This web page was created programmatically, to learn the article in its authentic location you’ll be able to go to the hyperlink bellow:
https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2026.1845959/full
and if you wish to take away this text from our web site please contact us
ORIGINAL RESEARCH article
Front. Nutr.
Sec. Nutritional Epidemiology
Abstract
Objective
Older adults with coexisting hypertension and sort 2 diabetes are at excessive danger for metabolic dysfunction-associated steatotic liver illness (MASLD). Normal-weight visceral weight problems (NWVO)—extra visceral fats regardless of regular physique mass index and waist circumference—is an neglected danger issue. Lifestyle is modifiable, however its function in explaining the NWVO-MASLD affiliation is unknown. We quantified the proportion of this affiliation statistically mediated by unhealthy way of life patterns.
Methods
This retrospective cohort examine included 26,289 adults aged ≥50 years with hypertension and sort 2 diabetes from the Shenzhen National Basic Public Health Services Program (2010–2023). NWVO was outlined utilizing the Chinese Visceral Adiposity Index alongside regular physique dimension standards. MASLD was identified by ultrasound and cardiometabolic standards. A composite way of life rating (bodily exercise, alcohol, smoking, dietary salt consumption) was derived. We utilized the generalized front-door method for causal mediation evaluation to estimate the path-specific impact of NWVO on MASLD incidence defined by way of life, sturdy to unmeasured confounding.
Results
Over a imply 5.5-year follow-up, NWVO was related to a considerably elevated MASLD danger (adjusted HR: 1.82, 95% CI: 1.76, 1.89). NWVO was related to a 2.35-fold greater danger of getting an unhealthy way of life (2.25, 2.44), which in flip elevated MASLD danger by 11.2% (8.7, 13.8). Unhealthy way of life statistically defined 19.8% (12.1, 33.6) of the entire NWVO-MASLD impact, similar to a mediated danger enhance of 41.2% (3.5, 92.7).
Conclusion
In this multimorbid older inhabitants, NWVO is a major MASLD danger issue, and modifiable way of life patterns account for roughly one-fifth of this affiliation. Our findings help integrating visceral adiposity evaluation into routine care and implementing multifaceted way of life interventions—concentrating on weight loss program, bodily exercise, and substance use—to scale back the burden of MASLD in growing older populations with metabolic comorbidities.
Summary
Keywords
Causal inference models, Cohort Studies, Healthy lifestyle, mediating effects, Metabolic dysfunction-associated steatotic liver disease, multimorbidity, older adults
Copyright
© 2026 Xi, Wang, Li, Ming, Yan, Li, Sun, Hu, Hu, Yan, Bai, Xiang, Gu, Lin, Liu and Hao. This is an open-access article distributed below the phrases of the Creative Commons Attribution License (CC BY). The use, distribution or copy in different boards is permitted, offered the unique creator(s) or licensor are credited and that the unique publication on this journal is cited, in accordance with accepted educational apply. No use, distribution or copy is permitted which doesn’t adjust to these phrases.
*Correspondence: Yuan-Tao Hao
Disclaimer
All claims expressed on this article are solely these of the authors and don’t essentially signify these of their affiliated organizations, or these of the writer, the editors and the reviewers. Any product that could be evaluated on this article or declare that could be made by its producer will not be assured or endorsed by the writer.
This web page was created programmatically, to learn the article in its authentic location you’ll be able to go to the hyperlink bellow:
https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2026.1845959/full
and if you wish to take away this text from our web site please contact us
