Associations of an overall healthy lifestyle with the risk of metabolic dysfunction-associated fatty liver disease

Abstract Background Metabolic dysfunction-associated fatty liver disease (MAFLD) affects up to one-third of the global population. Since no approved pharmacotherapy for MAFLD is available, lifestyle modification remains the cornerstone of clinical care. Our study aims to evaluate the association of...

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Main Authors: Caimei Yuan, Chengjing Zhang, Xin Geng, Chengwu Feng, Yang Su, Yinfan Wu, Ying Wang, Li Chen, Qiurong Ding, Trudy Voortman, Hongyang Wang, Geng Zong
Format: Article
Language:English
Published: BMC 2024-11-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-024-20663-x
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author Caimei Yuan
Chengjing Zhang
Xin Geng
Chengwu Feng
Yang Su
Yinfan Wu
Ying Wang
Li Chen
Qiurong Ding
Trudy Voortman
Hongyang Wang
Geng Zong
author_facet Caimei Yuan
Chengjing Zhang
Xin Geng
Chengwu Feng
Yang Su
Yinfan Wu
Ying Wang
Li Chen
Qiurong Ding
Trudy Voortman
Hongyang Wang
Geng Zong
author_sort Caimei Yuan
collection DOAJ
description Abstract Background Metabolic dysfunction-associated fatty liver disease (MAFLD) affects up to one-third of the global population. Since no approved pharmacotherapy for MAFLD is available, lifestyle modification remains the cornerstone of clinical care. Our study aims to evaluate the association of an overall healthy lifestyle with MAFLD risk. Methods We conducted an analysis of 327,387 participants from UK biobank. An overall healthy lifestyle score including six evidence-based lifestyles (diet, alcohol consumption, physical activity, sedentary behavior, sleep, and smoking) was assessed by questionnaires. MAFLD and its subtypes were diagnosed by blood biochemistry, ICD codes, and medication information from touchscreen and verbal interview. The prevalence ratios (PRs) and risk ratios (RRs) were estimated by Poisson regression models with robust variance. Results In the cross-sectional analysis, the PR (95% CI) was 0.83 (0.83 to 0.84) for MAFLD, and 0.83 (0.83 to 0.84) for MAFLD-overweight/obesity (MAFLD-O), 0.68 (0.66 to 0.70) for MAFLD-lean/normal weight and metabolic dysfunction (P-value for heterogeneity < 0.001), and 0.71 (0.71 to 0.72) for MAFLD-type 2 diabetes mellitus (MAFLD-T2D); and 0.68 (0.66 to 0.71) for dual (or more) etiology fatty liver disease (MAFLD-dual) and 0.83 (0.83 to 0.84) for single etiology MAFLD (MAFLD-single) (P-value for heterogeneity < 0.001) for one additional point in the overall healthy lifestyle score. During a median follow-up of 4.4 years, the RR (95% CI) was 0.83 (0.81 to 0.85) for MAFLD, and 0.83 (0.81 to 0.85) for MAFLD-O, 0.71 (0.62 to 0.81) for MAFLD-L, and 0.68 (0.64 to 0.72) for MAFLD-T2D (P-value for heterogeneity < 0.001); and 0.83 (0.81 to 0.85) for MAFLD-dual and 0.70 (0.58 to 0.85) for MAFLD-single (P-value for heterogeneity = 0.08) for one additional point in the overall healthy lifestyle score. These findings were validated in a prospective analysis among 15,721 participants with revisit data, and also supported by fatty liver index and proton density fat fraction data. Conclusions An overall healthy lifestyle that includes six evidence-based factors was strongly associated with lower MAFLD risk, especially the subtypes with multiple etiologies.
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spelling doaj-art-29093386d0fe4862996b2d973ec247662025-08-20T02:38:35ZengBMCBMC Public Health1471-24582024-11-0124111210.1186/s12889-024-20663-xAssociations of an overall healthy lifestyle with the risk of metabolic dysfunction-associated fatty liver diseaseCaimei Yuan0Chengjing Zhang1Xin Geng2Chengwu Feng3Yang Su4Yinfan Wu5Ying Wang6Li Chen7Qiurong Ding8Trudy Voortman9Hongyang Wang10Geng Zong11CAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of SciencesShanghai Eastern Hepatobiliary Surgery Hospital, Naval Medical UniversityShanghai Eastern Hepatobiliary Surgery Hospital, Naval Medical UniversityCAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of SciencesCAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of SciencesDepartment of clinical nutrition, Shanghai Fourth People’s Hospital, School of Medicine, Tongji UniversityDepartment of clinical nutrition, Shanghai Fourth People’s Hospital, School of Medicine, Tongji UniversityCAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of SciencesCAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of SciencesDepartment of Epidemiology, Erasmus MC University Medical CenterShanghai Eastern Hepatobiliary Surgery Hospital, Naval Medical UniversityCAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of SciencesAbstract Background Metabolic dysfunction-associated fatty liver disease (MAFLD) affects up to one-third of the global population. Since no approved pharmacotherapy for MAFLD is available, lifestyle modification remains the cornerstone of clinical care. Our study aims to evaluate the association of an overall healthy lifestyle with MAFLD risk. Methods We conducted an analysis of 327,387 participants from UK biobank. An overall healthy lifestyle score including six evidence-based lifestyles (diet, alcohol consumption, physical activity, sedentary behavior, sleep, and smoking) was assessed by questionnaires. MAFLD and its subtypes were diagnosed by blood biochemistry, ICD codes, and medication information from touchscreen and verbal interview. The prevalence ratios (PRs) and risk ratios (RRs) were estimated by Poisson regression models with robust variance. Results In the cross-sectional analysis, the PR (95% CI) was 0.83 (0.83 to 0.84) for MAFLD, and 0.83 (0.83 to 0.84) for MAFLD-overweight/obesity (MAFLD-O), 0.68 (0.66 to 0.70) for MAFLD-lean/normal weight and metabolic dysfunction (P-value for heterogeneity < 0.001), and 0.71 (0.71 to 0.72) for MAFLD-type 2 diabetes mellitus (MAFLD-T2D); and 0.68 (0.66 to 0.71) for dual (or more) etiology fatty liver disease (MAFLD-dual) and 0.83 (0.83 to 0.84) for single etiology MAFLD (MAFLD-single) (P-value for heterogeneity < 0.001) for one additional point in the overall healthy lifestyle score. During a median follow-up of 4.4 years, the RR (95% CI) was 0.83 (0.81 to 0.85) for MAFLD, and 0.83 (0.81 to 0.85) for MAFLD-O, 0.71 (0.62 to 0.81) for MAFLD-L, and 0.68 (0.64 to 0.72) for MAFLD-T2D (P-value for heterogeneity < 0.001); and 0.83 (0.81 to 0.85) for MAFLD-dual and 0.70 (0.58 to 0.85) for MAFLD-single (P-value for heterogeneity = 0.08) for one additional point in the overall healthy lifestyle score. These findings were validated in a prospective analysis among 15,721 participants with revisit data, and also supported by fatty liver index and proton density fat fraction data. Conclusions An overall healthy lifestyle that includes six evidence-based factors was strongly associated with lower MAFLD risk, especially the subtypes with multiple etiologies.https://doi.org/10.1186/s12889-024-20663-xLifestyle scoreHepatic steatosisFatty liver diseaseOverweightType 2 diabetesProton density fat fraction
spellingShingle Caimei Yuan
Chengjing Zhang
Xin Geng
Chengwu Feng
Yang Su
Yinfan Wu
Ying Wang
Li Chen
Qiurong Ding
Trudy Voortman
Hongyang Wang
Geng Zong
Associations of an overall healthy lifestyle with the risk of metabolic dysfunction-associated fatty liver disease
BMC Public Health
Lifestyle score
Hepatic steatosis
Fatty liver disease
Overweight
Type 2 diabetes
Proton density fat fraction
title Associations of an overall healthy lifestyle with the risk of metabolic dysfunction-associated fatty liver disease
title_full Associations of an overall healthy lifestyle with the risk of metabolic dysfunction-associated fatty liver disease
title_fullStr Associations of an overall healthy lifestyle with the risk of metabolic dysfunction-associated fatty liver disease
title_full_unstemmed Associations of an overall healthy lifestyle with the risk of metabolic dysfunction-associated fatty liver disease
title_short Associations of an overall healthy lifestyle with the risk of metabolic dysfunction-associated fatty liver disease
title_sort associations of an overall healthy lifestyle with the risk of metabolic dysfunction associated fatty liver disease
topic Lifestyle score
Hepatic steatosis
Fatty liver disease
Overweight
Type 2 diabetes
Proton density fat fraction
url https://doi.org/10.1186/s12889-024-20663-x
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