Exploring the Path of Mediterranean Diet, Non-Alcoholic Fatty Liver Disease (NAFLD) and Inflammation towards 10-Year Cardiovascular Disease (CVD) Risk: The ATTICA Study 10-Year Follow-Up (2002–2012)
Abstract
:1. Introduction
2. Materials and Methods
2.1. Sampling Procedure at Baseline Examination
2.2. Baseline Measurements
Demographics and Lifestyle
2.3. Dietary Assessment
2.4. Clinical Assessment
2.5. Definition of the Non-Alcoholic Fatty Liver Disease (NAFLD)
Fatty Liver Index
2.6. Follow-Up Examination (2011–2012)
2.7. Analytical Sample
2.8. Bioethics
2.9. Statistical Analysis
3. Results
3.1. Cross-Sectional Analysis
3.2. Prospective Analysis
4. Discussion
Strengths and Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
References
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Baseline Characteristics | FLI < 30 (n = 271) | 30 ≤ FLI < 60 (n = 137) | FLI ≥ 60 (n = 136) | p-Value |
---|---|---|---|---|
Gender, male, n (%) | 40 (21.9) * | 61 (44.5) | 82 (44.8) | <0.001 |
Age (years) | 43.8 (13.5) * | 54.6 (14.0) | 53.5 (13.7) | <0.001 |
Education (school years) | 12.6 (3.8) * | 10.9 (4.5) | 11.1 (4.3) | <0.001 |
MedDietScore (0–55) | 27.5 (2.9) * | 23.8 (5.0) | 21.8 (5.0) * | <0.001 |
Ethanol intake (g/day) ^ | 0 (0, 0) | 0 (0, 0) | 0 (0, 20) * | <0.001 |
Sedentary lifestyle, yes, n (%) | 176 (64.9) | 83 (60.6) | 96 (70.6) | 0.219 |
Smoking, yes, n (%) | 127 (46.9) | 70 (51.1) | 61 (44.9) | 0.567 |
Body mass index (kg/m2) | 23.1 (2.5) * | 27.3 (2.3) | 31.5 (4.1) * | <0.001 |
Waist circumference (cm) | 78.7 (9.1) | 93.0 (6.3) | 105 (8.4) | <0.001 |
Diabetes mellitus, yes, n (%) | 7 (2.6) | 10 (7.3) | 23 (16.9) | <0.001 |
Hypertension, yes, n (%) | 48 (18.5) | 44 (34.1) | 67 (51.1) | <0.001 |
Hypercholesterolemia, yes, n (%) | 111 (41.0) | 83 (60.6) | 72 (25.0) | <0.001 |
Triglycerides (mg/dL) | 80.0 (59.0, 103) * | 118 (92.0, 158) | 151 (106, 228) * | <0.001 † |
C-reactive protein (mg/L) | 0.56 (0.26, 1.51) * | 1.17 (0.62, 2.41) | 1.81 (0.99, 3.59) * | <0.001 † |
gamma-GT (IU/L) | 14.0 (12.0, 17.0) | 19.0 (14.0, 26.0) | 24.0 (19.5, 34.0) | <0.001 † |
Variable | Odds Ratio for NAFLD Presence | 95% Confidence Interval |
---|---|---|
MedDietScore (per 1/55) | 0.85 | (0.80, 0.91) |
Age (per 1 year) | 0.99 | (0.97, 1.02) |
Gender (male vs. female) | 5.05 | (2.70, 9.43) |
Education level (per 1 school year) | 1.00 | (0.92, 1.08) |
Smoking current, (yes vs. no) | 0.72 | (0.40, 1.31) |
Physical activity (yes vs. no) | 0.54 | (0.29, 1.01) |
C-reactive protein (per 1 mg/L) | 1.28 | (1.15, 1.42) |
Model | Model 1 OR (95% CI) | Model 2 OR (95% CI) | Model 3 OR (95% CI) |
---|---|---|---|
NAFLD (yes vs. no) | 2.4 (1.38, 4.29) | 1.35 (0.71, 2.58) | 0.93 (0.42, 2.03) |
MedDietScore (per 1/55) * | 0.88 (0.84, 0.92) | 0.99 (0.85, 0.94) | 0.87 (0.80, 0.96) |
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George, E.S.; Georgousopoulou, E.N.; Mellor, D.D.; Chrysohoou, C.; Pitsavos, C.; Panagiotakos, D.B. Exploring the Path of Mediterranean Diet, Non-Alcoholic Fatty Liver Disease (NAFLD) and Inflammation towards 10-Year Cardiovascular Disease (CVD) Risk: The ATTICA Study 10-Year Follow-Up (2002–2012). Nutrients 2022, 14, 2367. https://doi.org/10.3390/nu14122367
George ES, Georgousopoulou EN, Mellor DD, Chrysohoou C, Pitsavos C, Panagiotakos DB. Exploring the Path of Mediterranean Diet, Non-Alcoholic Fatty Liver Disease (NAFLD) and Inflammation towards 10-Year Cardiovascular Disease (CVD) Risk: The ATTICA Study 10-Year Follow-Up (2002–2012). Nutrients. 2022; 14(12):2367. https://doi.org/10.3390/nu14122367
Chicago/Turabian StyleGeorge, Elena S., Ekavi N. Georgousopoulou, Duane D. Mellor, Christina Chrysohoou, Christos Pitsavos, and Demosthenes B. Panagiotakos. 2022. "Exploring the Path of Mediterranean Diet, Non-Alcoholic Fatty Liver Disease (NAFLD) and Inflammation towards 10-Year Cardiovascular Disease (CVD) Risk: The ATTICA Study 10-Year Follow-Up (2002–2012)" Nutrients 14, no. 12: 2367. https://doi.org/10.3390/nu14122367