The Role of Global Physical Capacity Score in Key Parameters of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD)

Abstract

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is linked to metabolic syndrome, type 2 diabetes, and obesity. This study investigates the relationship between physical capacity, assessed by the Global Physical Capacity Score (GPCS), and MASLD-related parameters, including hepatic steatosis (CAP score), insulin resistance (HOMA-IR), and body mass index (BMI). Methods: A cross-sectional analysis was performed on 204 individuals with MASLD (mean age: 50 years; 57.6% males). Participants underwent physical tests to determine their GPCS. Hepatic steatosis was assessed using FibroScan® (Echosens, Paris, France), and metabolic markers were collected from fasting blood samples. Statistical analyses included linear and logistic regression models adjusted for potential confounders. Results: A higher GPCS was inversely associated with CAP (β = -5.30; p < 0.05), HOMA-IR (β = -0.28; p < 0.001), and BMI (β = -0.96; p < 0.001). Logistic regression analysis confirmed a lower risk of severe hepatic steatosis (OR = 0.44; p < 0.05), obesity (OR = 0.39; p < 0.05), and insulin resistance (OR = 0.32; p < 0.001) in individuals with higher GPCS values. Conclusions: The GPCS may indicate MASLD severity and reflect metabolic and hepatic health. Our findings support the promotion of physical activity and suggest a potential role for GPCS in risk stratification and personalized interventions for patients with MASLD.

Keywords: Global Physical Capacity Score; HOMA-IR; body mass index; hepatic steatosis; metabolic-associated steatotic liver disease; physical activity.

Figure 1

Flow chart of studies and participants. OB_AF: Obesity_ AF Study; M: Males; F: Females; GPCS: Global Physical Capacity Score.

Figure 2

Plot (a): Predictive margins with 95% CI for BMI from a linear regression of BMI on GPCS. Plot (b): Predictive margins with 95% CI for CAP from a linear regression of CAP on GPCS. Plot (c): Predictive margins with 95% CI of the prediction for HOMA-IR from a linear regression of HOMA-IR on GPCS. Model regression adjusted for gender (F 0, M1), age, marital status, HbA1, and cortisol. The dashed line indicates the median value of GPCS.