Nutrition/Obesity
Associations of Childhood BMI and Waist Circumference Trajectories with MASLD Risk in Early Adulthood: Evidence from the Ewha Birth and Growth Cohort Hyelim Lee* Hyelim Lee Lee Lee Lee Lee Department of Preventive Medicine, Ewha Womans University College of Medicine, Seoul, Korea.
Background: Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly NAFLD, is defined by hepatic steatosis with at least one cardiometabolic risk. While body mass index (BMI) and waist circumference (WC) are established risk factors for MASLD, evidence has largely relied on measurements at a single time point. Therefore, this study examined whether BMI and WC trajectories from ages 3 to 13–15 years were associated with MASLD at age 19.
Methods: This study included 215 participants from the Ewha Birth and Growth Cohort who had been followed up to age 19. After excluding 27 participants with an AST/ALT ratio >2 or missing MASLD-related biomarkers, 188 participants were included in the final analysis. MASLD at age 19 was defined as FLI >30 or HSI >36. BMI and WC were assessed longitudinally from ages 3 to 13–15 years using sex- and age-specific z-scores. Trajectories were identified using group-based trajectory modeling; three BMI and three WC trajectories were selected based on BIC and interpretability. Logistic regression was used to assess associations with MASLD, adjusting for sex, mother’s education, parental history of cardiometabolic disease, and physical activity, smoking, and alcohol drinking at age 19.
Results: Among 188 participants, 25% were classified as having MASLD at age 19. BMI and WC trajectories were each classified into three groups (BMI: low stable, moderate stable, high stable; WC: low U-shaped, moderate U-shaped, high increasing). Compared with the moderate BMI trajectory, the high stable BMI trajectory was associated with a higher risk of MASLD (adjusted OR 6.67, 95% CI 2.66–16.75). A similarly increased risk was observed for the high increasing WC trajectory compared with the moderate WC trajectory (adjusted OR 7.81, 95% CI 2.94–20.77). Of 46 participants classified as high in at least one trajectory-based group, 33 (72%) were classified as high in both. Notably, adolescents with concurrent high BMI and high WC trajectories had a higher risk of MASLD (adjusted OR 7.04, 95% CI 2.48–19.96).
Conclusions: Childhood BMI and WC trajectories were associated with MASLD risk at age 19, particularly among individuals with concurrent high trajectories. This suggests the relevance of monitoring both overall and central adiposity from early life to adolescence.
