Plasma Alkylresorcinol Metabolite, a Biomarker for Whole-Grain Intake, Is Inversely Associated with Risk of Nonalcoholic Fatty Liver Disease in a Case-Control Study of Chinese Adults

Abstract

Background Epidemiological studies consistently find associations between whole-grain intake and reduced risk of obesity and related metabolic diseases, yet data on the potential of whole grains to prevent fatty liver diseases are scarce. Objectives To examine whether plasma 3-(3, 5-dihydroxyphenyl)-1-propanoic acid (DHPPA), a biomarker of whole-grain wheat and rye intake, is associated with nonalcoholic fatty liver disease (NAFLD). Methods This case-control study of Chinese adults enrolled 940 NAFLD cases and 940 age- and sex-matched non-NAFLD controls (mean age: 55.2 years; 65% males). NAFLD diagnosis was defined as individuals whose hepatic ultrasound disclosed hepatic steatosis at any stage, after the exclusion of alcohol abuse and other liver diseases. Fasting plasma DHPPA concentration was measured by high-performance liquid chromatography-tandem mass spectrometry. Multivariate adjusted odds ratios (ORs) and 95% confidence intervals (CI) were estimated to assess the association between plasma DHPPA and NAFLD using conditional logistic regression. Results Plasma concentration of DHPPA was significantly lower in NAFLD patients compared to controls (median: 9.86 nmol/L vs. 10.9 nmol/L, P = 0.002). In multivariable logistic regression models, the ORs (95% CI) for NAFLD across increasing tertiles of plasma DHPPA were 1 (referent), 0.76 (0.54, 1.05) and 0.65 (0.45, 0.93), respectively (P for trend = 0.026). In addition, the inverse associations persisted in subgroups stratified by sex, age, BMI, abdominal adiposity, smoking status, physical activity, diabetes, hypertension, and hyperlipidemia. Conclusions These results indicate that increased plasma DHPPA concentration is associated with lower risk of NAFLD in Chinese adults, independently of well-known risk factors. Our finding provides evidence to support health benefits of whole-grain consumption on NAFLD. This trial was registered at clinicaltrials.gov as NCT03845868.

Dietary patterns and metabolic dysfunction-associated fatty liver disease in China’s multi-ethnic regions

“…This dietary pattern was dominated by high intake of coarse grains, wheat products, tea and potatoes, and the characteristic of this pattern was that it was rich in both high carbohydrates and dietary fibre. According to previous studies, high intake of dietary fibre and tea may be benefit for MAFLD prevention [ 43 – 45 ], while the intake of high carbohydrates may be related to higher risk of MAFLD [ 39 ].…”

Analysis of the association between dietary patterns and nonalcoholic fatty liver disease in a county in Guangxi

“…First, high intake of whole grains promotes fat reduction [ 48 , 49 ] and reduces the likelihood of obesity, which has been confirmed to be an important risk factor in NAFLD development [ 50 ]. Second, high intake of whole grains reduces oxidative stress and inflammatory markers [ 51 ], resulting in a decrease in liver enzymes and steatosis, thereby reducing the risk of NAFLD [ 52 , 53 ]. Finally, whole grain foods are a good source of micronutrients such as copper, and NAFLD patients show a decrease in hepatic copper concentration, which has a positive effect on the reduction of the risk of NAFLD development.…”

Peripheral amyloid-β clearance mediates cognitive impairment in non-alcoholic fatty liver disease

“…Definitions for diabetes, hyperlipidaemia, and hypertension were consistent with previous literature. 26 …”