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Past research on animals has suggested that taking niacin supplements (vitamin B3), a component of nicotinamide adenine dinucleotide (NAD) and nicotinamide adenine dinucleotide phosphate (NADP), can increase NAD levels to improve fatty liver.
The authors of the study wrote that a range of health issues, including CVD, obesity, and neurodegenerative diseases, are linked to issues with cellular NAD+ levels.
No prior prospective studies have explored the relationship between dietary niacin and the risk of death in NAFLD patients. This study aimed to examine the connection between dietary niacin intake and mortality (both all-cause and CVD) in NAFLD patients. Researchers analyzed data from 4315 NAFLD patients who took part in the National Health and Nutrition Examination Survey (NHANES) between 2003 and 2018, with an average follow-up period of 8.8 years.
The study found that higher dietary niacin intake was linked to a 30% lower risk of death from any cause (≥26.7 mg/d vs ≤18.4 mg/d) in NAFLD patients. However, researchers did not find a connection between an increased dietary niacin intake and a lower risk of death from CVD after accounting for age and sex.
Researchers also conducted additional analyses to understand the varying effects of niacin. They discovered that NAFLD patients with a vitamin B6 intake below 1.7 mg/d may benefit more from niacin supplementation than those with a higher B6 intake, possibly due to B6's role in the biosynthesis and metabolism of niacin.
Additionally, NAFLD patients without diabetes may be more likely to experience a link between reduced mortality risk and high niacin intake than patients with diabetes. This may be because niacin can raise blood sugar levels in patients with diabetes. Generally, the risk of death and CVD death is significantly higher in NAFLD patients with diabetes than in those without diabetes.
This study has limitations, including the lack of data on physical activity, the inability to establish causation, the potential for misclassification of CVD mortality, recall bias, and possible confounding variables. Future studies should increase the length of follow-up and work to determine the molecular mechanisms of dietary niacin intake on reducing the risks of death associated with NAFLD.
The authors concluded that the relationship between dietary niacin intake and reducing the risks of all-cause and CVD mortality in NAFLD patients requires further investigation to determine optimal intake levels.
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