Background & Aims

Nonalcoholic fatty liver disease (NAFLD) is associated with sugar-sweetened beverage (SSB) consumption in cross-sectional studies. In a prospective cohort, we examined the association of beverage consumption (SSB and diet soda) with incident NAFLD and changes in hepatic fat in the Framingham Heart Study (FHS).

Methods

We conducted a prospective observational study of participants from the FHS Third Generation and Offspring cohorts who participated in computed tomography sub-studies. Participants were classified according to their average SSB or diet soda consumption, which was derived from baseline and follow-up food frequency questionnaires: non-consumers (0–<1/month), occasional consumers (1/month–<1/week), and frequent consumers (≥1/week–≥1/day). Hepatic fat was quantified by the liver fat attenuation measurements on computed tomography scan. The primary dependent variable was incident NAFLD; secondarily, we investigated change in liver fat.

Results

The cohorts included 691 Offspring (mean age, 62.8 ± 8.2 years; 57.7% women) and 945 Third Generation participants (mean age, 48.4 ± 6.3 years; 46.6% women). In the Offspring cohort, there was a dose-response relationship with SSB consumption and incident NAFLD. Frequent SSB consumers had 2.53 times increased odds of incident NAFLD compared with non-consumers (95% confidence interval, 1.36–4.7) after multivariable analysis. For Offspring cohort participants, occasional and frequent consumers of SSB had a more adverse increase in liver fat compared with non-consumers.

Conclusions

Higher average SSB intake is associated with increase in liver fat over 6 years of follow-up and increased odds of incident NAFLD especially among the older cohort, whereas no consistent association was observed for the younger Third Generation cohort.

中文翻译：

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超过 6 年的含糖饮料、无糖汽水和非酒精性脂肪肝：弗雷明汉心脏研究

背景与目标

在横断面研究中，非酒精性脂肪性肝病 (NAFLD) 与含糖饮料 (SSB) 的消费有关。在一项前瞻性队列研究中，我们在弗雷明汉心脏研究 (FHS) 中检查了饮料消费（SSB 和无糖汽水）与 NAFLD 事件和肝脂肪变化之间的关系。

方法

我们对参加计算机断层扫描子研究的 FHS 第三代和后代队列的参与者进行了前瞻性观察研究。参与者根据他们的平均 SSB 或无糖汽水消费量进行分类，该消费量来自基线和后续食物频率问卷：非消费者（0-<1/月），偶尔消费者（1/月-<1/周）和频繁的消费者（≥1/周–≥1/天）。通过计算机断层扫描上的肝脏脂肪衰减测量来量化肝脏脂肪。主要因变量是 NAFLD；其次，我们调查了肝脏脂肪的变化。

结果

队列包括 691 名后代（平均年龄，62.8 ± 8.2 岁；57.7% 女性）和 945 名第三代参与者（平均年龄，48.4 ± 6.3 岁；46.6% 女性）。在后代队列中，SSB 消耗和 NAFLD 事件存在剂量反应关系。在多变量分析后，与非消费者相比，频繁的 SSB 消费者发生 NAFLD 的几率增加 2.53 倍（95% 置信区间，1.36-4.7）。对于后代队列参与者，与非消费者相比，SSB 的偶尔和频繁消费者的肝脏脂肪增加更为不利。

结论

较高的平均 SSB 摄入量与 6 年随访期间肝脏脂肪的增加和 NAFLD 发生率增加有关，尤其是在老年人群中，而在较年轻的第三代队列中没有观察到一致的关联。