Isotemporal substitution of different behaviour patterns with the presence of MAFLD in Chinese adults

作者全名："Wang, Jialu; Qi, Yan; Xin, Zhuojun; Huo, Yanan; Wan, Qin; Qin, Yingfen; Hu, Ruying; Shi, Lixin; Su, Qing; Yu, Xuefeng; Yan, Li; Qin, Guijun; Tang, Xulei; Chen, Gang; Xu, Min; Xu, Yu; Wang, Tiange; Zhao, Zhiyun; Gao, Zhengnan; Wang, Guixia; Shen, Feixia; Luo, Zuojie; Chen, Li; Li, Qiang; Ye, Zhen; Zhang, Yinfei; Liu, Chao; Wang, Youmin; Yang, Tao; Deng, Huacong; Chen, Lulu; Zeng, Tianshu; Zhao, Jiajun; Mu, Yiming; Wu, Shengli; Chen, Yuhong; Lu, Jieli; Wang, Weiqing; Ning, Guang; Bi, Yufang; Li, Mian"

作者地址："[Wang, Jialu; Qi, Yan; Xin, Zhuojun; Xu, Min; Xu, Yu; Wang, Tiange; Zhao, Zhiyun; Chen, Yuhong; Lu, Jieli; Wang, Weiqing; Ning, Guang; Bi, Yufang; Li, Mian] Shanghai Jiao Tong Univ, Ruijin Hosp, Shanghai Inst Endocrine & Metab Dis, Sch Med,Dept Endocrine & Metab Dis, Shanghai, Peoples R China; [Wang, Jialu; Qi, Yan; Xin, Zhuojun; Xu, Min; Xu, Yu; Wang, Tiange; Zhao, Zhiyun; Chen, Yuhong; Lu, Jieli; Wang, Weiqing; Ning, Guang; Bi, Yufang; Li, Mian] Shanghai Jiao Tong Univ, Ruijin Hosp,State Key Lab Med Genom, Sch Med,Key Lab Endocrine & Metab Dis,Shanghai Ke, Shanghai Natl Clin Res Ctr Metab Dis,Natl Hlth Co, Shanghai, Peoples R China; [Huo, Yanan] Nanchang Univ, Jiangxi Prov Peoples Hosp, Nanchang, Jiangxi, Peoples R China; [Wan, Qin] Southwest Med Univ, Affiliated Hosp, Dept Endocrinol, Luzhou, Peoples R China; [Qin, Yingfen; Luo, Zuojie] Guangxi Med Univ, Affiliated Hosp 1, Dept Endocrinol, Nanning, Peoples R China; [Hu, Ruying; Ye, Zhen] Zhejiang Prov Ctr Dis Control & Prevent, Hangzhou, Peoples R China; [Shi, Lixin] Guiyang Med Univ, Affiliated Hosp, Dept Endocrinol, Guiyang, Peoples R China; [Su, Qing] Shanghai Jiao Tong Univ, Xinhua Hosp, Sch Med, Shanghai, Peoples R China; [Yu, Xuefeng] Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Wuhan, Peoples R China; [Yan, Li] Sun Yat Sen Univ, Sun Yat Sen Mem Hosp, Guangzhou, Peoples R China; [Qin, Guijun] Zhengzhou Univ, Affiliated Hosp 1, Dept Endocrinol, Zhengzhou, Peoples R China; [Tang, Xulei] Lanzhou Univ, Hosp 1, Dept Endocrinol, Lanzhou, Peoples R China; [Chen, Gang] Fujian Med Univ, Fujian Prov Hosp, Fuzhou, Peoples R China; [Gao, Zhengnan] Affiliated Dalian Med Univ, Dalian Municipal Cent Hosp, Dalian, Peoples R China; [Wang, Guixia] First Hosp Jilin Univ, Dept Endocrinol, Changchun, Peoples R China; [Shen, Feixia] Wenzhou Med Univ, Affiliated Hosp 1, Dept Endocrinol, Wenzhou, Peoples R China; [Chen, Li] Shandong Univ, Qilu Hosp, Jinan, Peoples R China; [Li, Qiang] Harbin Med Univ, Affiliated Hosp 2, Dept Endocrinol, Harbin, Peoples R China; [Zhang, Yinfei] Cent Hosp Shanghai Jiading Dist, Dept Endocrinol, Shanghai, Peoples R China; [Liu, Chao] Jiangsu Prov Hosp Integrat Chinese & Western Med, Dept Endocrinol, Nanjing, Peoples R China; [Wang, Youmin] Anhui Med Univ, Affiliated Hosp 1, Dept Endocrinol, Hefei, Peoples R China; [Yang, Tao] Nanjing Med Univ, Affiliated Hosp 1, Dept Endocrinol, Nanjing, Peoples R China; [Deng, Huacong] Chongqing Med Univ, Affiliated Hosp 1, Dept Endocrinol, Chongqing, Peoples R China; [Chen, Lulu; Zeng, Tianshu] Huazhong Univ Sci & Technol, Union Hosp, Tongji Med Coll, Wuhan, Peoples R China; [Zhao, Jiajun] Shandong Univ, Shandong Prov Hosp, Jinan, Peoples R China; [Mu, Yiming] Chinese Peoples Liberat Army Gen Hosp, Dept Endocrinol, Beijing, Peoples R China; [Wu, Shengli] Karamay Municipal Peoples Hosp, Dept Endocrinol, Karamay, Xinjiang, Peoples R China"

通信作者："Bi, YF; Li, MA (通讯作者)，Shanghai Jiao Tong Univ, Sch Med,Shanghai Natl Clin Res Ctr Metab Dis,Key, Ruijin Hosp,Dept Endocrine & Metab Dis,Natl Hlth, Shanghai Inst Endocrine & Metab Dis,Shanghai Natl, 197 Rui Jin 2nd Rd, Shanghai 200025, Peoples R China."

来源：LIVER INTERNATIONAL

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000865712900001

JCR分区：Q1

影响因子：6.7

年份：2022

卷号：42

期号：12

开始页：2683

结束页：2695

文献类型：Article

关键词：behaviour pattern; isotemporal substitution; metabolic dysfunction-associated fatty liver disease; moderate-to-vigorous physical activity; sedentary behaviour

摘要："Background Lack of physical activity and excessive sitting time contributed to ectopic fat accumulation, especially in the liver. Previous studies have illustrated the harm of sedentary behaviour and the benefits of physical activity on fatty liver disease. We aimed to explore the association between the behaviour patterns and the risk of metabolic dysfunction-associated fatty liver disease (MAFLD) using isotemporal substitution model to examine the effect of replacing one behaviour to another while keeping the total time and other behaviours fixed among Chinese middle-aged and elderly population. Methods This study included 161 147 participants aged >= 40 years old from the nationwide, population-based cohort of the REACTION study. The International Physical Activity Questionnaire was used to measure self-reported time for sleeping, sitting, walking and moderate-to-vigorous physical activity (MVPA). MAFLD was defined by evidence of fatty liver index (FLI) >= 60 in addition to one of the following three patterns, namely overweight/obesity, presence of diabetes, or evidence of metabolic dysregulation. Isotemporal substitution models using logistic regression models to evaluate the association of replacement of different behaviour patterns with each other and the risk of MAFLD. Results Substitution of 60 minutes per day of sleeping, walking or total MVPA for sitting was associated with a 2%-8% reduction of MAFLD risk in overall participants. In employed individuals, replacing sitting time with occupational MVPA or nonoccupational MVPA both could bring benefits to liver steatosis. Stratified analysis found that replacing 60 minutes of sitting time with an equivalent time of other behaviour pattern could reduce approximately 8% of the risk among MAFLD participants with metabolic abnormalities. Such a relationship might be explained by the important mediated role of metabolic elements, such as waist circumference, body mass index, triglycerides and homoeostasis model assessment of insulin resistance. Furthermore, replacing sitting with MVPA showed a stronger association among participants who got enough sleep (sleep duration >= 7 hours per day). Conclusion Replacing sitting with other behaviour patterns could reduce the prevalence of MAFLD, and such substitution effect was much remarkably in individuals with abnormal metabolic status. Observably, obese individuals were more likely to benefit from appropriate changes in behaviour patterns. Moreover, the analysis of sleep duration stratification appealed that the adequacy of individual sleep duration also had a significant impact on the substitution effect. It is worth noting that adjusting the time allocation of behaviour patterns might have a beneficial impact on liver-metabolic health, and these findings might help us better recognize the importance of reasonable arrangement of behaviour patterns according to the individual's situation."

基金机构："National Natural Science Foundation of China [81870560, 91857205, 81970706, 81930021, 81970728, 81941017, 82022011, 82070880, 82088102]; Shanghai Municipal Government [20Y11905100]; Shanghai Shen Kang Hospital Development Center [SHDC12019101, SHDC2020CR1001A, SHDC2020CR3064B]; Shanghai Rising-Star Program [21QA1408100]"

基金资助正文："y This work was supported by the grants from the National Natural Science Foundation of China (grant numbers 81870560, 91857205, 81970706, 81930021, 81970728, 81941017, 82022011, 82070880, 82088102), Shanghai Municipal Government (grant number 20Y11905100), Shanghai Rising--Star Program (grant number 21QA1408100), and the Shanghai Shen Kang Hospital Development Center (grant numbers SHDC12019101, SHDC2020CR1001A, SHDC2020CR3064B)."