Food Insecurity Is Associated With Chronic Liver Disease Among US Adults.
Food Insecurity Is Associated With Chronic Liver Disease Among US Adults.
复制标题
食品不安全与美国成年人的慢性肝病有关。
DOI：
10.1097/mcg.0000000000001741
复制
发表时间：
2023
影响因子：
2.9
通讯作者：
Leung,CindyW
中科院分区：
文献类型：
--
作者：
Tapper,ElliotB;Mehta,Manaav;Leung,CindyW
背景：粮食不安全与许多不良的健康结果有关。大多数当代肝病是代谢性的，并受到营养状况的影响。有关粮食不安全与慢性肝病之间关联的数据有限。我们评估了食品不安全与肝脏硬度测量 (LSM) 之间的联系，肝脏硬度测量是肝脏健康的关键指标。方法：对 2017 年至 2018 年国家健康和营养检查调查中 3502 名 20 岁及以上受试者进行横断面分析。粮食安全是使用美国农业部的核心粮食安全模块来衡量的。使用年龄、性别、种族/民族、教育程度、贫困收入比、吸烟、体力活动、酒精摄入量、含糖饮料摄入量、2015 年健康饮食指数得分对模型进行调整。所有受试者均接受振动控制瞬态弹性成像，提供 LSM (kPa) 和肝脂肪变性测量（受控衰减参数，dB/m）。 LSM 分层：整个研究人群中 < 7、7 至 9.49、9.5 至 12.49（晚期纤维化）和≥ 12.5（肝硬化）并按年龄分层（20 至 49 岁和 50 岁及以上）结果：不同食物的平均控制衰减参数、丙氨酸转氨酶或天冬氨酸转氨酶值没有显着差异安全状态。然而，对于 50 岁及以上的成年人来说，粮食不安全与较高的平均 LSM（6.89±0.40 kPa 对比 5.77±0.14 kPa，P= 0.02）相关。多变量调整后，粮食不安全与 50 岁及以上成年人所有风险分层中较高的 LSM 相关：LSM≥ 7 kPa [比值比 (OR)：2.06，95% CI，1.06 至 4.02]； LSM≥ 9.5 kPa（OR：2.50，95% CI，1.11 至 5.64）； LSM≥ 12.5 kPa（OR：3.07，95% CI，1.21 至 7.80）。结论：食物不安全与肝纤维化以及老年人晚期纤维化和肝硬化的风险增加有关。
Background:Food insecurity is associated with many poor health outcomes. Most contemporary liver disease is metabolic and impacted by nutritional status. Data regarding the association between food insecurity and chronic liver disease are limited. We evaluated the linkage between food insecurity and liver stiffness measurements (LSMs), a key measure of liver health.Methods:A cross-sectional analysis of 3502 subjects aged 20 years and older from the 2017 to 2018 National Health and Nutrition Examination Survey. Food security was measured using the US Department of Agriculture’s Core Food Security Module. Models were adjusted using age, sex, race/ethnicity, education, poverty-income ratio, smoking, physical activity, alcohol intake, sugary beverage intake, Healthy Eating Index-2015 score. All subjects underwent vibration-controlled transient elastography, which provides LSMs (kPa) and a measure of hepatic steatosis (controlled attenuation parameter, dB/m). LSM was stratified:< 7, 7 to 9.49, 9.5 to 12.49 (advanced fibrosis), and≥ 12.5 (cirrhosis) in the whole-study population and stratified by age (20 to 49 y and 50 y and older)Results:There were no significant differences in mean controlled attenuation parameter, alanine aminotransferase, or aspartate aminotransferase values by food security status. However, food insecurity was associated with a higher mean LSM (6.89±0.40 kPa vs. 5.77±0.14 kPa, P= 0.02) for adults 50 years and older. After multivariate adjustment, food insecurity was associated with higher LSMs across all risk stratifications for adults 50 years and older: LSM≥ 7 kPa [odds ratio (OR): 2.06, 95% CI, 1.06 to 4.02]; LSM≥ 9.5 kPa (OR: 2.50, 95% CI, 1.11 to 5.64); LSM≥ 12.5 kPa (OR: 3.07, 95% CI, 1.21 to 7.80).Conclusions:Food insecurity is associated with liver fibrosis and an increased risk of advanced fibrosis and cirrhosis in older adults.