Chang Yang, Li Jiawei, Wu Gonghua, Zhang Juying, Guo Bing, Zhao Xing
/ （ 610041） Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2025 Jan 20;56(1):149-155. doi: 10.12182/20250160108.
To explore the association between physical activity levels and metabolic dysfunction-associated fatty liver disease (MAFLD) and the modifying effects of different types of obesity.
A cross-sectional study was conducted on 19925 participants recruited from the Chengdu sub-cohort of the Southwest China Natural Population Cohort. The participants were recruited between 2018 and 2019. The association between physical activity and MAFLD prevalence was examined using the inverse probability weighting (IPW) method based on the generalized propensity score (GPS). The odds ratios (OR) and the 95% confidence interval (CI) for moderate and vigorous physical activity were calculated using the mild physical activity group as a reference. A restricted cubic spline function was used to model the exposure-response relationship between physical activity and MAFLD risk. The potential modifying effects of obesity types on the association between physical activity and MAFLD were evaluated in male and female populations.
The prevalence of MAFLD was 17.30%. Compared to those engaging in mild physical activity, individuals participating in vigorous and moderate physical activities had a lower risk of MAFLD, with OR (95% CI) being 0.76 (0.67, 0.86) and 0.85 (0.76, 0.94), respectively. The exposure-response relationship showed a nonlinear association between physical activity and MAFLD risks ( = 0.005). The protective effect of physical activity against MAFLD was observed when physical activity reached approximately 20 METs-h/d. However, when physical activity exceeded 70 METs-h/d, no significant effect on MAFLD risk was observed. Among the female population, obesity type significantly modified the association between physical activity and MAFLD ( < 0.05). In females with central obesity, the protective effect of physical activity on MAFLD showed a threshold effect, with the lowest disease risk observed at approximately 25 METs-h/d. However, physical activity exceeding 37.5 METs-h/d showed no statistically significant association with MAFLD risk. In contrast, for females with peripheral obesity, high levels of physical activity had limited effects on reducing MAFLD risks.
Moderate physical activity can significantly reduce the risk of MAFLD, and the obesity types can modify this association. It is recommended that individuals engage in approximately 20-70 METs-h/d of physical activity. For females with central obesity, physical activity should not exceed 37.5 METs-h/d, while for females with peripheral obesity, it should not exceed 30 METs-h/d.
探讨身体活动水平与代谢功能障碍相关脂肪性肝病（MAFLD）之间的关联以及不同类型肥胖的调节作用。
对从中国西南自然人群队列成都子队列招募的19925名参与者进行了一项横断面研究。参与者于2018年至2019年招募。基于广义倾向得分（GPS），使用逆概率加权（IPW）方法检验身体活动与MAFLD患病率之间的关联。以轻度身体活动组为参照，计算中度和剧烈身体活动的比值比（OR）及95%置信区间（CI）。使用受限立方样条函数对身体活动与MAFLD风险之间的暴露-反应关系进行建模。在男性和女性人群中评估肥胖类型对身体活动与MAFLD关联的潜在调节作用。
MAFLD的患病率为17.30%。与进行轻度身体活动的人相比，参与剧烈和中度身体活动的个体患MAFLD的风险较低，OR（95%CI）分别为0.76（0.67，0.86）和0.85（0.76，0.94）。暴露-反应关系显示身体活动与MAFLD风险之间呈非线性关联（P = 0.005）。当身体活动达到约20梅脱-小时/天时，观察到身体活动对MAFLD具有保护作用。然而，当身体活动超过70梅脱-小时/天时，未观察到对MAFLD风险有显著影响。在女性人群中，肥胖类型显著改变了身体活动与MAFLD之间的关联（P < 0.05）。在中心性肥胖的女性中，身体活动对MAFLD的保护作用呈现阈值效应，在约25梅脱-小时/天时疾病风险最低。然而，超过37.5梅脱-小时/天的身体活动与MAFLD风险无统计学显著关联。相比之下，对于外周性肥胖的女性，高水平的身体活动对降低MAFLD风险的作用有限。
中度身体活动可显著降低MAFLD风险，肥胖类型可改变这种关联。建议个体进行约20 - 70梅脱-小时/天的身体活动。对于中心性肥胖的女性，身体活动不应超过37.5梅脱-小时/天，而对于外周性肥胖的女性，不应超过30梅脱-小时/天。
