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Original Article
- Metabolic Risk/Epidemiology
- Healthy Lifestyle and the Risk of Metabolic Dysfunction-Associated Fatty Liver Disease: A Large Prospective Cohort Study
- Qing Chang, Yixiao Zhang, Tingjing Zhang, Zuyun Liu, Limin Cao, Qing Zhang, Li Liu, Shaomei Sun, Xing Wang, Ming Zhou, Qiyu Jia, Kun Song, Yang Ding, Yuhong Zhao, Kaijun Niu, Yang Xia
- Diabetes Metab J. 2024;48(5):971-982. Published online March 19, 2024
- DOI: https://doi.org/10.4093/dmj.2023.0133
- 7,107 View
- 247 Download
- 11 Web of Science
- 10 Crossref
-
Abstract
PDF
Supplementary Material
PubReader 
ePub - Background
The incidence density of metabolic dysfunction-associated fatty liver disease (MAFLD) and the effect of a healthy lifestyle on the risk of MAFLD remain unknown. We evaluated the prevalence and incidence density of MAFLD and investigated the association between healthy lifestyle and the risk of MAFLD.
Methods
A cross-sectional analysis was conducted on 37,422 participants to explore the prevalence of MAFLD. A cohort analysis of 18,964 individuals was conducted to identify the incidence of MAFLD, as well as the association between healthy lifestyle and MAFLD. Cox proportional hazards regression was used to calculate the hazard ratio (HR) and 95% confidence interval (CI) with adjustments for confounding factors.
Results
The prevalence of MAFLD, non-alcoholic fatty liver disease, and their comorbidities were 30.38%, 28.09%, and 26.13%, respectively. After approximately 70 thousand person-years of follow-up, the incidence densities of the three conditions were 61.03, 55.49, and 51.64 per 1,000 person-years, respectively. Adherence to an overall healthy lifestyle was associated with a 19% decreased risk of MAFLD (HR, 0.81; 95% CI, 0.72 to 0.92), and the effects were modified by baseline age, sex, and body mass index (BMI). Subgroup analyses revealed that younger participants, men, and those with a lower BMI experienced more significant beneficial effects from healthy lifestyle.
Conclusion
Our results highlight the beneficial effect of adherence to a healthy lifestyle on the prevention of MAFLD. Health management for improving dietary intake, physical activity, and smoking and drinking habits are critical to improving MAFLD. -
Citations
Citations to this article as recorded by
- Impact of healthy lifestyles on the risk of metabolic dysfunction‐associated steatotic liver disease among adults with comorbid hypertension and diabetes: Novel insight from a largely middle‐aged and elderly cohort in South China
Jun‐Yan Xi, Yi‐Jing Wang, Xiao‐Heng Li, Nuo‐Min Sun, Rui‐Qi Ming, Hua‐Ling Yan, Huan‐Le Cai, Jian‐Jun Bai, Yi‐Ning Xiang, Jing Gu, Xiao Lin, Gang Liu, Yuan‐Tao Hao
Diabetes, Obesity and Metabolism.2025; 27(5): 2800. CrossRef - Cholesteryl ester transfer protein gene variants and metabolic dysfunction-associated steatotic liver disease: genetic associations with steatosis in obese and lean individuals
Asmaa AbdelFattah, Mahmoud Kattab, Hosny Abdel Ghany, Lamiaa Aly, Ahmed Mady, Aly Hamdi, Riham Soliman, Gamal Shiha, Nada El-Domiaty
Egyptian Liver Journal.2025;[Epub] CrossRef - Research trends on the quality of life in patients with metabolic dysfunction-associated fatty liver diseases: a scientific metrology study
Can Huang, Meng Chen, Yanfang Sun, Lin Zhang, Wei Liu
Frontiers in Nutrition.2025;[Epub] CrossRef - The relationship between tobacco and non-alcoholic fatty liver disease incidence: a systematic review and meta-analysis of observational studies
Jianxiang Jin, Yuping Zhang, Yiping Huang
Frontiers in Medicine.2025;[Epub] CrossRef - Enhancing MAFLD Care: Efficacy of a Multidisciplinary Community Intervention on Self-Management and Hepatic Outcomes
Huan-Jing Cai, Hai-Lun Liang, Lei-Yu Shi, Yi-Hui Rong, Jing Li, Yan Zhang, Rui-Fang Ma
INQUIRY: The Journal of Health Care Organization, Provision, and Financing.2025;[Epub] CrossRef - Mechanistic investigation of DDT/DDE in MASLD/MASH pathogenesis: An integrated network toxicology and transcriptomics approach
Yicheng Jiang, Yuancheng Shao, Jiaming Xue, Zhigang Chen, Qi Liu, Shuai Chen, Xihan Gu, Shufan Zhang, Liming Tang
Ecotoxicology and Environmental Safety.2025; 307: 119390. CrossRef - Multiorgan crosstalk in MASLD/MASH: from hepatic pathogenesis to systemic complications
Wenhua Bai, Zheng Zhu
Frontiers in Endocrinology.2025;[Epub] CrossRef - Diagnostic indicators and lifestyle interventions of metabolic-associated fatty liver disease
Tianzhu Chen, Xiang Qin, Jianping Jiang, Beihui He
Frontiers in Nutrition.2024;[Epub] CrossRef - Sex differences in pathogenesis and treatment of dyslipidemia in patients with type 2 diabetes and steatotic liver disease
Tatjana Ábel, Béla Benczúr, Éva Csajbókné Csobod
Frontiers in Medicine.2024;[Epub] CrossRef - Associations of traditional healthy lifestyle and sleep quality with metabolic dysfunction-associated fatty liver disease: two population-based studies
Jialu Yang, Qi Zhang, Wanying Zhao, Bingqi Ye, Siqi Li, Zhuoyu Zhang, Jingmeng Ju, Jialin He, Min Xia, Tiantian Xiong, Yan Liu
Nutrition & Diabetes.2024;[Epub] CrossRef
- Impact of healthy lifestyles on the risk of metabolic dysfunction‐associated steatotic liver disease among adults with comorbid hypertension and diabetes: Novel insight from a largely middle‐aged and elderly cohort in South China
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