The Potential Role of Dietary Niacin Intake in Reducing All-Cause Mortality Risk in MASLD Patients

The Influence of Dietary Niacin on All-Cause Mortality

A recent study investigated the relationship between dietary niacin intake and the risk of all-cause mortality and cardiovascular disease (CVD)-related mortality among patients diagnosed with metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as nonalcoholic fatty liver disease (NAFLD). The study's results showed that increased dietary niacin intake might be linked to a lower risk of all-cause mortality, though it did not significantly reduce the risk for cardiovascular disease mortality among individuals with MASLD.

Reducing Mortality Risk by 30%

The study, published in JAMA Network Open, suggests that higher dietary niacin intake can reduce the risk of all-cause mortality by 30% in patients with MASLD. However, it was also noted that niacin intake did not reduce the risk of mortality from cardiovascular disease (CVD). The findings were based on data analysis from the National Health and Nutrition Examination Survey (NHANES), involving 4,315 adults diagnosed with MASLD.

Additional Benefits for Certain Subgroups

Subgroup analyses pointed to additional interesting findings. The study showed that patients with a vitamin B6 intake below 1.7 mg/d could benefit more from niacin supplementation than those with a higher B6 intake. Additionally, patients with MASLD and without diabetes appeared to benefit more from high niacin intake than patients with diabetes.

Addressing the Study Limitations

While the study's results are promising, there are certain limitations to be considered. These include a lack of physical activity data, inability to establish causation, and possible recall bias and confounding variables. Despite these constraints, the study highlights the potential role of dietary niacin in managing MASLD and reducing all-cause mortality risk.

Investigating Niacin and Cardiovascular Disease Risk

While the study found no significant inverse correlation between niacin intake and cardiovascular disease mortality, it did identify that niacin metabolites, particularly 2PY and 4PY, are associated with CVD regardless of established risk factors. Furthermore, high levels of vitamin B3 breakdown products, resulting from excess niacin, are linked to increased risks of major adverse CVD events, potentially contributing to residual cardiovascular disease risk via inflammatory pathways.

The Need for Further Investigation

The study's findings indicate a need for more research to determine the optimal intake levels of dietary niacin for reducing the risk of all-cause and CVD mortality in patients with MASLD. Further insights into how niacin supplementation can be beneficial, its role in MASLD management, and its potential effects on cardiovascular disease risk are essential. This would provide valuable information for healthcare providers and patients about the benefits of dietary niacin.