Research Article: Dose–response relationship between tea consumption and mortality, cardiovascular, cerebrovascular, and renal outcomes in metabolic dysfunction-associated steatotic liver disease: a prospective cohort study
Abstract:
Tea is a widely consumed plant-derived beverage with potential metabolic and vascular effects, but its prognostic dose–response relationship in metabolic dysfunction-associated steatotic liver disease (MASLD) remains unclear.
We analyzed 360,548 UK Biobank participants, including 169,241 individuals with MASLD, 146,559 with no steatotic liver disease (SLD), and 44,748 with MASLD and increased alcohol intake (MetALD). Hepatic steatosis was defined using a fatty liver index (FLI)???60. Tea consumption was categorized as none, 1–2, 3–4, 5–6, and ?7 cups/day. The outcomes included all-cause mortality, cardiovascular disease, cerebrovascular disease, and chronic kidney disease. Cox regression, restricted cubic spline (RCS) analyses, inverse probability of treatment weighting (IPTW), subgroup analyses, and multiple sensitivity analyses were performed. The no SLD and MetALD cohorts were analyzed as comparators.
Among participants with MASLD, 16,611 deaths, 18,004 cardiovascular disease events, 7,106 cerebrovascular disease events, and 9,132 chronic kidney disease events occurred during follow-up. Tea consumption showed a reproducible non-linear association with mortality and cardiometabolic outcomes in MASLD. The RCS-derived nadirs ranged from 1.6 to 2.5 cups/day across the outcomes. In fully adjusted models, tea intake of 1–2 cups/day was associated with lower all-cause mortality (HR: 0.85, 95% CI: 0.81–0.90; p <?0.001) and a lower risk of cerebrovascular disease (HR: 0.83, 95% CI: 0.77–0.90; p <?0.001), whereas the ?7 cups/day category was associated with an increased risk of cardiovascular disease (HR: 1.09, 95% CI: 1.02–1.15; p =?0.006).
Tea consumption showed a consistent J-shaped association with mortality and major cardiometabolic outcomes in MASLD, with the lowest estimated risks occurring within a low-to-moderate range of intake. These findings support a dose-aware interpretation of tea consumption in MASLD.
Introduction:
Tea is a widely consumed plant-derived beverage with potential metabolic and vascular effects, but its prognostic dose–response relationship in metabolic dysfunction-associated steatotic liver disease (MASLD) remains unclear.
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