675 - Association of Niacin Intake, Obesity and Metabolic Dysfunction-Associated Steatotic Liver Disease in Pediatric Patients: National Health and Nutrition Examination Survey

Publication Number: 4660.675

Kaela S. Ellis, NewYork-Presbyterian Komansky Children’s Hospital, New York, NY, United States; Anjile An, Weill Cornell Medicine, New York, NY, United States; Aliza B. Solomon, Weill Cornell Medicine, New York, NY, United States; Melissa Rose, NewYork-Presbyterian Komansky Children’s Hospital, New York, NY, United States

Background: Pediatric obesity remains a significant public health issue associated with both immediate and long-term health risks including poor psychological and emotional well-being, cardiovascular disease, insulin resistance, type 2 diabetes, and metabolic dysfunction-associated steatotic liver disease (MASLD). Research remains limited on specific dietary components such as vitamin intake as potential risk factors for pediatric obesity, MASLD, and liver fibrosis.

Objective: This study aims to investigate the association between niacin intake, pediatric obesity and metabolic dysfunction-associated steatotic liver disease in a diverse, large-scale population in the United States.

Design/Methods: This cross-sectional study used data from the National Health and Nutrition Examination Survey (NHANES) 2017-2020, including participants aged 12-19 years. Dietary niacin intake was assessed using two 24-hour dietary recalls, with intake calculated as the average of both recalls. Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) was defined as hepatic steatosis plus at least one metabolic risk factor, including obesity, glucose intolerance, dyslipidemia, hypertriglyceridemia, or hypertension. Hepatic steatosis was identified using hepatic elastography (CAP ≥248 dB/m) or self-reported diagnosis. Participants lacking niacin or anthropometric data were excluded. All analyses incorporated sample weights tailored to the research period and data used. The design-based t-test, chi-squared test, and multivariable logistic regression was performed.

Results: Niacin consumption was significantly lower among individuals with MASLD (22 vs 24mg, p = 0.023). When analyzed by quartiles of intake, no clear trend emerged. However, after adjusting for potential confounders of age, sex, and race and ethnicity, individuals in the highest quartile of niacin intake (Q4) had significantly lower odds of MASLD (OR 0.55, 95% CI: 0.35, 0.86) compared to Q1. Hispanic ethnicity remained an independent risk factor (OR 2.35, 95% CI: 1.54, 3.59). Adolescents with MASLD had significantly higher BMI measures, diastolic blood pressure, liver enzymes (ALT, AST, GGT), and glucose metabolism markers, including fasting insulin and HbA1c (all p < 0.001). Lipid profiles were also reflective of dyslipidemia, with elevated triglycerides and LDL, and reduced HDL levels (all p < 0.001).

Conclusion(s): Adolescents with MASLD demonstrated distinct demographic, metabolic, and biochemical profiles, particularly higher rates among Hispanic youth and an association with lower niacin intake.

Table 1
Weighted logistic regression analysis examining the association between quartiles of dietary niacin intake and odds of MASLD, adjusted for age, sex, and race and ethnicity.

Figure 1
Forest plot showing odds ratios (ORs) and 95% confidence intervals from a weighted logistic regression model examining the association between quartiles of dietary niacin intake and odds of MASLD, adjusted for age, sex, and race and ethnicity.

Figure 2
Restricted cubic spline showing the association between dietary niacin intake and odds of MASLD among adolescents in A. unadjusted analysis and B. adjusted for age, sex, and race and ethnicity.