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Cited by 86Liver Disease Diagnosis and TreatmentPhysical Activity and HealthAlcohol Consumption and Health Effects

Physical activity, measured objectively, is associated with lower mortality in patients with nonalcoholic fatty liver disease

Kim, Donghee, Murag, Soumya, Cholankeril, George, Cheung, Amanda, Harrison, Stephen A., Younossi, Zobair M., Ahmed, Aijaz·2021·Clinical Gastroenterology and Hepatology
DOI 10.1016/j.cgh.2020.07.023
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Abstract

Background & aims The association between physical activity (PA) and all-cause and cause-specific mortality from nonalcoholic fatty liver disease (NAFLD) requires investigation. We studied whether PA, measured by accelerometer, is associated with all-cause and cause-specific mortality among individuals with NAFLD.Methods We performed a longitudinal analysis using the 2003 to 2006 US National Health and Nutrition Examination Survey data of adults (age, ≥20 y) and collecting mortality data through December 2015. NAFLD was defined based on the hepatic steatosis index or US fatty liver index scores, in the absence of other causes of chronic liver disease. PA was measured from participants who wore accelerometers 10 h/d for a minimum of 4 days over a 7-day period and were classified as total PA, moderate to vigorous PA (MVPA), and sedentary behavior.Results Over an average follow-up period of 10.6 years, increasing the duration of total PA was associated with a reduced risk of death, from any cause, in an age- and sex-adjusted model (hazard ratio [HR], 0.52; 95% CI, 0.32-0.86 for highest quartile vs lowest quartile; P for trend = .001) and multivariable model (HR, 0.46; 95% CI, 0.28-0.75; P for trend < .001) among individuals with NAFLD. Increasing the duration of MVPA was associated with a lower risk of death from any cause in individuals with NAFLD. Furthermore, longer total PA was associated with a lower risk for cardiovascular disease-related death in individuals with NAFLD (HR, 0.28; 95% CI, 0.08-0.98 for highest quartile vs lowest quartile; P for trend = .007). We did not find this association for cancer-related mortality in individuals with NAFLD. Increasing the duration of sedentary behavior did not affect all-cause or cause-specific mortality in individuals with NAFLD.Conclusions Longer total PA and MVPA, measured by accelerometers over a 7-day period, are associated with lower all-cause and cardiovascular mortality in individuals with NAFLD.

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  • Several observational studies have demonstrated that regular increased physical activity is associated with reduced risk for liver fibrosis (measured by non-invasive markers), cirrhosis, all-cause mortality and HCC.

    “Furthermore, several observational studies have demonstrated that regular increased physical activity is associated with reduced risk for liver fi brosis (measured by non-invasive markers), cirrhosis, allcause mortality 322 -324 and HCC. 325”

    From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [322]

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Authors
Kim, D., Murag, S., Cholankeril, G., Cheung, A., Harrison, S. A., Younossi, Z. M., & Ahmed, A.
Affiliations
  • Stanford Medicine (US)
  • Santa Clara Valley Medical Center (US)
  • University of Oxford (GB)
  • Inova Fairfax Hospital (US)
Corresponding author
Kim, Donghee
ORCID
Venue
Clinical Gastroenterology and Hepatology
Publisher
Elsevier BV
Published
2021-06
Volume
19
Issue
6
Pages
1240-1247.e5
ISSN
1542-3565 (ISSN-L)
DOI
10.1016/j.cgh.2020.07.023
OpenAlex
W3042493787
Cited by
86
References
36
Citations by year
2026: 7 · 2025: 16 · 2024: 26 · 2023: 11 · 2022: 16 · 2021: 8 · 2020: 2
FWCI
6.63
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Clinical Gastroenterology and Hepatology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
Keywords
non-alcoholic fatty liver disease, physical activity, moderate-to-vigorous physical activity, sedentary behavior, all-cause mortality, cardiovascular mortality, cancer mortality, accelerometer-measured activity, hepatic steatosis
MeSH terms
Adult, Cardiovascular Diseases, Humans, Nutrition Surveys, Exercise, Sedentary Behavior, Non-alcoholic Fatty Liver Disease

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