Τίτλος:
Mediterranean diet is inversely associated with steatosis and fibrosis and decreases ten-year diabetes and cardiovascular risk in NAFLD subjects: Results from the ATTICA prospective cohort study
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background and aims: We assessed the association of Mediterranean diet with NAFLD and their interaction in predicting ten-year diabetes onset and first fatal/non-fatal cardiovascular disease (CVD) incidence. Methods: The ATTICA prospective observational study in Athens, Greece included 1,514 men and 1,528 women (>18 years old) free-of-CVD at baseline. Liver steatosis and fibrosis indices were calculated. Mediterranean diet adherence was assessed through MedDietScore. At the ten-year follow-up visit, CVD evaluation was performed in an a priori specified subgroup of n = 2,020 participants and diabetes onset in n = 1,485 free-of-diabetes participants. Results: MedDietScore was inversely associated with steatosis and fibrosis; e.g. in the case of the TyG index the Odds Ratio (OR) of the 3rd vs. 1st MedDietScore tertile was = 0·53, [95% Confidence Interval (95% CI) (0·29, 0·95)] and the associations persisted in multi-adjusted models. NAFLD predicted incident diabetes prospectively over a ten year period [HR = 1·87, 95% CI (0·75, 4·61)] and the association remained significant only in subjects with low MedDietScore (below median) whereas diabetes onset among subjects with higher MedDietScore was not influenced by NAFLD. Similarly, NAFLD predicted CVD [Hazard Ratio (HR) = 3·01, 95%CI(2·28, 3·95)]; the effect remained significant only in subjects with MedDietScore below median [HR = 1·38, 95% CI (1·00, 1·93)] whereas it was essentially null [HR = 1·00,95% CI (0·38, 2·63)] among subjects with higher score. Mediation analysis revealed that adiponectin and adiponectin-to-leptin ratio were the strongest mediators. Conclusions: We report an inverse association between Mediterranean diet and NAFLD. Mediterranean diet protected against diabetes and CVD prospectively among subjects with NAFLD. © 2020 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism
Συγγραφείς:
Kouvari, M.
Boutari, C.
Chrysohoou, C.
Fragkopoulou, E.
Antonopoulou, S.
Tousoulis, D.
Pitsavos, C.
Panagiotakos, D.B.
Mantzoros, C.S.
the ATTICA study Investigators
Περιοδικό:
Clinical Nutrition Open Science
Εκδότης:
Churchill Livingstone
Λέξεις-κλειδιά:
adipocytokine; adiponectin; leptin, adult; Article; cardiovascular risk; clinical effectiveness; cohort analysis; diabetes mellitus; female; human; liver fibrosis; macronutrient; major clinical study; male; Mediterranean diet; nonalcoholic fatty liver; observational study; prospective study; risk reduction; scoring system; cardiovascular disease; comorbidity; fibrosis; Greece; liver; Mediterranean diet; middle aged; non insulin dependent diabetes mellitus; nonalcoholic fatty liver; pathology, Adult; Cardiovascular Diseases; Cohort Studies; Comorbidity; Diabetes Mellitus, Type 2; Diet, Mediterranean; Female; Fibrosis; Greece; Humans; Liver; Male; Middle Aged; Non-alcoholic Fatty Liver Disease; Prospective Studies
DOI:
10.1016/j.clnu.2020.10.058
