Sedentary Behavior as a Risk Factor for Liver Fibrosis Development in Patients with Metabolic Dysfunction-Associated...

Area of Science:

• Hepatology
• Metabolic Diseases
• Public Health

Background:

• Metabolic dysfunction-associated fatty liver disease (MASLD) impacts 20% of Italians, costing the NHS €7.94 billion annually.
• Advanced liver fibrosis is a key predictor of adverse outcomes in MASLD patients.
• Sedentary behavior (SB) is a modifiable risk factor, but evidence often relies on self-reported data.

Purpose of the Study:

• To investigate the association between objectively measured daily energy expenditure and liver stiffness in adults with MASLD.
• To determine if sedentary behavior correlates with increased liver stiffness in this population.

Main Methods:

• Cross-sectional analysis of 104 adults (18-65 years) with obesity and moderate-to-severe steatosis.
• Objective assessment of daily energy expenditure using 7-day wrist-worn actigraphy (METs/day).
• Non-invasive measurement of liver stiffness (LSM, kPa) via transient elastography (FibroScan®).

Main Results:

• Lower daily energy expenditure was independently associated with higher liver stiffness (p=0.002).
• Each 1-MET increase correlated with a -1.239 kPa reduction in liver stiffness.
• Sedentary individuals (≤1.5 METs) showed significantly higher liver stiffness (p=0.03) compared to non-sedentary individuals.

Conclusions:

• Objectively measured sedentary behavior is independently linked to increased liver stiffness in MASLD patients with obesity.
• Reducing sedentary time may be a practical strategy to mitigate liver fibrosis progression.
• Further longitudinal studies are needed to confirm causality and evaluate interventions in broader MASLD populations.