Abstract
BackgroundNut consumption has been associated with reduced inflammation, insulin resistance, and oxidative stress. However, the influence on the prevalence and severity of non-alcoholic fatty liver disease (NAFLD) has yet to be evaluated.Methods4655 subjects were included as part of a colorectal carcinoma screening program (SAKKOPI) between 07/2010 and 07/2019 and analyzed 2020. Patients were characterized using biochemical and metabolic parameters, as well as a detailed questionnaire on dietary habits. The diagnosis of NAFLD was established using abdominal ultrasound. Consumption of nuts was graded as: no consumption or <1 time/week, 1–6 times/week, 1 time/day and ≥2 times/day.ResultsMean age was 58.5±9.8years with a mean BMI of 26.5±4.7kg/m2. 2058 (44.2%) patients suffered from the metabolic syndrome, 2407 (51.6%) had arterial hypertension, 2287 (49.1%) showed prediabetes/diabetes, 1854 (39.4%) had dyslipidemia and 1984 patients (43.5%) were diagnosed with NAFLD. Prevalence of metabolic syndrome (1219 [48.7%] vs. 605 [40.2%] vs. 189 [37.4%] vs. 45 [31.7%], p<0.001) and NALFD (1184 [48.1%] vs. 594 [40.7%] vs. 158 [31.7%] vs. 48 [34.0%], p<0.001). On multivariable logistic regression analysis adjusting for potential confounders and dietary patterns, nut consumption ≥1time/day was inversely associated with NAFLD in the overall cohort (adjusted Odds ratio[aOR]: 0.719 [95%CI:0.558–0.926], p = 0.011). However, following subgroup analysis, this inverse association was only confirmed in male patients (aOR: 0.589 [95%CI: 0.411–0.844], p = 0.004) but not in females (aOR: 0.886 [95%CI: 0.616–1.275], p = 0.515). Moreover, patients who consumed nuts 1–6 times/week had a significantly lower prevalence of advanced fibrosis (Fib-4 score >2.67: aOR: 0.551 [95%CI: 0.338–0.898], p = 0.017; Forns-Index >6.9: aOR: 0.585 [95%CI: 0.402–0.850], p = 0.005).ConclusionsNut consumption might exert beneficial effects on the prevalence of NAFLD in males. The negative association with advanced fibrosis warrants further investigation.
Highlights
Non-alcoholic fatty liver disease (NAFLD) is regarded the emerging complex chronic liver disease of the 21st century, being significantly associated with increased cardiovascular and liverrelated risk [1,2,3]
Mean age was 58.5±9.8years with a mean body mass index (BMI) of 26.5±4.7kg/m2. 2058 (44.2%) patients suffered from the metabolic syndrome, 2407 (51.6%) had arterial hypertension, 2287 (49.1%) showed prediabetes/diabetes, 1854 (39.4%) had dyslipidemia and 1984 patients (43.5%) were diagnosed with NAFLD
On multivariable logistic regression analysis adjusting for potential confounders and dietary patterns, nut consumption 1time/day was inversely associated with NAFLD in the overall cohort
Summary
Non-alcoholic fatty liver disease (NAFLD) is regarded the emerging complex chronic liver disease of the 21st century, being significantly associated with increased cardiovascular and liverrelated risk [1,2,3]. A large body of evidence exists for the protective effect of nuts on T2DM [11, 12], metabolic syndrome (MetS) [12,13,14], obesity [10, 12, 13] and arterial hypertension [15] Apart from these beneficial effects on aspects of the MetS, their role in chronic liver disease and especially NAFLD merits further investigation since inflammation, oxidative stress and IR are considered key drivers of NAFLD [16,17,18]. A Chinese study reported a significantly lower prevalence of NAFLD in patients consuming nuts 4 times/week [19] Another Chinese study confirmed this inverse association of NAFLD and nut consumption only in a small subgroup of men when consuming 8.86g/day [20] while data from Caucasian subjects addressing this topic is scarce. The influence on the prevalence and severity of non-alcoholic fatty liver disease (NAFLD) has yet to be evaluated
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