Higher dietary niacin intake linked to lower risk for all-cause mortality in MASLD
Key takeaways:
- Higher dietary niacin intake was associated with lower risk for all-cause mortality among 4,315 adults with MASLD.
- Higher intake was not associated with reduced risk for cardiovascular disease mortality.
Increased intake of dietary niacin may reduce the risk for all-cause mortality but not cardiovascular disease-related mortality among patients with metabolic dysfunction-associated steatotic liver disease, data showed.
“Although niacin supplementation to increase [nicotinamide adenine dinucleotide] levels has been found to have a modest remission effect on fatty liver in an animal study and to be associated with improved muscle performance in a human intervention study, no prospective studies have been conducted assessing the association between niacin intake levels from foods and the risk of mortality in patients with NAFLD,” Jie Pan, MBBS, and colleagues at the Guangdong Provincial Key Laboratory of Food, Nutrition and Health at Sun Yat-sen University wrote in JAMA Network Open.
Using data from the National Health and Nutrition Examination Survey from 2003 to 2018, researchers investigated the association of dietary niacin intake with all-cause mortality and cardiovascular disease (CVD)-related mortality among 4,315 adults (mean age, 52.5 years; 55% men) with MASLD, formerly known as NAFLD. The cohort included 1,440 patients with reported baseline dietary niacin intake of 18.4 mg or less (tertile 1), 1,441 patients with an intake of 18.5 to 26.6 mg (tertile 2) and 1,434 with an intake of at least 26.7 mg (tertile 3).
During a median follow-up of 8.8 years, researchers reported 566 deaths, of which 197 were attributed to CVD. After adjusting for multiple confounders, the hazard ratios for all-cause mortality and CVD mortality in tertile 3 were 0.7 (95% CI, 0.5-0.96) and 0.65 (95% CI, 0.35-1.2), respectively, and 0.78 (95% CI, 0.6-1.02) and 0.87 (95% CI, 0.63-1.21) in tertile 2 compared with the lowest tertile.
Researchers reported “no evident nonlinear association” between dietary niacin intake and all-cause (P = 0.89) or CVD (P = 0.47) mortality in restricted cubic spline analysis.
“Findings from this cohort study of U.S. adults with NAFLD suggest that higher dietary niacin intake may be associated with a lower risk of all-cause mortality among individuals with NAFLD,” Pan and colleagues concluded. “Higher dietary niacin intake was not found to be associated with a lower risk of CVD mortality in this study.”
They continued: “The dose-response association of dietary niacin intake with reducing the risk of all-cause and CVD mortality among patients with NAFLD needs to be further investigated to determine optimal intake levels.”
Perspective
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Niacin, or vitamin B3, is essential for several cell metabolic functions and is added as a supplement to a number of foods.
Data from preclinical models suggest a possible benefit of niacin in MASLD. The current study used data from the highly respected NHANES database and explored the relationship of imputed dietary niacin intake and all-cause and cardiovascular mortality in patients with MASLD.
Lower all-cause mortality was seen in those with a dietary intake of more than 25 mg per day and there was a fairly linear improvement with higher amounts. Cardiovascular mortality benefit was not clearly demonstrated.
The limitation of this study is the assumption that over time dietary niacin intake remains steady and that MASLD remains static. These findings should be considered as hypothesis-generating for studies that provide more granular data. The findings do not support routine long-term ingestion of niacin in vitamins or other preparations in non-pregnant individuals with MASLD.
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