Lower serum carotenoids a red flag for mortality in MAFLD

Among patients with metabolic dysfunction-associated fatty liver disease (MAFLD), those with lower serum concentrations of α-carotene, β-carotene, β-cryptoxanthin, lycopene, and lutein/zeaxanthin are at heightened risk of all-cause and cardiovascular mortality, according to a study.

For the study, researchers used data from the Third National Health and Nutrition Examination Survey (NHANES III) and included 3,040 individuals with MAFLD. Cox proportional hazards regression models and restricted cubic spline (RCS) analyses were used to examine the associations between five major serum carotenoids and mortality.

Over a follow-up of 826,547 person-years, 1,325 all-cause and 429 cardiovascular deaths were documented.

For all-cause mortality, the highest vs lowest quartile of concentration of serum carotenoids was associated with a reduced risk. This was true for α-carotene (adjusted hazard ratio [aHR], 0.63, 95 percent confidence interval [CI], 0.49–0.81), β-carotene (aHR, 0.65, 95 percent CI, 0.52–0.80), β-cryptoxanthin (aHR, 0.64, 95 percent CI, 0.51–0.81), lycopene (aHR, 0.73, 95 percent CI, 0.56–0.95), and lutein/zeaxanthin (aHR, 0.69, 95 percent CI, 0.52–0.91).

Results were similar for cardiovascular mortality, such that the highest vs lowest quartile of concentration of serum carotenoids had a protective effect. This was observed with α-carotene (aHR, 0.51, 95 percent CI, 0.33–0.78), β-carotene (aHR, 0.54, 95 percent CI, 0.35–0.82), β-cryptoxanthin (aHR, 0.52, 95 percent CI, 0.34–0.80), lycopene (aHR, 0.63, 95 percent CI, 0.44–0.90), and lutein/zeaxanthin (aHR, 0.62, 95 percent CI, 0.39–0.99).

Serum α-carotene, β-cryptoxanthin, and lycopene had linear correlations with all-cause mortality. On the other hand, only β-carotene showed no linear correlation with cardiovascular mortality.