Diet Quality as an Associated Factor for Liver Function Enzyme Abnormalities Among Women of Reproductive Age

Background Elevated liver enzymes, such as alanine aminotransferase (ALT) and aspartate aminotransferase (AST), are early indicators of liver dysfunction in non-alcoholic fatty liver disease (NAFLD). The prevalence of NAFLD is increasing in Bangladesh, with studies indicating a higher prevalence among women. Additionally, rapid dietary transitions toward energy-dense foods rich in fat and sugar have contributed to the rising burden of non-communicable diseases. This study aimed to investigate the association between dietary intake, diet quality indicators, and elevated liver enzymes (ALT and AST) among women of reproductive age in Bangladesh. Methods A cross-sectional study was conducted among 240 women of reproductive age (15-49 years) randomly selected from community households in three selected districts of Bangladesh. Anthropometric and socioeconomic data were collected using standardized tools. Dietary intake was assessed using a single 24-hour dietary recall method and a Food Frequency Questionnaire (FFQ). Three complementary indices were applied to evaluate diet quality: Dietary Diversity (DD), Food Consumption Score (FCS), and the Bangladesh Healthy Eating Index (BD_HEI). The participant's blood was collected after overnight fasting. Serum ALT and AST levels were measured using a biochemical analyzer, and elevations in liver enzymes were defined according to standard clinical cut-off values. Descriptive and inferential statistics were performed using STATA version 15.1 (Stata Corp LLC, College Station, TX, USA). Results Among the 240 participants, 69 (28.7%) exhibited elevated ALT and/or AST levels, while 171 (71.3%) had normal values. Participants with elevated liver enzymes had higher intake of saturated fat (5.89 vs. 4.41 g, IQR: (3.84-9.63 vs. 2.98-7.15), p =0.010), cholesterol (55.21 vs. 30.41 mg, IQR: (15.21-137.92 vs. 0-106.61), p = 0.015). Participants with elevated liver enzymes had significantly lower FCS scores (23.2% vs. 9.4%, p = 0.014) but higher DD (27.5% vs. 15.8%, p = 0.036) as compared to normal liver enzymes. Multivariable logistic regression revealed that low FCS significantly increased the odds of elevated liver enzymes (AOR = 3.64, 95% CI: 1.53-8.62, p = 0.003). Conclusion This study highlights a significant association between poor FCS and liver enzyme abnormalities among Bangladeshi women of reproductive age. Integrating dietary quality interventions into reproductive health and noncommunicable disease (NCD) prevention programs could play a vital role in maintaining liver health and metabolic well-being in this vulnerable population.