title: Association between Dietary Vitamin C Intake and Non-Alcoholic Fatty Liver Disease: A Cross-Sectional Study among Middle-Aged and Older Adults.
abstract: BACKGROUND
  Non-alcoholic fatty liver disease (NAFLD) has become one of the most prevalent chronic liver disease all over the world. The objective of this study was to evaluate the association between dietary vitamin C intake and NAFLD.
  
  
  METHODS
  Subjects were diagnosed with NAFLD by abdominal ultrasound examination and the consumption of alcohol was less than 40g/day for men or less than 20g/day for women. Vitamin C intake was classified into four categories according to the quartile distribution in the study population: ≤74.80 mg/day, 74.81-110.15 mg/day, 110.16-146.06 mg/day, and ≥146.07 mg/day. The energy and multi-variable adjusted odds ratio (OR), as well as their corresponding 95% confidence interval (CI), were used to determine the relationship between dietary vitamin C intake and NAFLD through logistic regression.
  
  
  RESULTS
  The present cross-sectional study included 3471 subjects. A significant inverse association between dietary vitamin C intake and NAFLD was observed in the energy-adjusted and the multivariable model. The multivariable adjusted ORs (95%CI) for NAFLD were 0.69 (95%CI: 0.54-0.89), 0.93 (95%CI: 0.72-1.20), and 0.71 (95%CI: 0.53-0.95) in the second, third and fourth dietary vitamin C intake quartiles, respectively, compared with the lowest (first) quartile. The relative odds of NAFLD was decreased by 0.71 times in the fourth quartile of dietary vitamin C intake compared with the lowest quartile. After stratifying data by sex or the status of obesity, the inverse association remained valid in the male population or non-obesity population, but not in the female population or obesity population.
  
  
  CONCLUSIONS
  There might be a moderate inverse association between dietary vitamin C intake and NAFLD in middle-aged and older adults, especially for the male population and non-obesity population.
authors.affiliation: Health Management Center, Xiangya Hospital, Central South University, Changsha, Hunan Province, China.|Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, Hunan Province, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Wei
authors.affiliation: Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China.
authors.forename: Guang-Hua
authors.initials: GH
authors.lastname: Lei
authors.affiliation: Department of Infectious Disease, Xiangya Hospital, Central South University, Changsha, Hunan Province, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Fu
authors.affiliation: Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Zeng
authors.affiliation: Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China.
authors.forename: Tuo
authors.initials: T
authors.lastname: Yang
authors.affiliation: Health Management Center, Xiangya Hospital, Central South University, Changsha, Hunan Province, China.|Department of Infectious Disease, Xiangya Hospital, Central South University, Changsha, Hunan Province, China.
authors.forename: Shi-Fang
authors.initials: SF
authors.lastname: Peng
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000975:Antioxidants / Q000627:therapeutic use*; D001205:Ascorbic Acid / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D019587:Dietary Supplements / Q000032:analysis; D002149:Energy Intake; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control*; D009765:Obesity / Q000150:complications; D016017:Odds Ratio; D012307:Risk Factors; D014815:Vitamins / Q000627:therapeutic use*
chemical_list: D000975:Antioxidants; D014815:Vitamins; D001205:Ascorbic Acid
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