Evidence map›Paper›PMID 40879470›Full record

ArticleHepatology communications2025

Mediterranean diet and associated metabolite signatures in relation to MASLD progression: A prospective cohort study.

Kai Wang, Shijian Xiang, Qiangsheng He, Anran Liu, Chumei Huang, Zhen Yang, Renjie Li, Jiaxin Hu, Ruisheng Cai, Ningning Mi and 4 more

Abstract read
In one paragraph

Article in Hepatology communications, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Kai WangDepartment of Epidemiology and Biostatistics, Clinical Big Data Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China.
Shijian XiangDepartment of Pharmacy, Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China.
Qiangsheng HeDepartment of Epidemiology and Biostatistics, Clinical Big Data Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China.ORCID 0000-0001-6081-2447
Anran LiuClinical Nutrition Department, Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China.
Chumei HuangCenter for Digestive Disease, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China.
Zhen YangClinical Nutrition Department, Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China.
Renjie LiDepartment of Ultrasound, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China.
Jiaxin HuSchool of Medicine, Sun Yat-sen University, Shenzhen, Guangdong, China.
Ruisheng CaiDepartment of Epidemiology and Biostatistics, Clinical Big Data Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China.
Ningning MiDepartment of General Surgery, The First School of Clinical Medicine, Lanzhou University, Lanzhou, Gansu, China.
Zixin LiangDepartment of Epidemiology and Biostatistics, Clinical Big Data Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China.
Zuofeng XuDepartment of Ultrasound, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China.
Jinqiu YuanDepartment of Epidemiology and Biostatistics, Clinical Big Data Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China.ORCID 0000-0003-0016-776
Bin XiaDepartment of Epidemiology and Biostatistics, Clinical Big Data Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China.ORCID 0000-0003-4340-733

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMediterranean diet (MED) is recommended for managing metabolic dysfunction-associated steatotic liver disease (MASLD). However, associations between MED adherence, related metabolite signatures, and risks of liver-related events (LRE) and mortality in MASLD patients remain unclear.

methodsWe performed a prospective analysis using UK Biobank data, including 47,429 MASLD participants free of LRE at baseline. MED adherence was assessed as alternate Mediterranean Diet (aMED) score through a validated questionnaire. Metabolic biomarkers were measured using high-throughput nucleic magnetic resonance (NMR) spectroscopy. Cox regression and restricted cubic splines assessed the association of aMED, its components, with risk of LRE and mortality. Mediation analysis evaluated the role of metabolites in the relationship between aMED, its components, and MASLD progression.

resultsOver a median follow-up of 13.3 years, 296 LRE cases and 3616 deaths occurred. Higher aMED scores (6-9) were associated with lower risks of LRE (HR: 0.553, 95% CI: 0.351-0.874) and mortality (HR: 0.854, 95% CI: 0.762-0.956) compared with the lowest scores (0-3), with linear dose-response relationships. Vegetables and legumes were associated with lower LRE risk, while vegetables, nuts, fish, MUFA:SFA ratio, and moderate alcohol intake were linked to reduced mortality. Of 143 metabolites, 46 were significantly associated with aMED. Omega-3 fatty acids, the omega-3 to total fatty acid ratio, and albumin accounted for 7.9%, 11.9%, and 2.6% of the reduction in LRE, and 19.4%, 23.1%, and 4.7% of the mitigation in mortality, respectively.

conclusionsAdherence to MED is linked to reduced LRE risk and mortality in MASLD patients. Metabolic biomarkers, particularly small HDL particles and omega-3 fatty acids, may mitigate MASLD progression.

Indexed as

Diet, MediterraneanNon-alcoholic Fatty Liver DiseaseAdultAgedBiomarkersDisease ProgressionFemaleHumansMaleMiddle AgedProspective StudiesRisk FactorsUnited KingdomBiomarkerscohort studymediation effectMediterranean dietmetabolic dysfunction–associated steatotic liver diseasemetabolomics

Identifiers

PMID40879470
PMCPMC12401285

What Socratic holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.