Soft drinks consumption is associated with nonalcoholic fatty liver disease independent of metabolic syndrome in Chinese population
- 612 Downloads
Excessive consumption of soft drinks is associated with nonalcoholic fatty liver disease (NAFLD). However, the association between soft drinks consumption and NAFLD is unclear in non-Caucasian adults with relatively low soft drinks consumption. The aim of this study was to assess the association between soft drinks consumption and NAFLD in Chinese adults.
A cross-sectional study was conducted with 26,790 adults living in Tianjin, China. NAFLD (with elevated alanine aminotransferase [ALT]) was diagnosed by the liver ultrasonography and serum ALT concentrations. Soft drinks consumption was assessed using a validated self-administered food frequency questionnaire, and it was summarized as three categories for analysis: almost never (reference), <1 cup/week, and ≥1 cups/week. Metabolic syndrome (MetS) was defined according to the criteria of the American Heart Association scientific statements of 2009. The association between soft drinks consumption and NAFLD was assessed by multiple logistic regression analysis.
The prevalence of NAFLD and NAFLD with elevated ALT was 27.1 and 6.5%, respectively. After adjustment for potential confounding variables (including MetS), the odds ratios (95% confidence intervals) for NAFLD or NAFLD with elevated ALT across soft drinks consumption were 1.00 (reference) for almost never, 1.14 (1.02–1.27) or 1.16 (0.98–1.37) for <1 cup/week, and 1.26 (1.14–1.40) or 1.32 (1.13–1.53) for ≥1 cups/week (both P for trend <0.001), respectively.
This is the first study to demonstrate that soft drinks consumption is associated with NAFLD independent of MetS in Chinese adults with relatively low soft drinks consumption. These results suggest that reducing soft drinks consumption might be beneficial to the prevention of NAFLD.
KeywordsAlanine aminotransferase Metabolic syndrome Nonalcoholic fatty liver disease Soft drinks
We gratefully acknowledge all the participants of the study and Tianjin Medical University General Hospital Health Management Center for the possibility to perform the study. This study was supported by grants from the National Natural Science Foundation of China (No. 81673166, 81372118, 81372467 and 81302422), the key technologies R&D program of Tianjin (Key Project: No. 11ZCGYSY05700, 12ZCZDSY20400, 13ZCZDSY20200, and 15YFYZSY00020), the National Science and Technology Support Program (No. 2012BAI02B02), 2012 and 2016 Chinese Nutrition Society (CNS) Nutrition Research Foundation—DSM Research Fund (No. 2014-071, 2016-046 and 2016-023), the Technologies development program of Beichen District of Tianjin (No. bcws2013-21, bcws2014-05 and 2015-SHGY-02), the technologies project of Tianjin Binhai New Area (No. 2013-02-04 and 2013-02-06), the Science Foundation of Tianjin Medical University (No. 2010KY28 and 2013KYQ24), the Key Laboratory of Public Health Safety (Fudan University), Ministry of Education (No. GW2014-5), and the National Training Programs of Innovation and Entrepreneurship for Undergraduates (No. 201510062013), China.
- 5.Zampino R, Coppola N, Cirillo G, Boemio A, Pisaturo M, Marrone A, Macera M, Sagnelli E, Perrone L, Adinolfi LE, Miraglia del Giudice E (2013) Abdominal fat interacts with PNPLA3 I148 M, but not with the APOC3 variant in the pathogenesis of liver steatosis in chronic hepatitis C. J Viral Hepat 20:517–523CrossRefPubMedGoogle Scholar
- 16.Yu B, He H, Zhang Q, Wu H, Du H, Liu L, Wang C, Shi H, Xia Y, Guo X, Liu X, Li C, Bao X, Su Q, Meng G, Chu J, Mei Y, Sun S, Wang X, Zhou M, Jia Q, Zhao H, Song K, Niu K (2014) Soft drink consumption is associated with depressive symptoms among adults in China. J Affect Disord 172C:422–427Google Scholar
- 17.Gao X, Fan JG, Study Group of L, Metabolism CSoE (2013) Diagnosis and management of non-alcoholic fatty liver disease and related metabolic disorders: consensus statement from the Study Group of Liver and Metabolism, Chinese Society of Endocrinology. J Diabetes 5:406–415CrossRefPubMedPubMedCentralGoogle Scholar
- 20.Yang YXHM, Pan XC (2009) China food composition. Peking University Medical Press, BeijingGoogle Scholar
- 21.Oddy WH, Herbison CE, Jacoby P, Ambrosini GL, O’Sullivan TA, Ayonrinde OT, Olynyk JK, Black LJ, Beilin LJ, Mori TA, Hands BP, Adams LA (2013) The Western dietary pattern is prospectively associated with nonalcoholic fatty liver disease in adolescence. Am J Gastroenterol 108:778–785CrossRefPubMedGoogle Scholar
- 22.Xia Y, Wang N, Yu B, Zhang Q, Liu L, Meng G, Wu H, Du H, Shi H, Guo X, Liu X, Li C, Han P, Dong R, Wang X, Bao X, Su Q, Gu Y, Fang L, Yu F, Yang H, Kang L, Ma Y, Sun S, Wang X, Zhou M, Jia Q, Guo Q, Wu Y, Song K, Niu K (2016) Dietary patterns are associated with depressive symptoms among Chinese adults: a case-control study with propensity score matching. Eur J Nutr. doi: 10.1007/s00394-016-1293-y CrossRefPubMedGoogle Scholar
- 23.Mancia G, De Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G, Grassi G, Heagerty AM, Kjeldsen SE, Laurent S, Narkiewicz K, Ruilope L, Rynkiewicz A, Schmieder RE, Boudier HA, Zanchetti A, Vahanian A, Camm J, De Caterina R, Dean V, Dickstein K, Filippatos G, Funck-Brentano C, Hellemans I, Kristensen SD, McGregor K, Sechtem U, Silber S, Tendera M, Widimsky P, Zamorano JL, Erdine S, Kiowski W, Agabiti-Rosei E, Ambrosioni E, Lindholm LH, Viigimaa M, Adamopoulos S, Agabiti-Rosei E, Ambrosioni E, Bertomeu V, Clement D, Erdine S, Farsang C, Gaita D, Lip G, Mallion JM, Manolis AJ, Nilsson PM, O’Brien E, Ponikowski P, Redon J, Ruschitzka F, Tamargo J, van Zwieten P, Waeber B, Williams B, Management of Arterial Hypertension of the European Society of H, European Society of C (2007) 2007 Guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 25:1105–1187CrossRefPubMedGoogle Scholar
- 25.Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, Fruchart JC, James WP, Loria CM, Smith SC Jr, International Diabetes Federation Task Force on E, Prevention, Hational Heart L, Blood I, American Heart A, World Heart F, International Atherosclerosis S, International Association for the Study of O (2009) Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 120:1640–1645CrossRefGoogle Scholar
- 27.Luo K, Mao H (2016) The correlation of carbonated beverage and cardiovascular disease risk. China Mod Dr 54(155–158):162Google Scholar
- 28.Chen D (2001) Teach you how to choose carbonated beverages——Comparison of artificial sweeteners and preservatives in 121 kinds of canned carbonated beverages. Standard and Quality of Light Industry 45–46 (in Chinese)Google Scholar
- 31.Simon BR, Parlee SD, Learman BS, Mori H, Scheller EL, Cawthorn WP, Ning X, Gallagher K, Tyrberg B, Assadi-Porter FM, Evans CR, MacDougald OA (2013) Artificial sweeteners stimulate adipogenesis and suppress lipolysis independently of sweet taste receptors. J Biol Chem 288:32475–32489CrossRefPubMedPubMedCentralGoogle Scholar
- 41.Hamaguchi M, Kojima T, Itoh Y, Harano Y, Fujii K, Nakajima T, Kato T, Takeda N, Okuda J, Ida K, Kawahito Y, Yoshikawa T, Okanoue T (2007) The severity of ultrasonographic findings in nonalcoholic fatty liver disease reflects the metabolic syndrome and visceral fat accumulation. Am J Gastroenterol 102:2708–2715CrossRefPubMedGoogle Scholar
- 42.Brown RJ, de Banate MA, Rother KI (2010) Artificial sweeteners: a systematic review of metabolic effects in youth. Int J Pediatr Obes: IJPO: Off J Int Assoc Study Obes 5:305–312Google Scholar