Relationship between dietary active microbiota intake and non-alcoholic fatty liver disease: based on NHANES 2015-2023

Abstract

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

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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