Soft drinks consumption is associated with nonalcoholic fatty liver disease independent of metabolic syndrome in Chinese population

Ge Meng, Bo Zhang, Fei Yu, Chunlei Li, Qing Zhang, Li Liu, Hongmei Wu, Yang Xia, Xue Bao, Hongbin Shi, Qian Su, Yeqing Gu, Liyun Fang, Huijun Yang, Bin Yu, Shaomei Sun, Xing Wang, Ming Zhou, Qiyu Jia, Huanli Jiao, Bangmao Wang, Qi Guo, Livia A. Carvalhoa, Zhong Sun, Kun Song, Ming Yu, Kaijun Niu

Excessive consumption of soft drinks is associated with nonalcoholic fatty liver disease (NAFLD). However, the association between soft drinks consumption and NAFLD is unclear in non-Caucasian adults with relatively low soft drinks consumption. The aim of this study was to assess the association between soft drinks consumption and NAFLD in Chinese adults. A cross-sectional study was conducted with 26,790 adults living in Tianjin, China. NAFLD (with elevated alanine aminotransferase [ALT]) was diagnosed by the liver ultrasonography and serum ALT concentrations. Soft drinks consumption was assessed using a validated self-administered food frequency questionnaire, and it was summarized as three categories for analysis: almost never (reference), <1 cup/week, and ≥1 cups/week. Metabolic syndrome (MetS) was defined according to the criteria of the American Heart Association scientific statements of 2009. The association between soft drinks consumption and NAFLD was assessed by multiple logistic regression analysis. The prevalence of NAFLD and NAFLD with elevated ALT was 27.1 and 6.5%, respectively. After adjustment for potential confounding variables (including MetS), the odds ratios (95% confidence intervals) for NAFLD or NAFLD with elevated ALT across soft drinks consumption were 1.00 (reference) for almost never, 1.14 (1.02-1.27) or 1.16 (0.98-1.37) for <1 cup/week, and 1.26 (1.14-1.40) or 1.32 (1.13-1.53) for ≥1 cups/week (both P for trend <0.001), respectively. This is the first study to demonstrate that soft drinks consumption is associated with NAFLD independent of MetS in Chinese adults with relatively low soft drinks consumption. These results suggest that reducing soft drinks consumption might be beneficial to the prevention of NAFLD.