Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. May 27, 2025; 17(5): 103852
Published online May 27, 2025. doi: 10.4254/wjh.v17.i5.103852
Association between weight fluctuation and the risk of metabolic dysfunction-associated steatotic liver disease
Jin-Ping Wang, Jia-Yang Wang, Pei-Qi Sun, Xue-Wei Wang, Ze-Ting Yuan, Qin Cao, Shu-Ming Pan, Yuan-Ye Jiang
Jin-Ping Wang, Jia-Yang Wang, Pei-Qi Sun, Xue-Wei Wang, Ze-Ting Yuan, Qin Cao, Yuan-Ye Jiang, Department of Gastroenterology, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, China
Shu-Ming Pan, Department of Emergency, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, China
Co-first authors: Jin-Ping Wang and Jia-Yang Wang.
Co-corresponding authors: Yuan-Ye Jiang and Shu-Ming Pan.
Author contributions: Wang JP and Wang JY were responsible for software; Wang JP, Wang JY, Sun PQ, Wang XW, Yuan ZT and Cao Q were responsible for writing original draft; Wang JY, Sun PQ, Pan SM and Jiang YY were responsible for writing review editing; Wang JP, Wang JY and Yuan ZT were responsible for investigation; Wang JY and Sun PQ were responsible for visualization; Wang JP, Sun PQ, Wang XW and Cao Q were responsible for data curation; Jiang YY was responsible for funding acquisition and methodology; Pan SM and Jiang YY were responsible for project administration and supervision; all authors have read and approved the final manuscript.
Supported by National Natural Science Foundation of China, No. 82474378; Shanghai Natural Science Foundation, No. 22ZR1455900; Shanghai Municipal Health Planning Commission Clinical Research Specialized Face Project, No. 201940449; Key Project of Science and Technology Innovation Program of Shanghai Putuo District Health and Health System, No. ptkwws202201; Reserve Excellent Chinese Medicine Talent Program of Shanghai University of Traditional Chinese Medicine, No. 20D-RC-02; Apricot Grove, Shanghai Putuo District Excellent Young Talent Training Program, No. ptxlyq2201; and Shanghai Putuo District Health and Health System Characteristic Specialty Disease Construction Project, No. 2023tszb01.
Institutional review board statement: The Institutional Ethical Review Board approved this study (No. PTEC-A-2024-28(S)-1).
Informed consent statement: As no direct participant contact or additional data collection occurred, no statement of informed consent is required.
Conflict-of-interest statement: The authors declare that there are no conflicts of interest.
Data sharing statement: The original data presented in this study are available from the National Health and Nutrition Examination Survey database.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yuan-Ye Jiang, Deputy Chief Physician, Department of Gastroenterology, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, No. 164 Lanxi Road, Shanghai 200062, China. yuanye1014@126.com
Received: December 6, 2024
Revised: March 24, 2025
Accepted: April 24, 2025
Published online: May 27, 2025
Processing time: 172 Days and 21.7 Hours
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.

Keywords: Metabolic dysfunction-associated steatotic liver disease; Metabolic dysfunction-associated steatohepatitis; Weight fluctuation; Body mass index; Net weight; Physical activity intensity

Core Tip: The risk of metabolic dysfunction-associated steatotic liver disease (MASLD) increases with age in individuals transitioning from non-obese to obese or maintaining obesity. High-intensity physical activity is beneficial in reducing the risk of MASLD among individuals with stable obesity. Delineation of the dose-response relationship between weight fluctuation patterns and MASLD prevalence risk will facilitate the development of personalized exercise prescriptions.