Prevalence, Incidence, and Recovery of Metabolic Dysfunction-associated Steatotic Liver Disease and Associations With Weight Loss and Lipid Reduction in a Chinese Community-based Cohort

Background: As the most common chronic liver disease worldwide, the natural history of metabolic dysfunction-associated steatotic liver disease (MASLD) in the general population is barely reported. Methods: The Shanghai Suburban Adult Cohort and Biobank study recruited 36,404 adults between 2016 and...

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Main Authors: Yurou Xu, Youyi Wang, Xiajing Yao, Qi Zhao, Bo Chen, Na Wang, Tiejun Zhang, Yonggen Jiang, Yiling Wu, Na He, Genming Zhao, Zhongxing Sun, Xing Liu
Format: Article
Language:English
Published: Japan Epidemiological Association 2025-04-01
Series:Journal of Epidemiology
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Online Access:https://www.jstage.jst.go.jp/article/jea/35/4/35_JE20240224/_pdf
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author Yurou Xu
Youyi Wang
Xiajing Yao
Qi Zhao
Bo Chen
Na Wang
Tiejun Zhang
Yonggen Jiang
Yiling Wu
Na He
Genming Zhao
Zhongxing Sun
Xing Liu
author_facet Yurou Xu
Youyi Wang
Xiajing Yao
Qi Zhao
Bo Chen
Na Wang
Tiejun Zhang
Yonggen Jiang
Yiling Wu
Na He
Genming Zhao
Zhongxing Sun
Xing Liu
author_sort Yurou Xu
collection DOAJ
description Background: As the most common chronic liver disease worldwide, the natural history of metabolic dysfunction-associated steatotic liver disease (MASLD) in the general population is barely reported. Methods: The Shanghai Suburban Adult Cohort and Biobank study recruited 36,404 adults between 2016 and 2017, and followed up 25,085 participants between 2019 and 2023 in Songjiang District. A questionnaire survey was conducted using face-to-face interview, and physical examination and laboratory tests were conducted. MASLD was diagnosed using liver ultrasound and the cardiometabolic risk factors (CMRF). Results: A total of 36,122 and 21,831 participants met the criteria for baseline and follow-up analyses. The prevalence of MASLD at baseline was 36.8% overall, and 73.6% among those with a body mass index (BMI) over 28 kg/m2. After a median follow-up time of 4.26 years, the incidence density for MASLD was 8.4, and the recovery density was 11.4 per 100 person-years overall and was 20.0 and 8.4 per 100 person-years for those with baseline BMI over 28 kg/m2. Per 1 kg/m2 increase in baseline BMI was associated with a 15% increase in incidence (hazard ratio [HR] 1.15; 95% confidence interval [CI], 1.14–1.17) and an 8% decrease in recovery (HR 0.92; 95% CI, 0.90–0.93). From baseline to follow-up visit, participants who remained non-obese or remained normal cardiometabolic status always showed the lowest incidence and the highest recovery rate, followed by those with improved status. Conclusion: The prevalence and incidence of MASLD were high among Shanghai residents, and active recovery was also observed. Obesity was the most important risk factor, and weight loss and lipid level reduction were beneficial for preventing or reversing MASLD.
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spelling doaj-art-b6ceb45ca22c4605b2916ebf09497c182025-08-20T03:17:54ZengJapan Epidemiological AssociationJournal of Epidemiology0917-50401349-90922025-04-0135419520510.2188/jea.JE20240224Prevalence, Incidence, and Recovery of Metabolic Dysfunction-associated Steatotic Liver Disease and Associations With Weight Loss and Lipid Reduction in a Chinese Community-based CohortYurou Xu0Youyi Wang1Xiajing Yao2Qi Zhao3Bo Chen4Na Wang5Tiejun Zhang6Yonggen Jiang7Yiling Wu8Na He9Genming Zhao10Zhongxing Sun11Xing Liu12The Key Laboratory of Public Health Safety of Ministry of Education, Department of Epidemiology, School of Public Health, Fudan University, Shanghai, ChinaThe Key Laboratory of Public Health Safety of Ministry of Education, Department of Epidemiology, School of Public Health, Fudan University, Shanghai, ChinaSongjiang District Center for Disease Control and Prevention, Shanghai, ChinaThe Key Laboratory of Public Health Safety of Ministry of Education, Department of Epidemiology, School of Public Health, Fudan University, Shanghai, ChinaThe Key Laboratory of Public Health Safety of Ministry of Education, Department of Epidemiology, School of Public Health, Fudan University, Shanghai, ChinaThe Key Laboratory of Public Health Safety of Ministry of Education, Department of Epidemiology, School of Public Health, Fudan University, Shanghai, ChinaThe Key Laboratory of Public Health Safety of Ministry of Education, Department of Epidemiology, School of Public Health, Fudan University, Shanghai, ChinaSongjiang District Center for Disease Control and Prevention, Shanghai, ChinaSongjiang District Center for Disease Control and Prevention, Shanghai, ChinaThe Key Laboratory of Public Health Safety of Ministry of Education, Department of Epidemiology, School of Public Health, Fudan University, Shanghai, ChinaThe Key Laboratory of Public Health Safety of Ministry of Education, Department of Epidemiology, School of Public Health, Fudan University, Shanghai, ChinaSongjiang District Center for Disease Control and Prevention, Shanghai, ChinaThe Key Laboratory of Public Health Safety of Ministry of Education, Department of Epidemiology, School of Public Health, Fudan University, Shanghai, ChinaBackground: As the most common chronic liver disease worldwide, the natural history of metabolic dysfunction-associated steatotic liver disease (MASLD) in the general population is barely reported. Methods: The Shanghai Suburban Adult Cohort and Biobank study recruited 36,404 adults between 2016 and 2017, and followed up 25,085 participants between 2019 and 2023 in Songjiang District. A questionnaire survey was conducted using face-to-face interview, and physical examination and laboratory tests were conducted. MASLD was diagnosed using liver ultrasound and the cardiometabolic risk factors (CMRF). Results: A total of 36,122 and 21,831 participants met the criteria for baseline and follow-up analyses. The prevalence of MASLD at baseline was 36.8% overall, and 73.6% among those with a body mass index (BMI) over 28 kg/m2. After a median follow-up time of 4.26 years, the incidence density for MASLD was 8.4, and the recovery density was 11.4 per 100 person-years overall and was 20.0 and 8.4 per 100 person-years for those with baseline BMI over 28 kg/m2. Per 1 kg/m2 increase in baseline BMI was associated with a 15% increase in incidence (hazard ratio [HR] 1.15; 95% confidence interval [CI], 1.14–1.17) and an 8% decrease in recovery (HR 0.92; 95% CI, 0.90–0.93). From baseline to follow-up visit, participants who remained non-obese or remained normal cardiometabolic status always showed the lowest incidence and the highest recovery rate, followed by those with improved status. Conclusion: The prevalence and incidence of MASLD were high among Shanghai residents, and active recovery was also observed. Obesity was the most important risk factor, and weight loss and lipid level reduction were beneficial for preventing or reversing MASLD.https://www.jstage.jst.go.jp/article/jea/35/4/35_JE20240224/_pdfmetabolic dysfunction associated steatotic liver diseaseprevalenceincidencerecoveryweight losscohort study
spellingShingle Yurou Xu
Youyi Wang
Xiajing Yao
Qi Zhao
Bo Chen
Na Wang
Tiejun Zhang
Yonggen Jiang
Yiling Wu
Na He
Genming Zhao
Zhongxing Sun
Xing Liu
Prevalence, Incidence, and Recovery of Metabolic Dysfunction-associated Steatotic Liver Disease and Associations With Weight Loss and Lipid Reduction in a Chinese Community-based Cohort
Journal of Epidemiology
metabolic dysfunction associated steatotic liver disease
prevalence
incidence
recovery
weight loss
cohort study
title Prevalence, Incidence, and Recovery of Metabolic Dysfunction-associated Steatotic Liver Disease and Associations With Weight Loss and Lipid Reduction in a Chinese Community-based Cohort
title_full Prevalence, Incidence, and Recovery of Metabolic Dysfunction-associated Steatotic Liver Disease and Associations With Weight Loss and Lipid Reduction in a Chinese Community-based Cohort
title_fullStr Prevalence, Incidence, and Recovery of Metabolic Dysfunction-associated Steatotic Liver Disease and Associations With Weight Loss and Lipid Reduction in a Chinese Community-based Cohort
title_full_unstemmed Prevalence, Incidence, and Recovery of Metabolic Dysfunction-associated Steatotic Liver Disease and Associations With Weight Loss and Lipid Reduction in a Chinese Community-based Cohort
title_short Prevalence, Incidence, and Recovery of Metabolic Dysfunction-associated Steatotic Liver Disease and Associations With Weight Loss and Lipid Reduction in a Chinese Community-based Cohort
title_sort prevalence incidence and recovery of metabolic dysfunction associated steatotic liver disease and associations with weight loss and lipid reduction in a chinese community based cohort
topic metabolic dysfunction associated steatotic liver disease
prevalence
incidence
recovery
weight loss
cohort study
url https://www.jstage.jst.go.jp/article/jea/35/4/35_JE20240224/_pdf
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