膳食活性微生物摄入与非酒精性脂肪性肝病的关联性:基于2015—2023年NHANES调查

摘要/Abstract

摘要： 目的探讨膳食活性微生物摄入与非酒精性脂肪性肝病(NAFLD)之间的相关性。方法基于2015—2023 年美国国家健康与营养调查(NHANES)数据库横断面数据,共纳入2 903例参与者,基于肝脏超声瞬时弹性成像和控制衰减参数(CAP)将研究对象分为NAFLD组(≥248 dB/m)和对照组(<248 dB/m)。根据Sander′s膳食活微生物分类系统计算研究对象膳食活性微生物摄入水平并计算摄入指数MedHi。采用多因素logistic回归分析检验膳食活性微生物摄入量与NAFLD之间的独立关联,受限立方样条模型(RCS)检测剂量关系。结果最终纳入2 903例成年参与者,检出NAFLD 1 235例,成年人群中NAFLD发生率为42.54%。与对照组相比,NAFLD患者膳食活性微生物高摄入量占比更低(52.71%),而低摄入量(30.61%)和中等摄入量(16.68%)占比更高,NAFLD患者的MedHi指数低于对照组,组间差异具有统计学意义(P<0.05)。多因素logistic回归结果显示,与膳食活性微生物低摄入量人群相比,高摄入量人群NAFLD的患病风险降低(OR=0.763),MedHi指数升高与NAFLD患病风险降低独立相关(OR=0.784)。剂量-反应关系检测表明,MedHi指数与NAFLD患病率均呈现明显的非线性剂量依赖关系(非线性P<0.001)。结论膳食活性微生物摄入与NAFLD存在显著关联,维持一定比例的膳食活性微生物摄入在改善肝脏健康方面发挥重要作用。

关键词: 膳食微生物, 非酒精性脂肪肝病, NHANES, 横断面研究

Abstract: Objective To explore the correlation between dietary active microbiota intake and non-alcoholic fatty liver disease (NAFLD). Methods Data from the NHANES cross-sectional survey conducted from 2015 to 2023 were selected, including 2 903 participants. Participants were divided into the NAFLD group (≥248 dB/m) and the control group (<248 dB/m) based on liver ultrasonography transient elastography and controlled attenuation parameter (CAP). Dietary active microbiota intake was assessed using the Sanders dietary active microbiota classification system, and the MedHi index was calculated. Multivariate logistic regression was used to examine the independent association between dietary active microbiota intake and NAFLD. Restricted cubic splines (RCS) were used to detect the dose-response relationship. Results A total of 2 903 adult participants were included, of whom 1 235 were diagnosed with NAFLD, yielding an NAFLD prevalence of 42.54%. Compared with the control group, the NAFLD group had a lower proportion of high dietary active microbiota intake (52.71%) and higher proportions of low (30.61%) and moderate (16.68%) intake. The MedHi index in the NAFLD group was lower than that in the control group, with a statistically significant difference (P<0.05). Multivariate logistic regression analysis, after adjusting for all covariates, showed that compared to the low intake group, the high intake group of dietary active microbiota had a lower risk of NAFLD (OR=0.763). The increase in MedHi index was independently associated with a reduced risk of NAFLD (OR=0.784). Dose-response analysis revealed a clear nonlinear dose-dependent relationship between MedHi and the prevalence of NAFLD (nonlinear P<0.001). Conclusion Dietary active microbiota intake is significantly associated with NAFLD, and maintaining a certain level of dietary active microbiota intake plays an important role in improving liver health.

Key words: Dietary microbiota, Non-alcoholic fatty liver disease, NHANES, Cross-sectional study

张维. 膳食活性微生物摄入与非酒精性脂肪性肝病的关联性:基于2015—2023年NHANES调查[J]. 肝脏, 2026, 31(4): 553-559.

ZHANG Wei. Relationship between dietary active microbiota intake and non-alcoholic fatty liver disease: based on NHANES 2015-2023[J]. Chinese Hepatolgy, 2026, 31(4): 553-559.

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