ArticleHepatology communications2025
Mediterranean diet and associated metabolite signatures in relation to MASLD progression: A prospective cohort study.
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.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- MASLD and sarcopenia research (2012-2025): a multi-database bibliometric analysis.Frontiers in nutrition · 2026Pooled it
- Hepatology: Emerging Paradigms in MASLD, Viral Hepatitis, Cholestatic Liver Disease, Portal Hypertension and Hepatocellular Carcinoma: Summary of the First Annual Paris International Liver Meeting 2026.Liver international : official journal of the International Association for the Study of the Liver · 2026Review
- Comment on "Mediterranean Diet Adherence Is Associated With Reduced Liver Fibrosis Risk in Metabolic Dysfunction-Associated Steatotic Liver Disease".Journal of gastroenterology and hepatology · 2026Article
- Emerging omics diagnosis of perihilar cholangiocarcinoma.Journal of gastroenterology · 2026Article
- Gut microbiota supportive dietary pattern associated with reduced MASLD risk mediated by metabolomic profiles: a prospective cohort study.Nutrition journal · 2026Article
- Article
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Authors and funding
14 authors.
Funding
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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.
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