Association between macronutrient intake and liver dysfunction among tuberculosis patients in rural China

Abstract Background Macronutrients play a vital role in liver dysfunction and affect the treatment and prognosis of tuberculosis. This study aimed to clarify the associations between macronutrients intakes or to energy percentages and liver dysfunction in tuberculosis patients. Methods In this cross-sectional study, 2695 active tuberculosis patients aged ≥ 18 years were included based on the data from local tuberculosis clinics in Linyi rural areas, China. Macronutrients intakes and to energy percentages were assessed by the 24-hour dietary recalls. The concentration of alanine transferase (ALT) or aspartate transaminase (AST) greater than 40 U/L was defined liver dysfunction. In addition, restricted cubic spline (RCS) was applied to determine the dose-response relationships. Results Among those who were male, or normal BMI, or consumed energy less than 1646.80 kcal/d, it was suggested both inverse associations between protein (47.30–78.80 g/d) or fat (> 20.30 g/d) intake and the risks of liver dysfunction in all models (all P-trend < 0.05). Moreover, the RCS model showed J-shaped associations between protein, fat intake, the fat or carbohydrate to energy percentages and the odds of liver dysfunction (the cut-off values = 70.69 g/d, 47.50 g/d, 22% and 69%, respectively, and all P-nonlinearity < 0.05). Conclusions An appropriate increase in dietary intakes of protein or fat might reduce liver dysfunction risk. However, intakes of more than 70.69 g/d for protein or 47.50 g/d for fat could increase the risk of liver dysfunction. Our study may provide a novel idea of alleviating liver dysfunction with nutritional improvement.