Background Elevated liver enzymes, such as alanine aminotransferase (ALT) and aspartate aminotransferase (AST), are early indicators of liver dysfunction in non-alcoholic fatty liver disease (NAFLD). The prevalence of NAFLD is increasing in Bangladesh, with studies indicating a higher prevalence among women. Additionally, rapid dietary transitions toward energy-dense foods rich in fat and sugar have contributed to the rising burden of non-communicable diseases. This study aimed to investigate the association between dietary intake, diet quality indicators, and elevated liver enzymes (ALT and AST) among women of reproductive age in Bangladesh. Methods A cross-sectional study was conducted among 240 women of reproductive age (15-49 years) randomly selected from community households in three selected districts of Bangladesh. Anthropometric and socioeconomic data were collected using standardized tools. Dietary intake was assessed using a single 24-hour dietary recall method and a Food Frequency Questionnaire (FFQ). Three complementary indices were applied to evaluate diet quality: Dietary Diversity (DD), Food Consumption Score (FCS), and the Bangladesh Healthy Eating Index (BDHEI). The participant's blood was collected after overnight fasting. Serum ALT and AST levels were measured using a biochemical analyzer, and elevations in liver enzymes were defined according to standard clinical cut-off values. Descriptive and inferential statistics were performed using STATA version 15. 1 (Stata Corp LLC, College Station, TX, USA). Results Among the 240 participants, 69 (28. 7%) exhibited elevated ALT and/or AST levels, while 171 (71. 3%) had normal values. Participants with elevated liver enzymes had higher intake of saturated fat (5. 89 vs. 4. 41 g, IQR: (3. 84-9. 63 vs. 2. 98-7. 15), p =0. 010), cholesterol (55. 21 vs. 30. 41 mg, IQR: (15. 21-137. 92 vs. 0-106. 61), p = 0. 015). Participants with elevated liver enzymes had significantly lower FCS scores (23. 2% vs. 9. 4%, p = 0. 014) but higher DD (27. 5% vs. 15. 8%, p = 0. 036) as compared to normal liver enzymes. Multivariable logistic regression revealed that low FCS significantly increased the odds of elevated liver enzymes (AOR = 3. 64, 95% CI: 1. 53-8. 62, p = 0. 003). Conclusion This study highlights a significant association between poor FCS and liver enzyme abnormalities among Bangladeshi women of reproductive age. Integrating dietary quality interventions into reproductive health and noncommunicable disease (NCD) prevention programs could play a vital role in maintaining liver health and metabolic well-being in this vulnerable population.
Noor et al. (Thu,) studied this question.