The role of plasma glucose in association of food-specific serum immunoglobulin G reactivity with metabolic dysfunction-associated fatty liver disease: a real-world cross-sectional study

Abstract Background As the immune response product to food antigens, food-specific serum immunoglobulin G reactivity (FSsIgGR) has been reported the clinical relevance to metabolic disorders, but its connections to metabolic dysfunction-associated fatty liver disease (MAFLD) remain underexplored, pa...

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Main Authors: Guanchao Sun, Wenjuan Wu, Binbin Su, Ru Zhang, Xiaoyu Dong, Lihui Wang, Shiping Xu, Hui Shi
Format: Article
Language:English
Published: BMC 2025-06-01
Series:Diabetology & Metabolic Syndrome
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Online Access:https://doi.org/10.1186/s13098-025-01756-y
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author Guanchao Sun
Wenjuan Wu
Binbin Su
Ru Zhang
Xiaoyu Dong
Lihui Wang
Shiping Xu
Hui Shi
author_facet Guanchao Sun
Wenjuan Wu
Binbin Su
Ru Zhang
Xiaoyu Dong
Lihui Wang
Shiping Xu
Hui Shi
author_sort Guanchao Sun
collection DOAJ
description Abstract Background As the immune response product to food antigens, food-specific serum immunoglobulin G reactivity (FSsIgGR) has been reported the clinical relevance to metabolic disorders, but its connections to metabolic dysfunction-associated fatty liver disease (MAFLD) remain underexplored, particularly within Chinese populations. Understanding this association could facilitate personal diet modification for MAFLD treatment. We investigated the association between FSsIgGR and MAFLD and the mediating roles of plasma glucose markers, specifically fasting blood glucose (FPG) and hemoglobin A1c (HbA1c). Methods This study utilized data from the Second Medical Center of the Chinese PLA General Hospital from 2017 to 2021, to analyze the relationships between FSsIgGR and MAFLD in 25,928 participants. Using a robust sampling method and adjusting for various covariates, we explored both linear and nonlinear associations using linear regression models, restricted cubic splines (RCS), subgroup analysis, and sensitivity analysis. Furthermore, mediation analyses were conducted to evaluate the role of plasma glucose markers, such as FPG and HbA1c, in these relationships. Results The overall prevalence of FSsIgGR-positive and MAFLD was 60.8% and 53.5%, respectively, with a mean age of 49.6 ± 9.7 years (68.8% male). Both the quantity and level of FSsIgGR exhibited negatively linear associations with MAFLD (OR 0.98, 95% CI 0.96–0.99, P = 0.041; OR 0.99, 95% CI 0.97–0.99, P = 0.044), even after adjusting for multiple covariates. Sensitivity analyses supported the robustness of these findings. Of note, subgroup analysis showed that FSsIgGR still was negatively associated with MAFLD patients without Type 2 diabetes (OR 0.98, 95% CI 0.95–0.99) or insulin resistance (OR 0.97, 95% CI 0.94–0.99), while that statistical significance of associations disappears in MAFLD patients with Type 2 diabetes or insulin resistance. Furthermore, plasma glucose markers, particularly FPG, significantly mediated the relationship between FSsIgGR and MAFLD, with indirect effects estimated at 15.5% (P = 0.0002). Conclusions These findings indicated FSsIgGR was linked to a reduced risk of MAFLD, particularly MAFLD without Type 2 diabetes or insulin resistance, and plasma glucose mediated that process. Further research is needed to elucidate the mechanism underlying that association, expecting to provide reference for personalized diet of MAFLD patients.
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spelling doaj-art-d67e28a022b248adae4430ffa152312a2025-08-20T03:47:16ZengBMCDiabetology & Metabolic Syndrome1758-59962025-06-0117111210.1186/s13098-025-01756-yThe role of plasma glucose in association of food-specific serum immunoglobulin G reactivity with metabolic dysfunction-associated fatty liver disease: a real-world cross-sectional studyGuanchao Sun0Wenjuan Wu1Binbin Su2Ru Zhang3Xiaoyu Dong4Lihui Wang5Shiping Xu6Hui Shi7Department of Gastroenterology, Second Medical Center of Chinese PLA General HospitalDepartment of Gastroenterology, Second Medical Center of Chinese PLA General HospitalDepartment of Gastroenterology, Second Medical Center of Chinese PLA General HospitalDepartment of Gastroenterology, Second Medical Center of Chinese PLA General HospitalDepartment of Gastroenterology, Second Medical Center of Chinese PLA General HospitalDepartment of Gastroenterology, Second Medical Center of Chinese PLA General HospitalDepartment of Gastroenterology, Second Medical Center of Chinese PLA General HospitalDepartment of Gastroenterology, Second Medical Center of Chinese PLA General HospitalAbstract Background As the immune response product to food antigens, food-specific serum immunoglobulin G reactivity (FSsIgGR) has been reported the clinical relevance to metabolic disorders, but its connections to metabolic dysfunction-associated fatty liver disease (MAFLD) remain underexplored, particularly within Chinese populations. Understanding this association could facilitate personal diet modification for MAFLD treatment. We investigated the association between FSsIgGR and MAFLD and the mediating roles of plasma glucose markers, specifically fasting blood glucose (FPG) and hemoglobin A1c (HbA1c). Methods This study utilized data from the Second Medical Center of the Chinese PLA General Hospital from 2017 to 2021, to analyze the relationships between FSsIgGR and MAFLD in 25,928 participants. Using a robust sampling method and adjusting for various covariates, we explored both linear and nonlinear associations using linear regression models, restricted cubic splines (RCS), subgroup analysis, and sensitivity analysis. Furthermore, mediation analyses were conducted to evaluate the role of plasma glucose markers, such as FPG and HbA1c, in these relationships. Results The overall prevalence of FSsIgGR-positive and MAFLD was 60.8% and 53.5%, respectively, with a mean age of 49.6 ± 9.7 years (68.8% male). Both the quantity and level of FSsIgGR exhibited negatively linear associations with MAFLD (OR 0.98, 95% CI 0.96–0.99, P = 0.041; OR 0.99, 95% CI 0.97–0.99, P = 0.044), even after adjusting for multiple covariates. Sensitivity analyses supported the robustness of these findings. Of note, subgroup analysis showed that FSsIgGR still was negatively associated with MAFLD patients without Type 2 diabetes (OR 0.98, 95% CI 0.95–0.99) or insulin resistance (OR 0.97, 95% CI 0.94–0.99), while that statistical significance of associations disappears in MAFLD patients with Type 2 diabetes or insulin resistance. Furthermore, plasma glucose markers, particularly FPG, significantly mediated the relationship between FSsIgGR and MAFLD, with indirect effects estimated at 15.5% (P = 0.0002). Conclusions These findings indicated FSsIgGR was linked to a reduced risk of MAFLD, particularly MAFLD without Type 2 diabetes or insulin resistance, and plasma glucose mediated that process. Further research is needed to elucidate the mechanism underlying that association, expecting to provide reference for personalized diet of MAFLD patients.https://doi.org/10.1186/s13098-025-01756-yFood-specific serum immunoglobulin G reactivityMetabolic dysfunction-associated fatty liver diseasePlasma glucoseMediation analysesCross-sectional study
spellingShingle Guanchao Sun
Wenjuan Wu
Binbin Su
Ru Zhang
Xiaoyu Dong
Lihui Wang
Shiping Xu
Hui Shi
The role of plasma glucose in association of food-specific serum immunoglobulin G reactivity with metabolic dysfunction-associated fatty liver disease: a real-world cross-sectional study
Diabetology & Metabolic Syndrome
Food-specific serum immunoglobulin G reactivity
Metabolic dysfunction-associated fatty liver disease
Plasma glucose
Mediation analyses
Cross-sectional study
title The role of plasma glucose in association of food-specific serum immunoglobulin G reactivity with metabolic dysfunction-associated fatty liver disease: a real-world cross-sectional study
title_full The role of plasma glucose in association of food-specific serum immunoglobulin G reactivity with metabolic dysfunction-associated fatty liver disease: a real-world cross-sectional study
title_fullStr The role of plasma glucose in association of food-specific serum immunoglobulin G reactivity with metabolic dysfunction-associated fatty liver disease: a real-world cross-sectional study
title_full_unstemmed The role of plasma glucose in association of food-specific serum immunoglobulin G reactivity with metabolic dysfunction-associated fatty liver disease: a real-world cross-sectional study
title_short The role of plasma glucose in association of food-specific serum immunoglobulin G reactivity with metabolic dysfunction-associated fatty liver disease: a real-world cross-sectional study
title_sort role of plasma glucose in association of food specific serum immunoglobulin g reactivity with metabolic dysfunction associated fatty liver disease a real world cross sectional study
topic Food-specific serum immunoglobulin G reactivity
Metabolic dysfunction-associated fatty liver disease
Plasma glucose
Mediation analyses
Cross-sectional study
url https://doi.org/10.1186/s13098-025-01756-y
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