Abstract
Fructose intake has been associated with non-alcoholic fatty liver disease (NAFLD). The objective of this study was to assess the consumption of dietary fructose according to: 1) classification of hepatic steatosis by two indexes and 2) diagnosis of NAFLD by MRI. We conducted a cross-sectional analysis among 100 young adults from Mexico City. The Hepatic Steatosis Index (HSI) and the Fatty Liver Index (FLI) were estimated using Body Mass Index (BMI), waist circumference, and fasting concentrations of glucose, triglycerides, and hepatic enzymes (ALT, AST, GGT). A semi-quantitative food frequency questionnaire was administered to obtain dietary sources of fructose. We estimated the concordance between the hepatic indices and NAFLD and the correlation between the index scores and the percentage of liver fat. Eighteen percent presented NAFLD; 44% and 46% were classified with hepatic steatosis according to HSI and FLI, respectively. We compared dietary intake of fructose by each outcome: HSI, FLI, and NAFLD. Sugar-sweetened beverages (SSB) and juices were consumed significantly more by those with steatosis by FLI and NAFLD suggesting that SSB intake is linked to metabolic alterations that predict the risk of having NAFLD at a young age.
Highlights
Non-alcoholic fatty liver disease (NAFLD) is defined as the excessive accumulation of triglycerides (>5%) in the hepatocytes in the absence of significant alcohol consumption [1,2]
We found that 18% of the participants presented NAFLD by magnetic resonance imaging (MRI), which is similar to previous reports in this age group [33]
We found that, in our sample, the sensitivity was around 77%, which is consistent with previous publications [34,35], and the prevalence of steatosis (44% and 46% according to Hepatic Steatosis Index (HSI) and Fatty Liver Index (FLI), respectively) was similar to a previous study in Mexico (49%) [36]
Summary
Non-alcoholic fatty liver disease (NAFLD) is defined as the excessive accumulation of triglycerides (>5%) in the hepatocytes in the absence of significant alcohol consumption [1,2]. This hepatic steatosis can progress to fibrosis and cirrhosis [3,4]. Patients with NAFLD have increased risk for hepatic malignancy and cardiovascular events [7]. NAFLD has been increasing in the last 20 years in adolescents and adults in the U.S [8,9]. In Mexico, the national prevalence of NAFLD is unknown, but has been estimated to be between 20 to 29.9% [10,11]
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