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

Area of Science:

• Metabolic and Nutritional Epidemiology
• Public Health
• Clinical Medicine

Background:

• Nonalcoholic fatty liver disease (NAFLD), also known as metabolic dysfunction-associated steatotic liver disease (MASLD), is a growing global health concern.
• Dietary patterns and lifestyle choices are fundamental to managing NAFLD.
• Understanding the link between diet-induced inflammation and NAFLD is critical for public health strategies.

Purpose of the Study:

• To investigate the association between diet-related inflammation and NAFLD in Iranian adults.
• To explore the mediating roles of hypertension, C-reactive protein (CRP), diabetes, and dyslipidemia in this relationship.
• To utilize Structural Equation Modeling (SEM) for a comprehensive analysis.

Main Methods:

• The study analyzed data from 3110 Iranian adults in the Amol Cohort Study (AmolCS).
• Dietary inflammatory potential was assessed using the energy-adjusted dietary inflammatory index (E-DII) score.
• Structural Equation Modeling (SEM) was employed to analyze the complex associations.

Main Results:

• A significant association was found between the E-DII score and NAFLD in the total sample and in males, mediated by hypertension and CRP.
• In the total sample and females, the E-DII score significantly affected NAFLD, with diabetes acting as a mediator.
• Dyslipidemia was identified as a risk factor for NAFLD and partially mediated the effect of hypertension.

Conclusions:

• Dietary inflammation is significantly associated with NAFLD through mediated pathways involving hypertension, CRP, diabetes, and dyslipidemia.
• These findings emphasize the intricate relationship between diet, inflammation, and NAFLD in the Iranian adult population.
• Further longitudinal research in high-risk groups is recommended to confirm these associations.