Abstract 2169: Dietary inflammatory potential and mortality among patients with MAFLD
Authors: Lyu Zhangyan , Zhang Yacong , Li Wenxuan , Si Guoijn , Chen Kexin 
Published: March 2024

Background: Inflammation is important in metabolic dysfunction-associated fatty liver disease (MAFLD) development and progression. However, evidence regarding the influence of dietary inflammatory potential and mortality among people with MAFLD is rare. This study aimed to elucidate the association of the energy-density dietary inflammatory index (E-DII) with all-cause and cause-specific mortality among MAFLD patients.

Methods: Data were obtained from the National Health and Nutrition Examination Survey (NHANES) (1988-1994, 1999-2010). MAFLD was defined as the evidence of hepatic steatosis with ≥1 of the following: type 2 diabetes (T2DM), overweight/obesity (OW, BMI ≥ 25 kg/m2), or lean metabolic dysregulation (MD). Dietary intake was assessed through 24-hour dietary recalls. E-DII scores and component intakes were divided into tertiles, with T1 as the reference. Through linkage to National Death Index by December 31, 2019, mortality from all cause, cardiovascular disease (CVD), and cancer were identified. Multivariable Cox proportional hazards regression model and restricted cubic splines (RCS) were used to analyze the association between dietary inflammatory potential and mortality among MAFLD and its subtypes patients.

Results: A total of 6537 MAFLD patients were included in the present analysis. During the median follow-up of 16.8 years, 2281 total deaths (534 cancer-related, 750 CVD-related) were documented. Compared to high dietary inflammatory potential, low dietary inflammatory potential presented a inverse association with all-cause mortality risk in MAFLD patients (HR T2 vs. T1 = 0.83, 95% CI = 0.72-0.95, HR T3 vs. T1 = 0.88, 95% CI = 0.76-1.01, P trend = 0.092) and OW subtype patients (HR T2 vs. T1 = 0.77, 95% CI = 0.63-0.93, HR T3 vs. T1 = 0.76, 95% CI = 0.63-0.92, P trend = 0.009). No significant benefit was observed among T2DM and MD subtype patients. Further component analysis found that eicosapentaenoic acid (EPA) (HR = 0.74, 95% CI = 0.66-0.83), docosapentaenoic acid (DPA) (HR = 0.72, 95% CI = 0.65-0.80), docosahexaenoic acid (DHA) (HR = 0.85, 95% CI = 0.65-0.80), and linoleic acid (HR = 0.86, 95% CI = 0.79-0.94) were linked with reduced cancer mortality risk in MAFLD patients. Further RCS analyses found that the effect pattern of EPA, DPA, and DHA on both all-cause and cause-specific mortality was presented as “J shaped” (P non-linear &lt; 0.05). Similar results were observed for all-cause and CVD mortality among both MAFLD and OW subtype patients. When excluding participants who died within five years, consistent results were presented.

Conclusions: The findings of this study suggest that keep low-inflammatory dietary pattern, especially appropriate level of PUFAs component (EPA, DPA, and DHA) intake were associated with a lower risk of cancer mortality in MAFLD patients. These findings may inform future public health guidelines regarding specific dietary consumption, and liver-related health promotion.

Citation Format: Zhangyan Lyu, Yacong Zhang, Wenxuan Li, Guoijn Si, Kexin Chen. Dietary inflammatory potential and mortality among patients with MAFLD [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2169.