Hostname: page-component-669899f699-8p65j Total loading time: 0 Render date: 2025-05-03T08:41:34.247Z Has data issue: false hasContentIssue false
  • English
  • Français

Association between dietary tea consumption and non-alcoholic fatty liver disease: a study based on Mendelian randomisation and National Health and Nutrition Examination Survey (2005-2018) association between tea and non-alcoholic fatty liver disease

Published online by Cambridge University Press:  30 October 2024

Shuyu Liu Open the ORCID record for Shuyu Liu [Opens in a new window] ,
Quanpeng Li ,
Peng Chen ,
Yuting Wang ,
Xianxiu Ge ,
Fei Wang ,
Mengyue Zhou ,
Jianing Xu ,
Yingting Zhu  and
Lin Miao
...Show all authors
Shuyu Liu
Affiliation:
Medical Center for Digestive Diseases, Second Affiliated Hospital, Nanjing Medical University, Nanjing, People’s Republic of China
Quanpeng Li
Affiliation:
Medical Center for Digestive Diseases, Second Affiliated Hospital, Nanjing Medical University, Nanjing, People’s Republic of China
Peng Chen
Affiliation:
The Fourth Affiliated Hospital of Nanjing Medical University, Nanjing, People’s Republic of China
Yuting Wang
Affiliation:
Medical Center for Digestive Diseases, Second Affiliated Hospital, Nanjing Medical University, Nanjing, People’s Republic of China
Xianxiu Ge
Affiliation:
Medical Center for Digestive Diseases, Second Affiliated Hospital, Nanjing Medical University, Nanjing, People’s Republic of China
Fei Wang
Affiliation:
Medical Center for Digestive Diseases, Second Affiliated Hospital, Nanjing Medical University, Nanjing, People’s Republic of China
Mengyue Zhou
Affiliation:
Department of Gastroenterology of Nanjing Pukou Hospital of Traditional Chinese Medicine, Nanjing, People’s Republic of China
Jianing Xu
Affiliation:
Medical Center for Digestive Diseases, Second Affiliated Hospital, Nanjing Medical University, Nanjing, People’s Republic of China
Yingting Zhu
Affiliation:
Medical Center for Digestive Diseases, Second Affiliated Hospital, Nanjing Medical University, Nanjing, People’s Republic of China
Lin Miao*
Affiliation:
Medical Center for Digestive Diseases, Second Affiliated Hospital, Nanjing Medical University, Nanjing, People’s Republic of China
Xueting Deng*
Affiliation:
Medical Center for Digestive Diseases, Second Affiliated Hospital, Nanjing Medical University, Nanjing, People’s Republic of China
*
*Corresponding authors: Xueting Deng, email [email protected]; Lin Miao, email [email protected]. Institution email: [email protected]
*Corresponding authors: Xueting Deng, email [email protected]; Lin Miao, email [email protected]. Institution email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Tea can improve the progression of some metabolic diseases through anti-inflammatory and antioxidant effects, but its impact on non-alcoholic fatty liver disease (NAFLD) is still controversial. The aim of this paper is to identify the relationship between tea and NAFLD by Mendelian randomisation (MR) and complete clinical validation using National Health and Nutrition Examination Survey (NHANES) database. MR used data from Genome Wide Association Study, with inverse-variance weighted (IVW) as principal analytical methods. The reliability of the results was verified by a series of sensitivity and heterogeneity tests. Subsequently, clinical validation was conducted using NHANES (2005–2018), involving 22 257 participants, grouped by the type of tea. Green tea drinkers were categorised into four groups (Q1–Q4) by quartiles of green tea intake, from lowest to highest (similar for black tea drinkers and other tea drinkers). Models were constructed by logistic regression to estimate the role of tea consumption (Q1–4) on NAFLD. Finally, using fibrosis-4 index (FIB-4) to evaluate the severity of hepatic fibrosis, the effect of tea consumption (Q1–4) on the degree of hepatic fibrosis was investigated by linear regression. IVW method (OR = 0·43, 95 % CI: 0·21, 0·85, P = 0·01) and weighted median method (OR = 0·35, 95 % CI: 0·14, 0·91, P = 0·03) revealed there was a causal relationship between tea and NAFLD. An array of sensitivity analyses validated the reliability of results. Analysis of NHANES indicated tea drinker present a slightly lower prevalence of NAFLD than non-tea drinker (green tea drinkers: 47·6 %, black tea drinkers: 46·3 %, other tea drinker: 43·2 %, non-tea drinkers: 48·1 %, P < 0·05). After adjusting for confounders, compared with the lowest black tea consumption (Q1), the population with the highest black tea consumption (Q4) was independently related to lower presence of NAFLD (Q4: OR = 0·69, 95 % CI: 0·50, 0·93, P < 0·05), such association remained stable in the overweight subgroup. As further analysed, Q4 also displayed a significant negative correlation with the level of hepatic fibrosis in patients with NAFLD (β = –0·073, 95 % CI: –0·126, −0·020, P < 0·01).Tea reduces the morbidity of NAFLD and ameliorates hepatic fibrosis degree in those already suffering from the disease.

Keywords

BeveragesTeanon-alcoholic fatty liver diseaseNational Health and Nutrition Examination Survey
Type
Research Article
Information
British Journal of Nutrition , Volume 132 , Issue 9 , 14 November 2024 , pp. 1194 - 1204
Check for updates
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of The Nutrition Society

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Wesolowski, SR, Kasmi, KC, Jonscher, KR, et al. (2017) Developmental origins of NAFLD: a womb with a clue. Nat Rev Gastroenterol Hepatol 14, 81–96.CrossRefGoogle ScholarPubMed
Younossi, ZM, Koenig, AB, Abdelatif, D, et al. (2016) Global epidemiology of nonalcoholic fatty liver disease-meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology (Baltimore, Md) 64, 73–84.CrossRefGoogle Scholar
Younossi, Z, Anstee, QM, Marietti, M, et al. (2018) Global burden of NAFLD and NASH: trends, predictions, risk factors and prevention. Nat Rev Gastroenterol Hepatol 15, 11–20.CrossRefGoogle ScholarPubMed
Martel, C, Esposti, DD, Bouchet, A, et al. (2012) Non-alcoholic steatohepatitis: new insights from OMICS studies. Curr Pharmaceut Biotechnol 13, 726–735.CrossRefGoogle ScholarPubMed
Yang, CS & Wang, ZY (1993) Tea and cancer. J Natl Cancer Institute 85, 1038–1049.CrossRefGoogle ScholarPubMed
Xia, HM, Wang, J, Xie, XJ, et al. (2019) Green tea polyphenols attenuate hepatic steatosis, and reduce insulin resistance and inflammation in high-fat diet-induced rats. Int J Mol Med 44, 1523–1530.Google ScholarPubMed
Wu, Z, Huang, S, Li, T, et al. (2021) Gut microbiota from green tea polyphenol-dosed mice improves intestinal epithelial homeostasis and ameliorates experimental colitis. Microbiome 9, 184.CrossRefGoogle ScholarPubMed
Mokra, D, Joskova, M & Mokry, J (2022) Therapeutic effects of green tea polyphenol (-)-Epigallocatechin-3-Gallate (EGCG) in relation to molecular pathways controlling inflammation, oxidative stress, and apoptosis. Int J Mol Sci 24, 340.CrossRefGoogle ScholarPubMed
Guo, W, Ge, X, Lu, J, et al. (2022) Diet and risk of non-alcoholic fatty liver disease, cirrhosis, and liver cancer: a large prospective cohort study in UK Biobank. Nutrients 14, 5335.CrossRefGoogle ScholarPubMed
Tang, G, Xu, Y, Zhang, C, et al. (2021) Green Tea and Epigallocatechin Gallate (EGCG) for the management of Nonalcoholic Fatty Liver Diseases (NAFLD): insights into the role of oxidative stress and antioxidant mechanism. Antioxidants (Basel, Switzerland) 10, 1076.Google ScholarPubMed
Sekula, P, Del Greco, MF, Pattaro, C, et al. (2016) Mendelian randomization as an approach to assess causality using observational data. J Am Soc Nephrol: JASN 27, 3253–3265.CrossRefGoogle Scholar
Ghodsian, N, Abner, E, Emdin, CA, et al. (2021) Electronic health record-based genome-wide meta-analysis provides insights on the genetic architecture of non-alcoholic fatty liver disease. Cell Rep Med 2, 100437.CrossRefGoogle ScholarPubMed
Pirastu, N, McDonnell, C, Grzeszkowiak, EJ, et al. (2022) Using genetic variation to disentangle the complex relationship between food intake and health outcomes. PLoS Genetics 18, e1010162.CrossRefGoogle ScholarPubMed
Li, C, Niu, M, Guo, Z, et al. (2022) A mild causal relationship between tea consumption and obesity in general population: a two-sample Mendelian randomization study. Front Genetics 13, 795049.CrossRefGoogle ScholarPubMed
Liu, X, Yu, Y, Hou, L, et al. (2023) Association between dietary habits and the risk of migraine: a Mendelian randomization study. Front Nutr 10, 1123657.CrossRefGoogle Scholar
Sun, Y, Liang, Z, Xia, X, et al. (2023) Extra cup of tea intake associated with increased risk of Alzheimer’s disease: genetic insights from Mendelian randomization. Front Nutr 10, 1052281.CrossRefGoogle ScholarPubMed
Brion, MJ, Shakhbazov, K & Visscher, PM (2013) Calculating statistical power in Mendelian randomization studies. Int J Epidemiol 42, 1497–1501.CrossRefGoogle ScholarPubMed
Pierce, BL & Burgess, S (2013) Efficient design for Mendelian randomization studies: subsample and 2-sample instrumental variable estimators. Am J Epidemiol 178, 1177–1184.CrossRefGoogle ScholarPubMed
Bedogni, G, Bellentani, S, Miglioli, L, et al. (2006) The Fatty Liver Index: a simple and accurate predictor of hepatic steatosis in the general population. BMC Gastroenterol 6, 33.CrossRefGoogle ScholarPubMed
Pinzani, M, Vizzutti, F, Arena, U, et al. (2008) Technology Insight: noninvasive assessment of liver fibrosis by biochemical scores and elastography. Nat Clin Pract Gastroenterol Hepatol 5, 95–106.CrossRefGoogle ScholarPubMed
Bowden, J, Davey Smith, G, Haycock, PC, et al. (2016) Consistent estimation in Mendelian randomization with some invalid instruments using a weighted median estimator. Genetic Epidemiol 40, 304–314.CrossRefGoogle ScholarPubMed
Burgess, S & Thompson, SG (2017) Interpreting findings from Mendelian randomization using the MR-Egger method. Eur J Epidemiol 32, 377–389.CrossRefGoogle ScholarPubMed
Verbanck, M, Chen, CY, Neale, B, et al. (2018) Detection of widespread horizontal pleiotropy in causal relationships inferred from Mendelian randomization between complex traits and diseases. Nat Genetics 50, 693–698.CrossRefGoogle ScholarPubMed
Xie, J, Huang, H, Liu, Z, et al. (2023) The associations between modifiable risk factors and nonalcoholic fatty liver disease: a comprehensive Mendelian randomization study. Hepatology (Baltimore, Md) 77, 949–964.CrossRefGoogle ScholarPubMed
Yuan, S, Chen, J, Li, X, et al. (2022) Lifestyle and metabolic factors for nonalcoholic fatty liver disease: Mendelian randomization study. Eur J Epidemiol 37, 723–733.CrossRefGoogle ScholarPubMed
Cai, J, Zhang, L, Chen, C, et al. (2023) Association between serum Klotho concentration and heart failure in adults, a cross-sectional study from NHANES 2007–2016. Int J Cardiol 370, 236–243.CrossRefGoogle ScholarPubMed
Tao, Z, Zhang, R, Zuo, W, et al. (2023) Association between dietary intake of anthocyanidins and heart failure among American adults: NHANES (2007–2010 and 2017–2018). Front Nutr 10, 1107637.CrossRefGoogle Scholar
Soleimani, D, Ranjbar, G, Rezvani, R, et al. (2019) Dietary patterns in relation to hepatic fibrosis among patients with nonalcoholic fatty liver disease. Diabetes, Metab Syndrome Obes: Targets Ther 12, 315–324.CrossRefGoogle Scholar
Xia, Y, Wang, X, Zhang, S, et al. (2019) Daily tea drinking is not associated with newly diagnosed non-alcoholic fatty liver disease in Chinese adults: the Tianjin chronic low-grade systemic inflammation and health cohort study. Nutr J 18, 71.CrossRefGoogle Scholar
Huo, YB, Bai, YN, Zhang, DS, et al. (2021) Analysis on influencing factors for nonalcoholic fatty liver disease in Jinchang cohort. Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi 42, 493–498.Google ScholarPubMed
Imai, K & Nakachi, K (1995) Cross sectional study of effects of drinking green tea on cardiovascular and liver diseases. BMJ (Clin Res Ed) 310, 693–696.CrossRefGoogle ScholarPubMed
Saleh, IG, Ali, Z, Abe, N, et al. (2013) Effect of green tea and its polyphenols on mouse liver. Fitoterapia 90, 151–159.CrossRefGoogle ScholarPubMed
Hoofnagle, JH, Bonkovsky, HL, Phillips, EJ, et al. (2021) HLA-B*35:01 and Green Tea-Induced Liver Injury. Hepatology 73, 2484–2493.CrossRefGoogle Scholar
Cho, T, Wang, X, Yeung, K, et al. (2021) Liver injury caused by green tea extract in PD-1 (-/-) mice: an impaired immune tolerance model for idiosyncratic drug-induced liver injury. Chem Res Toxicol 34, 849–856.CrossRefGoogle ScholarPubMed
Smith, GD & Ebrahim, S (2003) ‘Mendelian randomization’: can genetic epidemiology contribute to understanding environmental determinants of disease? Int J Epidemiol 32, 1–22.CrossRefGoogle ScholarPubMed
Nehmi-Filho, V, Santamarina, AB, de Freitas, JA, et al. (2022) Novel nutraceutical supplements with yeast β-glucan, prebiotics, minerals, and Silybum marianum (silymarin) ameliorate obesity-related metabolic and clinical parameters: a double-blind randomized trial. Front Endocrinol (Lausanne) 13, 1089938.CrossRefGoogle ScholarPubMed
Khan, N & Mukhtar, H (2018) Tea polyphenols in promotion of human health. Nutrients 11, 39.CrossRefGoogle ScholarPubMed
Ohishi, T, Goto, S, Monira, P, et al. (2016) Anti-inflammatory action of green tea. Anti-Inflamm Anti-Allergy Agents Med Chem 15, 74–90.CrossRefGoogle ScholarPubMed
Li, HY, Huang, SY, Zhou, DD, et al. (2023) Theabrownin inhibits obesity and non-alcoholic fatty liver disease in mice via serotonin-related signaling pathways and gut-liver axis. J Adv Res 52, 59–72.CrossRefGoogle ScholarPubMed
Zhang, W, An, R, Li, Q, et al. (2020) Theaflavin TF3 relieves hepatocyte lipid deposition through activating an AMPK signaling pathway by targeting plasma kallikrein. J Agric Food Chem 68, 2673–2683.CrossRefGoogle ScholarPubMed
Valim, V, Martins-Filho, OA, Gouvea, M, et al. (2022) Effectiveness, safety, and immunogenicity of half dose ChAdOx1 nCoV-19 COVID-19 vaccine: Viana project. Front Immunol 13, 966416.CrossRefGoogle ScholarPubMed
Huang, YW, Wang, LT, Zhang, M, et al. (2023) Caffeine can alleviate non-alcoholic fatty liver disease by augmenting LDLR expression via targeting EGFR. Food Funct 14, 3269–3278.CrossRefGoogle ScholarPubMed
Shen, Y, Xiao, X, Wu, K, et al. (2020) Effects and molecular mechanisms of Ninghong black tea extract in nonalcoholic fatty liver disease of rats. J Food Sci 85, 800–807.CrossRefGoogle ScholarPubMed
Li, B, Mao, Q, Xiong, R, et al. (2022) Preventive effects of different black and dark teas on obesity and non-alcoholic fatty liver disease and modulate gut microbiota in high-fat diet fed mice. Foods 11, 3457.CrossRefGoogle ScholarPubMed
Karolczak, D, Seget, M, Bajerska, J, et al. (2019) Green tea extract prevents the development of nonalcoholic liver steatosis in rats fed a high-fat diet. Polish J Pathol: Offic J Polish Soc Pathologists 70, 295–303.CrossRefGoogle ScholarPubMed
Pan, H, Gao, Y & Tu, Y (2016) Mechanisms of body weight reduction by black tea polyphenols. Molecules 21, 1659.CrossRefGoogle ScholarPubMed
Yang, HH, Zhou, H, Zhu, WZ, et al. (2020) Green tea consumption may be associated with cardiovascular disease risk and nonalcoholic fatty liver disease in type 2 diabetics: a cross-sectional study in Southeast China. J Med Food 23, 1120–1127.CrossRefGoogle ScholarPubMed
Forst, T, Botz, I, Berse, M, et al. (2024) Non-alcoholic fatty liver disease in obese subjects as related to increasing insulin resistance and deteriorating glucose control: three years of follow-up from a longitudinal survey. J Diabetes Metab Disord 23, 999–1006.CrossRefGoogle ScholarPubMed
Supplementary material: File

Liu et al. supplementary material

Liu et al. supplementary material
Download Liu et al. supplementary material(File)
File 348.2 KB