ArticlePloS one2025
Exploring the association between dietary indices and metabolic dysfunction-associated steatotic liver disease: Mediation analysis and evidence from NHANES.
Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Composite dietary antioxidant index and risk of metabolic dysfunction - associated steatotic liver disease: evidence from a prospective cohort study.Nutrition & metabolism · 2026Article
- Effect of nutritional intervention on interleukin-18 and alpha-2-macroglobulin in women with obesity and metabolic dysfunction-associated fatty liver disease: a prospective cohort study.Journal of health, population, and nutrition · 2026Article
- Association of the atherogenic index of plasma and a novel triglyceride-glucose-body shape index with stroke: insights from NHANES and machine learning approaches.BMC cardiovascular disorders · 2026Article
- Systemic immune-inflammation index-mediated association of composite dietary antioxidant index with obesity in children and adolescents: based on NHANES 2011-2018.Lipids in health and disease · 2025Article
- Sex Differences in the Association Between the Korean Healthy Eating Index and Liver Enzymes Among Korean Adults.Nutrients · 2025Article
- Association between circadian syndrome and MASLD risk: evidence from a large cross-sectional study.BMC gastroenterology · 2025Article
- Association of dietary inflammatory index with liver fibrosis and fatty liver index in a population with metabolic dysfunction-associated steatotic liver disease: A cross-sectional study.Frontiers in nutrition · 2025Article
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6 authors.
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Abstract
backgroundThe association between dietary indices and metabolic dysfunction-associated steatotic liver disease (MASLD) has shown inconsistent results in previous studies. Additionally, the potential mediating variables linking dietary quality to MASLD have not been adequately explored.
methodsWe analyzed data from 6,369 participants in the National Health and Nutrition Examination Survey (NHANES) 2007-2018. Three dietary indices-Healthy Eating Index (HEI), Energy-adjusted Dietary Inflammatory Index (EDII), and Composite Dietary Antioxidant Index (CDAI)-were evaluated for their associations with MASLD using logistic regression models adjusted for a comprehensive range of covariates. Mediation analysis was performed to evaluate the roles of potential mediators from four domains: insulin resistance (homeostatic model assessment of insulin resistance, HOMA-IR; metabolic score for insulin resistance, METS-IR), systemic inflammation (systemic inflammatory response index, SIRI; systemic immune-inflammation index, SII), obesity or visceral fat distribution (a body shape index, ABSI; body roundness index, BRI), and oxidative stress (Gamma-Glutamyltransferase, GGT; Bilirubin; Uric Acid).
resultsAfter adjusting for all covariates, only HEI showed a consistent inverse association with MASLD, while EDII and CDAI showed no significant associations. Mediation analysis identified METS-IR, HOMA-IR, BRI, and ABSI as significant mediators in the relationship between HEI and MASLD, with mediation proportion accounting for 47.16%, 48.84%, 52.69%, and 13.84%, respectively.
conclusionHigher HEI is associated with a reduced risk of MASLD. The findings suggest that insulin resistance and visceral fat distribution partially mediate the relationship between HEI and MASLD, providing insights into potential mechanisms linking diet and liver health.
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