Abstract
Non-alcoholic fatty liver disease (NAFLD) is highly prevalent worldwide. Oxidative stress is thought to be a major mechanism, and previous epidemiological studies found higher serum levels of antioxidant carotenoids were associated with reduced risk for development and progression of NAFLD. The objective of this analysis is to examine cross-sectional associations between dietary and serum levels of carotenoids in relation to NAFLD among a nationally representative sample of US adults. We used data from the 2003–2014 National Health and Nutrition Examination Survey (NHANES). Dietary carotenoid intake was estimated from a 24-hour recall, while serum carotenoids were measured from 2003 to 2006. The NAFLD status was determined based upon US Fatty Liver Index (FLI) value ≥30. Regression models were used to estimate associations between carotenoids and NAFLD by controlling for covariates and adjusting for survey design variables. Overall, 33% of participants were classified as having NAFLD. Intake of all carotenoids, with the exception of lycopene, was lower among those with NAFLD. This association was significant for the highest quartiles of intake of α-carotene, β-carotene, β-cryptoxanthin, and lutein/zeaxanthin. For serum measures, the highest level of all carotenoids was associated with significantly reduced odds of NAFLD. In conclusion, higher intake and serum levels of most carotenoids were associated with lower odds of having NAFLD. Identification of such modifiable lifestyle factors provide an opportunity to limit or prevent the disease and its progression.
Highlights
Non-alcoholic fatty liver disease (NAFLD) is highly prevalent worldwide, and is the most common liver disease in the United States with an estimated prevalence of 30% among adults [1], and 3% to 12%among children [2]
Hepatic steatosis increases risk for progression to non-alcoholic steatohepatitis (NASH), which is characterized by activation of hepatic macrophages, infiltration of inflammatory immune cells, hepatocyte ballooning, and cell death
To evaluate whether the effects of carotenoid intake might be attributable more generally to a healthy diet, we looked at models adjusted for the healthy eating index (HEI) 2015 score
Summary
Non-alcoholic fatty liver disease (NAFLD) is highly prevalent worldwide, and is the most common liver disease in the United States with an estimated prevalence of 30% among adults [1], and 3% to 12%among children [2]. Non-alcoholic fatty liver disease (NAFLD) is highly prevalent worldwide, and is the most common liver disease in the United States with an estimated prevalence of 30% among adults [1], and 3% to 12%. Study of Liver Diseases defines NAFLD as presence of both “evidence of hepatic steatosis (HS), either by imaging or histology” and “lack of secondary causes of hepatic fat accumulation such as significant alcohol consumption, long-term use of a steatogenic medication, or monogenic hereditary disorders” [3]. Hepatic steatosis increases risk for progression to non-alcoholic steatohepatitis (NASH), which is characterized by activation of hepatic macrophages, infiltration of inflammatory immune cells, hepatocyte ballooning, and cell death. NASH, in turn, drastically increases risk for fibrosis, cirrhosis leading to liver failure, and hepatocellular carcinoma [3,4].
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