Exploring the link between dietary inflammatory index and NAFLD through a structural equation modeling approach

Abstract Nonalcoholic fatty liver disease (NAFLD) or metabolic dysfunction–associated steatotic liver disease (MASLD) is a significant global public health dilemma with wide-ranging social and economic implications. Diet and lifestyle modifications remain essential components of NAFLD management. Th...

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Main Authors: Azam Doustmohammadian, Farhad Zamani, James R. Hébert, Maziar Moradi-Lakeh, Sepideh Esfandyiari, Bahareh Amirkalali, Nima Motamed, Mansooreh Maadi, Sherry Price, Esmaeel Gholizadeh, Hossein Ajdarkosh
Format: Article
Language:English
Published: BMC 2024-12-01
Series:Journal of Health, Population and Nutrition
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Online Access:https://doi.org/10.1186/s41043-024-00721-1
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author Azam Doustmohammadian
Farhad Zamani
James R. Hébert
Maziar Moradi-Lakeh
Sepideh Esfandyiari
Bahareh Amirkalali
Nima Motamed
Mansooreh Maadi
Sherry Price
Esmaeel Gholizadeh
Hossein Ajdarkosh
author_facet Azam Doustmohammadian
Farhad Zamani
James R. Hébert
Maziar Moradi-Lakeh
Sepideh Esfandyiari
Bahareh Amirkalali
Nima Motamed
Mansooreh Maadi
Sherry Price
Esmaeel Gholizadeh
Hossein Ajdarkosh
author_sort Azam Doustmohammadian
collection DOAJ
description Abstract Nonalcoholic fatty liver disease (NAFLD) or metabolic dysfunction–associated steatotic liver disease (MASLD) is a significant global public health dilemma with wide-ranging social and economic implications. Diet and lifestyle modifications remain essential components of NAFLD management. The current study investigated the association between diet-related inflammation and NAFLD among 3110 Iranian adults participating in the Amol Cohort Study (AmolCS), employing the Structural Equation Modeling (SEM) approach.The inflammatory potential of the diet was quantified using an energy-adjusted dietary index (E-DII) score. Findings showed that in the total sample and separately in males, the E-DII score had a significant effect on NAFLD, with mediation through hypertension (βstandardized = 0.16, and 0.13, p < 0.001, respectively) and c-reactive protein (CRP) (βstandardized = 0.07, and 0.07, p < 0.001, respectively). In the total sample and separately in females, the E-DII score significantly affected NAFLD, with mediation through diabetes (βstandardized = 0.06, p < 0.001, and 0.07, p = 0.006, respectively). In full and both gender-specific models, dyslipidemia was a risk factor for NAFLD and partially mediated the effect of hypertension on NAFLD. The current study concluded a mediated association between dietary inflammation and NAFLD through hypertension, CRP, diabetes, and dyslipidemia, suggesting further longitudinal studies, especially in high-risk populations. These findings underscore the complex interplay between diet, inflammation, and NAFLD in Iranian adults.
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spelling doaj-art-7cccea56c35d42088420b19692c9ab502024-12-29T12:37:03ZengBMCJournal of Health, Population and Nutrition2072-13152024-12-0143111010.1186/s41043-024-00721-1Exploring the link between dietary inflammatory index and NAFLD through a structural equation modeling approachAzam Doustmohammadian0Farhad Zamani1James R. Hébert2Maziar Moradi-Lakeh3Sepideh Esfandyiari4Bahareh Amirkalali5Nima Motamed6Mansooreh Maadi7Sherry Price8Esmaeel Gholizadeh9Hossein Ajdarkosh10Gastrointestinal and Liver Diseases Research Center, Iran University of Medical SciencesGastrointestinal and Liver Diseases Research Center, Iran University of Medical SciencesCancer Prevention & Control Program, University of South CarolinaPreventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, University of Medical SciencesDepartment of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical SciencesGastrointestinal and Liver Diseases Research Center, Iran University of Medical SciencesDepartment of Social Medicine, Zanjan University of Medical SciencesGastrointestinal and Liver Diseases Research Center, Iran University of Medical SciencesCancer Prevention & Control Program, University of South CarolinaGastrointestinal and Liver Diseases Research Center, Iran University of Medical SciencesGastrointestinal and Liver Diseases Research Center, Iran University of Medical SciencesAbstract Nonalcoholic fatty liver disease (NAFLD) or metabolic dysfunction–associated steatotic liver disease (MASLD) is a significant global public health dilemma with wide-ranging social and economic implications. Diet and lifestyle modifications remain essential components of NAFLD management. The current study investigated the association between diet-related inflammation and NAFLD among 3110 Iranian adults participating in the Amol Cohort Study (AmolCS), employing the Structural Equation Modeling (SEM) approach.The inflammatory potential of the diet was quantified using an energy-adjusted dietary index (E-DII) score. Findings showed that in the total sample and separately in males, the E-DII score had a significant effect on NAFLD, with mediation through hypertension (βstandardized = 0.16, and 0.13, p < 0.001, respectively) and c-reactive protein (CRP) (βstandardized = 0.07, and 0.07, p < 0.001, respectively). In the total sample and separately in females, the E-DII score significantly affected NAFLD, with mediation through diabetes (βstandardized = 0.06, p < 0.001, and 0.07, p = 0.006, respectively). In full and both gender-specific models, dyslipidemia was a risk factor for NAFLD and partially mediated the effect of hypertension on NAFLD. The current study concluded a mediated association between dietary inflammation and NAFLD through hypertension, CRP, diabetes, and dyslipidemia, suggesting further longitudinal studies, especially in high-risk populations. These findings underscore the complex interplay between diet, inflammation, and NAFLD in Iranian adults.https://doi.org/10.1186/s41043-024-00721-1DietDietary inflammatory indexNAFLDStructural equation modelingIranian cohort
spellingShingle Azam Doustmohammadian
Farhad Zamani
James R. Hébert
Maziar Moradi-Lakeh
Sepideh Esfandyiari
Bahareh Amirkalali
Nima Motamed
Mansooreh Maadi
Sherry Price
Esmaeel Gholizadeh
Hossein Ajdarkosh
Exploring the link between dietary inflammatory index and NAFLD through a structural equation modeling approach
Journal of Health, Population and Nutrition
Diet
Dietary inflammatory index
NAFLD
Structural equation modeling
Iranian cohort
title Exploring the link between dietary inflammatory index and NAFLD through a structural equation modeling approach
title_full Exploring the link between dietary inflammatory index and NAFLD through a structural equation modeling approach
title_fullStr Exploring the link between dietary inflammatory index and NAFLD through a structural equation modeling approach
title_full_unstemmed Exploring the link between dietary inflammatory index and NAFLD through a structural equation modeling approach
title_short Exploring the link between dietary inflammatory index and NAFLD through a structural equation modeling approach
title_sort exploring the link between dietary inflammatory index and nafld through a structural equation modeling approach
topic Diet
Dietary inflammatory index
NAFLD
Structural equation modeling
Iranian cohort
url https://doi.org/10.1186/s41043-024-00721-1
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