.43 (1.04–1.98)] and α-carotene [1.67 (1.01–2.74)] were positively associated with liver fibrosis. In addition, marginally inverse association between lutein + zeaxanthin and liver steatosis and positive association between vitamin B12 and liver fibrosis were found. In linear regression, the above-mentioned associations between vitamin C, β-carotene, and lutein + zeaxanthin and liver steatosis, and serum vitamin C, choline, α-carotene, and vitamin B12 and liver fibrosis were also found. The above-mentioned associations were mainly linear, while the relationship between β-carotene and liver steatosis might be non-linear.Conclusion: Vitamin C, α-carotene, β-carotene, lutein + zeaxanthin, choline and vitamin B12 may be associated with liver steatosis and fibrosis.

Highlights

  • Non-alcoholic fatty liver disease (NAFLD) is a major cause of liver disease worldwide, and 25% of the adult population in the world has NAFLD [1]

  • This study aimed to explore the clinical relevance of vitamin A, B vitamins, vitamin C and carotenoids (α-carotene, β-carotene, β-cryptoxanthin, lycopene, lutein + zeaxanthin) with liver steatosis and fibrosis in the 2017–2018 National Health and Nutrition Examination Survey (NHANES) (N = 4,352)

  • Vitamin C, α-carotene, β-carotene, lutein + zeaxanthin, choline and vitamin B12 may be associated with liver steatosis and fibrosis

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Summary

Introduction

Non-alcoholic fatty liver disease (NAFLD) is a major cause of liver disease worldwide, and 25% of the adult population in the world has NAFLD [1]. Substantial advances have been made in NAFLD mechanisms, diagnostics, and treatment [2], NAFLD remains the center of attention within liver owing to its high prevalence and growing burden in the general population [3]. Studies on other vitamins and carotenoids and NAFLD are scarce. Based on the 2017–2018 National Health and Nutrition Examination Survey (NHANES), we aimed to examine the clinical relevance of vitamin A, B vitamins (vitamin B1, vitamin B2, niacin, vitamin B6, folate, vitamin B12, and choline), vitamin C and carotenoids (α-carotene, β-carotene, β-cryptoxanthin, lycopene, lutein + zeaxanthin) with liver steatosis and fibrosis detected by transient elastography in adults. Vitamins and carotenoids may be involved in the pathogenesis of non-alcoholic fatty liver disease (NAFLD). Related publications mainly focused on vitamin D and vitamin E, and studies on other vitamins and carotenoids and NAFLD are scarce

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