Association of physical activity with MAFLD/MASLD and LF among adults in NHANES, 2017-2020

To investigate the correlations between physical activity (PA) and metabolic associated fatty liver disease (MAFLD) or metabolic dysfunction-associated steatotic liver disease (MASLD) within a substantial population-based survey, and to examine the association between PA and liver fibrosis (LF).

Data from the 2017-2020 NHANES cycle were utilized in this study. PA was divided into four types: leisure-time PA (LTPA), transportation-related PA (TPA), occupational PA (OPA) and total time PA (total PA, which is composed of OPA, TPA and LTPA). Weighted logistic regression models were performed to analyze the associations between PA and MAFLD/MASLD and LF. Mediation analysis was used to explore whether LTPA completely mediated the statistically significant relationship between total PA and MAFLD/MASLD or LF.

The study encompassed a sample size of 5897 participants aged 20 years and above, among the total participants, 2568 individuals with MAFLD and 2588 individuals with MASLD. There was no statistically significant correlation observed between OPA/TPA and MAFLD/MASLD and LF; however, active LTPA demonstrated an inverse association with MAFLD/MASLD (OR: 0.548; 95% CI: 0.458, 0.656/OR: 0.543; 95% CI: 0.453, 0.650), as well as a negative correlation with significant/advanced LF (OR: 0.457; 95% CI: 0.334,0.625/OR: 0.427; 95% CI: 0.295,0.619). There was also a significant inverse association between total PA and MAFLD/MASLD or LF, but this association was carried by the difference in LTPA.

Participation in active LTPA is associated with a reduced likelihood of MAFLD/MASLD and LF, while neither OPA nor TPA can replace these effects of LTPA.