ArticleInternal and emergency medicine2026
Dietary sodium density as a potential nutritional marker of HSI-defined hepatic steatosis in Korean adults: a nationwide cross-sectional study with a dose-response analysis.
Article in Internal and emergency medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe association between energy-adjusted dietary sodium density and non-invasively assessed hepatic steatosis remains poorly defined in population-based studies.
aimWe investigated the association and dose-response relationship between dietary sodium density and HSI-defined hepatic steatosis in Korean adults.
methodsWe analyzed 14,445 adults (aged ≥20 years) from the 2021-2023 KNHANES. Sodium intake from a 24-h recall was calculated as sodium density (mg/1,000 kcal). HSI ≥36 defined hepatic steatosis; descriptive analyses compared HSI <36 versus ≥36, whereas regression analyses used HSI <30 as the reference, with HSI 30.0-35.9 treated separately.
resultsCompared with HSI <30, each 100 mg/1,000 kcal increase in sodium density was associated with higher odds of HSI-defined hepatic steatosis across all models: Unadjusted OR 1.058 (95% CI 1.032-1.085; P<0.001), Age/Sex-adjusted OR 1.051 (95% CI 1.024-1.079; P<0.001), Lifestyle-adjusted OR 1.048 (95% CI 1.020-1.077; P=0.001), and Fully adjusted OR 1.054 (95% CI 1.020-1.089; P=0.002). Participants in the highest sodium density quartile (Q4) exhibited 36.2% higher odds of HSI-defined hepatic steatosis than those in the lowest quartile (Q1) (adjusted OR 1.362; 95% CI 1.144-1.621; P=0.0004; P for trend = 0.001). The association remained robust after adjusting for potassium density (OR 1.042; 95% CI 1.012-1.072; P=0.005). RCS analysis showed an approximately linear increase in odds across the observed range, without evidence of non-linearity (P=0.738).
conclusionsElevated sodium density was associated with higher odds of HSI-defined hepatic steatosis and may serve as a nutritional marker of metabolic liver health.
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