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. 2025 Feb 1;59(2):168-176.
doi: 10.1097/MCG.0000000000001985.

Association Between Different Types of Physical Activity and Hepatic Steatosis and Liver Fibrosis: A Cross-Sectional Study Based on NHANES

Bo Sun  1 , Ying Kang  2 , Junming Zhou  1 , Ying Feng  1 , Wutao Wang  3 , Xiaowei Wu  1 , Xiaohua Zhang  1 , Minli Li  1
Affiliations

Association Between Different Types of Physical Activity and Hepatic Steatosis and Liver Fibrosis: A Cross-Sectional Study Based on NHANES

Bo Sun et al. J Clin Gastroenterol. .

Abstract

Background and aims: Many studies have shown a link between physical activity (PA) and nonalcoholic fatty liver disease (NAFLD). However, more research is needed to investigate the relationship between different types of PA and NAFLD. This study aimed to explore the potential link between different types of PA, hepatic steatosis, and liver fibrosis.

Study: A cross-sectional study was conducted using the data set from the National Health and Nutrition Examination Survey (NHANES) from 2017 to 2020. A multiple linear regression model was used to examine the linear relationship between different types of PA, the controlled attenuation parameter (CAP), and liver stiffness measurement (LSM). In addition, smoothing curve fitting and threshold effect analysis were used to depict their nonlinear relationship.

Results: This study involved 5933 adults. Multiple linear regression analysis revealed a significantly negative correlation between leisure-time PA and CAP, while the relationship between occupation-related PA, transportation-related PA, and CAP was not significant. Subgroup analysis further revealed that leisure-time PA was significantly negatively correlated with CAP in women and younger age groups (under 60 y old), while the relationship was not significant in men and older age groups. In addition, there was a significant negative correlation between leisure-time PA and liver fibrosis in men.

Conclusions: Leisure-time PA can prevent hepatic steatosis, and women and young people benefit more. Occupation-related PA is not associated with hepatic steatosis and cannot replace leisure-time PA. In men, increasing leisure-time PA is more effective in preventing liver fibrosis.

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Figures

FIGURE 1
FIGURE 1
Flowchart of participant selection. CAP indicates controlled attenuation parameter; NHANES, National Health and Nutrition Examination Survey; LSM, liver stiffness measurement.
FIGURE 2
FIGURE 2
The association between total PA and CAP. (A) Each black point represents a sample. (B) The solid red line represents the smooth curve fit between variables. Blue bands represent the 95% CI from the fit. CAP indicates controlled attenuation parameter; MET, metabolic equivalent of task; PA, physical activity.
FIGURE 3
FIGURE 3
The association between leisure-time PA and CAP. (A) Each black point represents a sample. (B) The solid red line represents the smooth curve fit between variables. Blue bands represent the 95% CI from the fit. (C) The association between leisure-time PA and CAP stratified by gender. (D) The association between leisure-time PA and CAP stratified by age group. CAP indicates controlled attenuation parameter; MET, metabolic equivalent of task; PA, physical activity.
FIGURE 4
FIGURE 4
The association between occupation-related PA and CAP. (A) Each black point represents a sample. (B) The solid red line represents the smooth curve fit between variables. Blue bands represent the 95% CI from the fit. CAP indicates controlled attenuation parameter; MET, metabolic equivalent of task; PA, physical activity.
FIGURE 5
FIGURE 5
The association between leisure-time PA and LSM. (A) Each black point represents a sample. (B) The solid red line represents the smooth curve fit between variables. Blue bands represent the 95% CI from the fit. (C) The association between leisure-time PA and LSM stratified by gender. (D) The association between leisure-time PA and LSM stratified by age group. LSM indicates liver stiffness measurement; MET, metabolic equivalent of task; PA, physical activity.
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