Association of Dietary Phytochemical Index and Anthropometric Risk Factors with Non-alcoholic Fatty Liver Disease in People with Diabetes

Background and Objectives: High prevalence of non-alcoholic fatty liver disease in patients with type 2 diabetes mellitus results in deleterious complications and morbidities. Therefore, the aim of this study was to assess nutritional and anthropometrical risk factors in progression of non-alcoholic fatty liver disease in diabetic patients.  Materials & Methods: Totally, 133 non-alcoholic fatty liver disease patients (CAP score > 270) and 67 controls (CAP score < 270) were selected from the patients with type 2 diabetes mellitus in a clinic. Dietary phytochemical index was calculated via data from a validated 147-item FFQ. Body composition were measured using dual-energy X-ray absorptiometry. Other anthropometric indices and laboratory assays were used as well. Logistic regression models were used to estimate multivariable ORs. Results: After adjustment for potential confounders, risk of progression for non-alcoholic fatty liver disease in participants with higher dietary phytochemical indices significantly decreased (OR = 0.35, 95% CI: 0.12–0.98, p = 0.048). After fully adjustment of covariates and independently from body mass index, positive associations were seen between the highest tertile of TLR (OR = 7.99, 95% CI: 2.43–26.26, p = 0.001), METS-VF (OR = 4.55, 95% CI: 1.46–14.2,  p = 0.009) and risk of non-alcoholic fatty liver disease. Conclusion: Findings of this study have demonstrated that phytochemical components of diet play protective roles against non-alcoholic fatty liver disease.  Moreover, TLR and METS-VF are addressed as novel estimators of central obesity as a risk factor for non-alcoholic fatty liver disease in diabetes.