Association between longitudinal weight change and clinical outcome in individuals with MASLD
Association between longitudinal weight change and clinical outcome in individuals with MASLD
Background: weight control remains the cornerstone for metabolic dysfunction-associated steatotic liver disease (MASLD) management. We assessed the relationships between dynamic weight change and the risk of liver-related events (LREs) and liver stiffness changes in MASLD.
Methods: by enrolling adult MASLD individuals with ≥2 weight measurements from 16 tertiary referral centers, we assessed how longitude weight change, including the following categories (stable ≤5% change, weight loss >5% decrease, weight gain >5% increase) and changing status of obesity (persistent non-obesity, persistent obesity, transition from non-obesity to obesity, transition from obesity to non-obesity), were associated with LREs. Analyses were undertaken with multivariable linear regressions, Cox proportional hazards regression and logistic regression adjusting for age, sex, ethnicity, baseline BMI, hypertension, T2D, LSM, CAP, and SGLT-2i/GLP-1RAs usage. Analyses between weight change and liver stiffness change were also undertaken.
Results: 10,014 MASLD individuals with ≥2 weight measurements were included. Over a measurement interval of 29.2 months, 123 LREs occurred during 12.4 months follow-up after the final weight assessment. Weight gain >5% was associated with increased risk of LREs (aHR=1.84(95%CI:1.01-3.09), P=0.020) and liver stiffness progression (aOR=2.07(95%CI:1.55–2.74), P<0.001), while weight loss >5% exhibited liver stiffness improvement. Although those who progressed to or persisted with obesity, had higher LREs risk, obesity reversal had a comparable LREs risk (aHR=1.44(95%CI:0.57–3.61), P=0.435) to the persistent non-obese.
Conclusions: in MASLD, weight gain is associated with increased LREs risks and liver stiffness progression. Conversely, weight loss confers benefits for liver stiffness improvement and modifies LREs risk in those who achieve obesity reversal.
Shi, Yu
66782e90-b78c-4566-990b-72fcf9251e6f
Zhou, Ruoqi
31a01ca7-af2c-4c10-8be0-068dd31fc4c5
Kim, Seung Up
09872485-4af2-4ca5-8040-fcbe30c98f8c
Byrne, Christopher D.
1370b997-cead-4229-83a7-53301ed2a43c
VCTE-Prognosis Study Group
Shi, Yu
66782e90-b78c-4566-990b-72fcf9251e6f
Zhou, Ruoqi
31a01ca7-af2c-4c10-8be0-068dd31fc4c5
Kim, Seung Up
09872485-4af2-4ca5-8040-fcbe30c98f8c
Byrne, Christopher D.
1370b997-cead-4229-83a7-53301ed2a43c
Shi, Yu, Zhou, Ruoqi and Kim, Seung Up
,
et al. and VCTE-Prognosis Study Group
(2025)
Association between longitudinal weight change and clinical outcome in individuals with MASLD.
Hepatology.
(doi:10.1097/HEP.0000000000001557).
Abstract
Background: weight control remains the cornerstone for metabolic dysfunction-associated steatotic liver disease (MASLD) management. We assessed the relationships between dynamic weight change and the risk of liver-related events (LREs) and liver stiffness changes in MASLD.
Methods: by enrolling adult MASLD individuals with ≥2 weight measurements from 16 tertiary referral centers, we assessed how longitude weight change, including the following categories (stable ≤5% change, weight loss >5% decrease, weight gain >5% increase) and changing status of obesity (persistent non-obesity, persistent obesity, transition from non-obesity to obesity, transition from obesity to non-obesity), were associated with LREs. Analyses were undertaken with multivariable linear regressions, Cox proportional hazards regression and logistic regression adjusting for age, sex, ethnicity, baseline BMI, hypertension, T2D, LSM, CAP, and SGLT-2i/GLP-1RAs usage. Analyses between weight change and liver stiffness change were also undertaken.
Results: 10,014 MASLD individuals with ≥2 weight measurements were included. Over a measurement interval of 29.2 months, 123 LREs occurred during 12.4 months follow-up after the final weight assessment. Weight gain >5% was associated with increased risk of LREs (aHR=1.84(95%CI:1.01-3.09), P=0.020) and liver stiffness progression (aOR=2.07(95%CI:1.55–2.74), P<0.001), while weight loss >5% exhibited liver stiffness improvement. Although those who progressed to or persisted with obesity, had higher LREs risk, obesity reversal had a comparable LREs risk (aHR=1.44(95%CI:0.57–3.61), P=0.435) to the persistent non-obese.
Conclusions: in MASLD, weight gain is associated with increased LREs risks and liver stiffness progression. Conversely, weight loss confers benefits for liver stiffness improvement and modifies LREs risk in those who achieve obesity reversal.
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Accepted/In Press date: 9 September 2025
e-pub ahead of print date: 8 October 2025
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Local EPrints ID: 505963
URI: http://eprints.soton.ac.uk/id/eprint/505963
ISSN: 0270-9139
PURE UUID: ff44cffc-ad42-4953-895a-1df2ab4963fa
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Date deposited: 24 Oct 2025 16:39
Last modified: 25 Oct 2025 01:38
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Author:
Yu Shi
Author:
Ruoqi Zhou
Author:
Seung Up Kim
Corporate Author: et al.
Corporate Author: VCTE-Prognosis Study Group
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