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. 2022 Jul 13:9:943790.
doi: 10.3389/fnut.2022.943790. eCollection 2022.

The Association of Salt Intake and Non-alcoholic Fatty Liver Disease in People With Type 2 Diabetes: A Cross-Sectional Study

Fuyuko Takahashi  1 , Yoshitaka Hashimoto  1   2 , Ayumi Kaji  1 , Ryosuke Sakai  1 , Yuka Kawate  1 , Takuro Okamura  1 , Noriyuki Kitagawa  1   3 , Hiroshi Okada  1 , Naoko Nakanishi  1 , Saori Majima  1 , Takafumi Osaka  1 , Takafumi Senmaru  1 , Emi Ushigome  1 , Masahide Hamaguchi  1 , Michiaki Fukui  1
Affiliations

The Association of Salt Intake and Non-alcoholic Fatty Liver Disease in People With Type 2 Diabetes: A Cross-Sectional Study

Fuyuko Takahashi et al. Front Nutr. .

Abstract

Objectives: Non-alcoholic fatty liver disease (NAFLD), which has a close relationship with type 2 diabetes (T2D), is related to salt intake in the general population. In contrast, the relationship between salt intake and the presence of NAFLD in patients with T2D has not been clarified.

Methods: Salt intake (g/day) was assessed using urinary sodium excretion, and a high salt intake was defined as an intake greater than the median amount of 9.5 g/day. Hepatic steatosis index (HSI) ≥ 36 points was used to diagnosed NAFLD. Odds ratios of high salt intake to the presence of NAFLD were evaluated by logistic regression analysis.

Results: The frequency of NAFLD was 36.5% in 310 patients with T2D (66.7 ± 10.7 years old and 148 men). The patients with high salt intake had a higher body mass index (25.0 ± 4.0 vs. 23.4 ± 3.8 kg/m2, p < 0.001) than those with low salt intake. HSI in patients with high salt intake was higher than that in patients with low salt intake (36.2 ± 6.2 vs. 34.3 ± 5.5 points, p = 0.005). In addition, the presence of NALFD in patients with high salt intake was higher than that in patients with low salt intake (44.5% vs. 28.4%, p = 0.005). High salt intake was associated with the prevalence of NAFLD [adjusted odds ratio, 1.76 (95% confidence interval: 1.02-3.03), p = 0.043].

Conclusion: This cross-sectional study revealed that salt intake is related to the prevalence of NAFLD in patients with T2D.

Keywords: NAFLD; diet; nutrition; salt intake; type 2 diabetes.

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Conflict of interest statement

YH received personal fees from Novo Nordisk Pharma Ltd., Mitsubishi Tanabe Pharma Corp., Kowa Company Ltd., Sanofi K.K., Takeda Pharmaceutical Co., Ltd., Ono Pharmaceutical Co., Ltd., Daiichi Sankyo Co., Ltd., and Sumitomo Dainippon Pharma Co., Ltd. outside of the submitted work. HO received grant support from the Japan Society for the Promotion of Science and personal fees from Daiichi Sankyo Co., Ltd., Takeda Pharmaceutical Co., Ltd., Sumitomo Dainippon Pharma Co., Ltd., Novo Nordisk Pharma Ltd., MSD K.K., Kyowa Hakko Kirin Company Ltd., Kowa Pharmaceutical Co., Ltd., Eli Lilly Japan K.K., Ono Pharmaceutical Co., Ltd., Kissei Pharmaceutical Co., Ltd., Sanofi K.K., and Mitsubishi Tanabe Pharma Corporation. NN received grant support from the Japan Society for the Promotion of Science (JSPS KAKENHI grant numbers: 19K23999 and 20K16158) and the Japan Food Chemical Research Foundation, and personal fees from Novo Nordisk Pharma Ltd. and Kowa Pharmaceutical Co., Ltd. TOs received grants from Combi Corporation and personal fees from Toa Eiyo Corp., Mitsubishi Tanabe Pharma Corp., Daiichi Sankyo Co., Ltd., Novo Nordisk Pharma Ltd., Nippon Boehringer Ingelheim Co., Ltd., Ono Pharmaceutical Co., Ltd., Kyowa Kirin Co., Ltd., Sumitomo Dainippon Pharma Co., Ltd., MSD K.K., Takeda Pharmaceutical Co., Ltd., Kowa Pharma Co., Ltd., Eli Lilly Japan K.K., and AstraZeneca K.K., outside of the submitted work. TS received personal fees from Kyowa Hakko Kirin Co., Ltd., Astellas Pharma Inc., Mitsubishi Tanabe Pharma Co., Kowa Pharma Co., Ltd., Sanofi K.K., Taisho Toyama Pharma Co., Ltd., Kissei Pharma Co., Ltd., MSD K.K., Novo Nordisk Pharma Ltd., Ono Pharma Co., Ltd., Eli Lilly Japan K.K., and Takeda Pharma Co., Ltd., outside the submitted work. EU received grant support from the Japanese Study Group for Physiology and Management of Blood Pressure, Astellas Foundation for Research on Metabolic Disorders (grant number: 4024), Japan Society for the Promotion of Science, Mishima Kaiun Memorial Foundation, and personal fees from Sumitomo Dainippon Pharma Co., Ltd., Mitsubishi Tanabe Pharma Corporation, Nippon Boehringer Ingelheim Co., Ltd., Sanofi K.K., Kowa Pharmaceutical Co., Ltd., Daiichi Sankyo Co., Ltd., Kyowa Hakko Kirin Co., Ltd., AstraZeneca K.K., Novo Nordisk Pharma Ltd., Ono Pharmaceutical Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Ltd., and MSD K.K. outside of the submitted work. The donated fund laboratory of diabetes therapeutics is an endowment department supported by an unrestricted grant from Taiyo Kagaku Co., Ltd., Taisho Pharmaceutical Co., Ltd., and Ono Pharmaceutical Co., Ltd. MH received grants from Yamada Bee Farm, Oishi Kenko Inc., Nippon Boehringer Ingelheim Co., Ltd., AstraZeneca K.K., and Ono Pharma Co., Ltd. and personal fees from Eli Lilly, Japan, Sanofi K.K., Sumitomo Dainippon Pharma Co., Ltd., Daiichi Sankyo Co., Ltd., Mitsubishi Tanabe Pharma Corp., AstraZeneca K.K., Ono Pharma Co., Ltd., and Kowa Pharma Co., Ltd., outside the submitted work. MF received grants from Eli Lilly, Japan, K.K., Nippon Boehringer Ingelheim Co., Ltd., Sanwa Kagagu Kenkyusho Co., Ltd., Oishi Kenko Inc., MSD K.K., Kowa Pharma Co., Ltd., Kissei Pharma Co., Ltd., Sumitomo Dainippon Pharma Co., Ltd., Ono Pharma Co. Ltd., Mitsubishi Tanabe Pharma Corp., Abbott Japan Co., Ltd., Daiichi Sankyo Co., Ltd., Johnson & Johnson K.K. Medical Co., Astellas Pharma Inc., Kyowa Kirin Co., Ltd., Novo Nordisk Pharma Ltd., Yamada Bee Farm, Taisho Pharma Co., Ltd., Terumo Corp., Takeda Pharma Co., Ltd., Tejin Pharma Ltd., Sanofi K.K., Nippon Chemiphar Co., Ltd., and TERUMO CORPORATION, and personal fees from Astellas Pharma Inc., Nippon Boehringer Ingelheim Co., Ltd., Sanwa Kagaku Kenkyusho Co., Ltd., MSD K.K., Mochida Pharma Co., Ltd., Eli Lilly Japan K.K., Kissei Pharma Co., Ltd., AstraZeneca K.K., Mitsubishi Tanabe Pharma Corp., TERUMO CORPORATION, Daiichi Sankyo Co., Ltd., Bayer Yakuhin, Ltd., Takeda Pharma Co., Ltd., Teijin Pharma Ltd., Ono Pharma Co., Ltd., Taisho Pharma Co., Ltd., Kyowa Kirin Co., Ltd., Abbott Japan Co., Ltd., Sumitomo Dainippon Pharma Co., Ltd., Arkray Inc., Medtronic Japan Co., Ltd., Novo Nordisk Pharma Ltd., Kowa Pharma Co., Ltd., Nipro Corp., and Sanofi K.K., outside of the submitted work. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Study flow diagram for the registration of patients. BDHQ, a brief-type self-administered diet history questionnaire; HSI, hepatic steatosis index; T2D, type 2 diabetes.
See this image and copyright information in PMC

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