The association between sedentary behavior and MASLD in overweight and obese adults: investigating the role of inflammatory markers using NHANES data (2017–March 2020)

BackgroundMetabolic dysfunction-associated steatotic liver disease (MASLD) has been linked to sedentary behavior (SB), yet the extent to which systemic inflammation mediates this relationship remains unclear. This study aims to demonstrate the mediating function of inflammatory markers in the link b...

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Main Authors: Zehong Zhou, Linfang Li, Chusi Wang, Shiqi Li, Pengfei Chen, Jiesheng Huang, Ming Peng
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Nutrition
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Online Access:https://www.frontiersin.org/articles/10.3389/fnut.2025.1579453/full
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author Zehong Zhou
Linfang Li
Chusi Wang
Shiqi Li
Pengfei Chen
Jiesheng Huang
Ming Peng
author_facet Zehong Zhou
Linfang Li
Chusi Wang
Shiqi Li
Pengfei Chen
Jiesheng Huang
Ming Peng
author_sort Zehong Zhou
collection DOAJ
description BackgroundMetabolic dysfunction-associated steatotic liver disease (MASLD) has been linked to sedentary behavior (SB), yet the extent to which systemic inflammation mediates this relationship remains unclear. This study aims to demonstrate the mediating function of inflammatory markers in the link between sedentary behavior and metabolic dysfunction-associated steatotic liver disease (MASLD) in overweight and obese individuals.MethodsIn this cross-sectional study, we analyzed pre-pandemic data (2017–March 2020) from the National Health and Nutrition Examination Survey (NHANES), including 3,729 overweight/obese adults with MASLD defined by a controlled attenuation parameter (CAP) ≥ 302 dB/m. Self-reported SB (≥480 min/day vs. <480 min/day) and vigorous recreational activity were assessed alongside inflammatory markers (high-sensitivity C-reactive protein [HSCRP], albumin [ALB], white blood cell count [WBC], and neutrophil count [NE]). And weighted multivariable logistic and linear regression models, as well as mediation analyses, were conducted to account for the complex sampling design of the NHANES data.ResultsWeighted logistic regression showed that severe SB was associated with higher MASLD odds (OR = 1.43, 95% CI: 1.02–1.99), which further increased (OR = 2.88, 95% CI: 1.77–4.71) in participants lacking vigorous physical activity. Independent predictors of MASLD included lower ALB (OR = 0.55) and higher WBC (OR = 1.16) and NE (OR = 1.17). Mediation analysis indicated that HSCRP, ALB, WBC, and NE, respectively, accounted for 10.48, 3.23, 7.17, and 6.46% of the SB – MASLD association.ConclusionOur findings suggest that severe sedentary behavior is an independent risk factor for MASLD, with some evidence suggesting that this relationship may be influenced by inflammatory markers. However, longitudinal studies are necessary to better understand the nature of these associations and to explore the underlying mechanisms involved.
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spelling doaj-art-addbe6fc49a543a4a5ef6ceee835ee412025-08-20T02:35:16ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2025-06-011210.3389/fnut.2025.15794531579453The association between sedentary behavior and MASLD in overweight and obese adults: investigating the role of inflammatory markers using NHANES data (2017–March 2020)Zehong Zhou0Linfang Li1Chusi Wang2Shiqi Li3Pengfei Chen4Jiesheng Huang5Ming Peng6Department of Clinical Laboratory Medicine, Zhongshan Hospital of Traditional Chinese Medicine, Zhongshan, ChinaDepartment of Clinical Laboratory Medicine, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, ChinaDepartment of Hepatobiliary Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, ChinaDepartment of Classical Chinese Medicine, Zhongshan Hospital of Traditional Chinese Medicine, Zhongshan, ChinaDepartment of Clinical Laboratory Medicine, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, ChinaDepartment of Clinical Laboratory Medicine, Zhongshan Hospital of Traditional Chinese Medicine, Zhongshan, ChinaDepartment of Clinical Laboratory Medicine, Zhongshan Hospital of Traditional Chinese Medicine, Zhongshan, ChinaBackgroundMetabolic dysfunction-associated steatotic liver disease (MASLD) has been linked to sedentary behavior (SB), yet the extent to which systemic inflammation mediates this relationship remains unclear. This study aims to demonstrate the mediating function of inflammatory markers in the link between sedentary behavior and metabolic dysfunction-associated steatotic liver disease (MASLD) in overweight and obese individuals.MethodsIn this cross-sectional study, we analyzed pre-pandemic data (2017–March 2020) from the National Health and Nutrition Examination Survey (NHANES), including 3,729 overweight/obese adults with MASLD defined by a controlled attenuation parameter (CAP) ≥ 302 dB/m. Self-reported SB (≥480 min/day vs. <480 min/day) and vigorous recreational activity were assessed alongside inflammatory markers (high-sensitivity C-reactive protein [HSCRP], albumin [ALB], white blood cell count [WBC], and neutrophil count [NE]). And weighted multivariable logistic and linear regression models, as well as mediation analyses, were conducted to account for the complex sampling design of the NHANES data.ResultsWeighted logistic regression showed that severe SB was associated with higher MASLD odds (OR = 1.43, 95% CI: 1.02–1.99), which further increased (OR = 2.88, 95% CI: 1.77–4.71) in participants lacking vigorous physical activity. Independent predictors of MASLD included lower ALB (OR = 0.55) and higher WBC (OR = 1.16) and NE (OR = 1.17). Mediation analysis indicated that HSCRP, ALB, WBC, and NE, respectively, accounted for 10.48, 3.23, 7.17, and 6.46% of the SB – MASLD association.ConclusionOur findings suggest that severe sedentary behavior is an independent risk factor for MASLD, with some evidence suggesting that this relationship may be influenced by inflammatory markers. However, longitudinal studies are necessary to better understand the nature of these associations and to explore the underlying mechanisms involved.https://www.frontiersin.org/articles/10.3389/fnut.2025.1579453/fullMASLDmetabolic dysfunction associated steatotic liver diseasesedentary behavior (SB)inflammatory markersNHANES (National Health and Nutrition Examination Survey)mediation analysis
spellingShingle Zehong Zhou
Linfang Li
Chusi Wang
Shiqi Li
Pengfei Chen
Jiesheng Huang
Ming Peng
The association between sedentary behavior and MASLD in overweight and obese adults: investigating the role of inflammatory markers using NHANES data (2017–March 2020)
Frontiers in Nutrition
MASLD
metabolic dysfunction associated steatotic liver disease
sedentary behavior (SB)
inflammatory markers
NHANES (National Health and Nutrition Examination Survey)
mediation analysis
title The association between sedentary behavior and MASLD in overweight and obese adults: investigating the role of inflammatory markers using NHANES data (2017–March 2020)
title_full The association between sedentary behavior and MASLD in overweight and obese adults: investigating the role of inflammatory markers using NHANES data (2017–March 2020)
title_fullStr The association between sedentary behavior and MASLD in overweight and obese adults: investigating the role of inflammatory markers using NHANES data (2017–March 2020)
title_full_unstemmed The association between sedentary behavior and MASLD in overweight and obese adults: investigating the role of inflammatory markers using NHANES data (2017–March 2020)
title_short The association between sedentary behavior and MASLD in overweight and obese adults: investigating the role of inflammatory markers using NHANES data (2017–March 2020)
title_sort association between sedentary behavior and masld in overweight and obese adults investigating the role of inflammatory markers using nhanes data 2017 march 2020
topic MASLD
metabolic dysfunction associated steatotic liver disease
sedentary behavior (SB)
inflammatory markers
NHANES (National Health and Nutrition Examination Survey)
mediation analysis
url https://www.frontiersin.org/articles/10.3389/fnut.2025.1579453/full
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