体重波动与代谢功能障碍相关脂肪性肝病风险之间的关联。

Association between weight fluctuation and the risk of metabolic dysfunction-associated steatotic liver disease.

作者信息

Wang Jin-Ping, Wang Jia-Yang, Sun Pei-Qi, Wang Xue-Wei, Yuan Ze-Ting, Cao Qin, Pan Shu-Ming, Jiang Yuan-Ye

机构信息

Department of Gastroenterology, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, China.

Department of Emergency, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, China.

出版信息

World J Hepatol. 2025 May 27;17(5):103852. doi: 10.4254/wjh.v17.i5.103852.

DOI:10.4254/wjh.v17.i5.103852

PMID:40501466

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12149894/

Abstract

BACKGROUND

The global incidence of metabolic dysfunction-associated steatotic liver disease (MASLD) has increased in recent years. It has already been demonstrated that exercise and weight change are associated with the occurrence of MASLD; however, the association between weight fluctuation caused by different exercise intensities and the risk of MASLD remains to be studied.

AIM

To investigate the impact of weight fluctuation and physical activity intensity on the risk of MASLD prevalence.

METHODS

Data from the National Health and Nutrition Examination Survey database including five cycles from 2009 to 2018 were analyzed. The model included variables such as age, sex, and poverty income ratio. Weighted multivariate logistic regression was used to examine the influence of different weight fluctuation patterns within the two time intervals on the prevalence of MASLD. Nonparametric restricted cubic spline curves were used to analyze the non-linear relationship between net weight change and MASLD prevalence.

RESULTS

Among 3183 MASLD cases, the risk of MASLD increased with age for individuals transitioning from non-obese to obese or maintaining obesity, with odds ratio (OR) changing from 8.91 (95%CI: 7.40-10.88) and 11.87 (95%CI: 9.65-14.60) at 10 years before baseline to 9.58 (95%CI: 8.08-11.37) and 12.51 (95%CI: 9.33-16.78) at 25 years. Stable obesity correlated with age-dependent MASLD prevalence escalation, whereas increased physical activity attenuated MASLD risk in this group, with an OR changing from 13.64 (95%CI: 10.59-17.57) to 6.42 (95%CI: 4.24-9.72). Further analysis of the net weight changes revealed a paradoxical risk elevation with intensified physical activity during different time periods.

CONCLUSION

The risk of MASLD increases in individuals transitioning from non-obese to obese or maintaining obesity. High-intensity physical activity is beneficial for MASLD among individuals with stable obesity.

摘要

背景

近年来，代谢功能障碍相关脂肪性肝病（MASLD）的全球发病率有所上升。已有研究表明，运动和体重变化与MASLD的发生有关；然而，不同运动强度引起的体重波动与MASLD风险之间的关联仍有待研究。

目的

探讨体重波动和身体活动强度对MASLD患病率风险的影响。

方法

分析了来自2009年至2018年五个周期的美国国家健康与营养检查调查数据库的数据。该模型纳入了年龄、性别和贫困收入比等变量。采用加权多因素逻辑回归分析两个时间间隔内不同体重波动模式对MASLD患病率的影响。使用非参数限制立方样条曲线分析净体重变化与MASLD患病率之间的非线性关系。

结果

在3183例MASLD病例中，从非肥胖转变为肥胖或维持肥胖的个体中MASLD风险随年龄增加，优势比（OR）从基线前10年的8.91（95%CI：7.40-10.88）和11.87（95%CI：9.65-14.60）变为25年时的9.58（95%CI：8.08-11.37）和12.51（95%CI：9.33-16.78）。稳定肥胖与年龄相关的MASLD患病率升高相关，而该组中身体活动增加会降低MASLD风险，OR从13.64（95%CI：10.59-17.57）变为6.42（95%CI：4.24-9.72）。对净体重变化的进一步分析显示，在不同时间段内，身体活动增强会出现矛盾的风险升高。