TY - JOUR
T1 - A healthy lifestyle is prospectively associated with lower onset of metabolic dysfunction–associated steatotic liver disease
AU - Grinshpan, Laura S.
AU - Haim, Yaara Even
AU - Ivancovsky-Wajcman, Dana
AU - Fliss-Isakov, Naomi
AU - Nov, Yuval
AU - Webb, Muriel
AU - Shibolet, Oren
AU - Kariv, Revital
AU - Zelber-Sagi, Shira
N1 - Publisher Copyright:
© 2024 The Author(s).
PY - 2024/11/1
Y1 - 2024/11/1
N2 - Background: Metabolic dysfunction–associated steatotic liver disease (MASLD) is associated with an unhealthy lifestyle. However, there is limited prospective evidence regarding the association between combined lifestyle factors and MASLD. This study aims to test the association of a combination of lifestyle components, expressed as a healthy lifestyle index (HLI), and unhealthful eating behavior habits with MASLD, insulin resistance (IR), liver fibrosis, and metabolic dysfunction–associated steatohepatitis. Methods: A prospective cohort study was conducted among participants of metabolic and hepatic screening surveys. MASLD was evaluated by ultrasonography or controlled attenuation parameter at 2 time points to assess new-onset, persistence, or remission, and IR was estimated by homeostasis model assessment. Presumed liver fibrosis and metabolic dysfunction–associated steatohepatitis were evaluated using FibroMax biomarkers. The HLI was calculated as the sum of 4 lifestyle components: nonsmoking, healthy weight, healthy diet, and physical activity. Results: The final cohort included 315 subjects with 6.7 years of follow-up, 40–70 years old. In multivariable analyses, a favorable lifestyle (≥ 3 components) was independently associated with lower odds of new-onset MASLD (OR = 0.42; 95% CI: 0.19–0.90). Similarly, a favorable lifestyle was associated with lower odds of new-onset/persistent (vs. never/remission) MASLD and IR, respectively (OR = 0.49; 95% CI: 0.30–0.80; OR = 0.40; 95% CI: 0.24–0.66). There was a dose-response association between HLI and new-onset/persistent MASLD and IR. A favorable lifestyle was associated with lower odds of new-onset metabolic dysfunction–associated steatohepatitis (OR = 0.50; 95% CI: 0.27–0.95). Adjusting for HLI, unhealthful eating behavior habits were associated with higher odds of MASLD prevalence (OR = 1.81; 95% CI: 1.07–3.06). Conclusions: Adherence to a healthy lifestyle is prospectively associated with lower odds of MASLD, markers of liver damage, and IR. A holistic approach that considers overall lifestyle and eating behavior may be useful for preventing MASLD.
AB - Background: Metabolic dysfunction–associated steatotic liver disease (MASLD) is associated with an unhealthy lifestyle. However, there is limited prospective evidence regarding the association between combined lifestyle factors and MASLD. This study aims to test the association of a combination of lifestyle components, expressed as a healthy lifestyle index (HLI), and unhealthful eating behavior habits with MASLD, insulin resistance (IR), liver fibrosis, and metabolic dysfunction–associated steatohepatitis. Methods: A prospective cohort study was conducted among participants of metabolic and hepatic screening surveys. MASLD was evaluated by ultrasonography or controlled attenuation parameter at 2 time points to assess new-onset, persistence, or remission, and IR was estimated by homeostasis model assessment. Presumed liver fibrosis and metabolic dysfunction–associated steatohepatitis were evaluated using FibroMax biomarkers. The HLI was calculated as the sum of 4 lifestyle components: nonsmoking, healthy weight, healthy diet, and physical activity. Results: The final cohort included 315 subjects with 6.7 years of follow-up, 40–70 years old. In multivariable analyses, a favorable lifestyle (≥ 3 components) was independently associated with lower odds of new-onset MASLD (OR = 0.42; 95% CI: 0.19–0.90). Similarly, a favorable lifestyle was associated with lower odds of new-onset/persistent (vs. never/remission) MASLD and IR, respectively (OR = 0.49; 95% CI: 0.30–0.80; OR = 0.40; 95% CI: 0.24–0.66). There was a dose-response association between HLI and new-onset/persistent MASLD and IR. A favorable lifestyle was associated with lower odds of new-onset metabolic dysfunction–associated steatohepatitis (OR = 0.50; 95% CI: 0.27–0.95). Adjusting for HLI, unhealthful eating behavior habits were associated with higher odds of MASLD prevalence (OR = 1.81; 95% CI: 1.07–3.06). Conclusions: Adherence to a healthy lifestyle is prospectively associated with lower odds of MASLD, markers of liver damage, and IR. A holistic approach that considers overall lifestyle and eating behavior may be useful for preventing MASLD.
KW - MASLD
KW - fatty liver
KW - healthy lifestyle index
KW - insulin resistance
KW - steatohepatitis
UR - http://www.scopus.com/inward/record.url?scp=85209102174&partnerID=8YFLogxK
U2 - 10.1097/HC9.0000000000000583
DO - 10.1097/HC9.0000000000000583
M3 - Article
C2 - 39495134
AN - SCOPUS:85209102174
SN - 2471-254X
VL - 8
JO - Hepatology Communications
JF - Hepatology Communications
IS - 11
M1 - e0583
ER -