BMI subclassification and future risk of metabolic dysfunction-associated steatotic liver disease and liver-related events
Zhang, Shunming LU ; Coral, Daniel E LU
; Huo, Zhenyu
; Borné, Yan
LU
; Zheng, Ming-Hua
; Huang, Tao
and Qi, Lu
(2026)
In The Journal of nutrition
- Abstract
BACKGROUND: Recent research using a data-driven cluster approach has identified five discordant subclassifying body mass index (BMI) subgroups, characterized by cardiometabolic biomarkers deviated from those predicted by BMI.
OBJECTIVE: This study aimed to investigate the associations of these subgroups with risks of metabolic dysfunction-associated steatotic liver disease (MASLD) and liver-related events (LREs).
METHODS: This prospective cohort study included 423,091 participants. The same cluster analysis as reported by Coral and colleagues was performed to classify subpopulations. Incident MASLD and LREs were determined by electronic health records. Cox proportional hazards models were used to evaluate the hazard ratio... (More)
BACKGROUND: Recent research using a data-driven cluster approach has identified five discordant subclassifying body mass index (BMI) subgroups, characterized by cardiometabolic biomarkers deviated from those predicted by BMI.
OBJECTIVE: This study aimed to investigate the associations of these subgroups with risks of metabolic dysfunction-associated steatotic liver disease (MASLD) and liver-related events (LREs).
METHODS: This prospective cohort study included 423,091 participants. The same cluster analysis as reported by Coral and colleagues was performed to classify subpopulations. Incident MASLD and LREs were determined by electronic health records. Cox proportional hazards models were used to evaluate the hazard ratio (HR) and 95% confidence interval (CI).
RESULTS: Profiles derived from the study were similar to those identified in the work by Coral and colleagues. Individuals with discordantly high liver transaminase (HR [95% CI]: 1.72 [1.51, 1.96] for MASLD and 1.42 [1.23, 1.65] for LREs in males and 1.92 [1.61, 2.28] for MASLD and 1.68 [1.32, 2.14] for LREs in females) and hyperglycemia (HR [95% CI]: 1.36 [1.06, 1.74] for MASLD and 1.31 [1.01, 1.70] for LREs in males and 1.62 [1.27, 2.08] for MASLD and 1.80 [1.31, 2.47] for LREs in females) had higher risks of liver outcomes compared with the concordant profile. In contrast, we observed a lower risk of MASLD (0.71; 0.60, 0.84) in females with discordantly high blood pressure relative to their BMI. For discordant adverse lipid profile and discordant inflammatory profile, no significant associations were observed. In addition, the BMI subclassification profiles had better predictive ability among males.
CONCLUSIONS: Metabolically distinct BMI subgroups exhibit heterogeneous risks of MASLD and LREs.
(Less)
- author
- Zhang, Shunming
LU
; Coral, Daniel E
LU
; Huo, Zhenyu
; Borné, Yan
LU
; Zheng, Ming-Hua
; Huang, Tao
and Qi, Lu
- organization
- publishing date
- 2026-01-29
- type
- Contribution to journal
- publication status
- epub
- subject
- in
- The Journal of nutrition
- article number
- 101386
- publisher
- Oxford University Press
- external identifiers
-
- pmid:41620177
- ISSN
- 1541-6100
- DOI
- 10.1016/j.tjnut.2026.101386
- language
- English
- LU publication?
- yes
- additional info
- Copyright © 2026 The Author(s). Published by Elsevier Inc. All rights reserved.
- id
- eb3debeb-7762-4e3e-9741-1291fcf4fc6d
- date added to LUP
- 2026-02-03 12:01:10
- date last changed
- 2026-02-03 13:37:10
@article{eb3debeb-7762-4e3e-9741-1291fcf4fc6d,
abstract = {{<p>BACKGROUND: Recent research using a data-driven cluster approach has identified five discordant subclassifying body mass index (BMI) subgroups, characterized by cardiometabolic biomarkers deviated from those predicted by BMI.</p><p>OBJECTIVE: This study aimed to investigate the associations of these subgroups with risks of metabolic dysfunction-associated steatotic liver disease (MASLD) and liver-related events (LREs).</p><p>METHODS: This prospective cohort study included 423,091 participants. The same cluster analysis as reported by Coral and colleagues was performed to classify subpopulations. Incident MASLD and LREs were determined by electronic health records. Cox proportional hazards models were used to evaluate the hazard ratio (HR) and 95% confidence interval (CI).</p><p>RESULTS: Profiles derived from the study were similar to those identified in the work by Coral and colleagues. Individuals with discordantly high liver transaminase (HR [95% CI]: 1.72 [1.51, 1.96] for MASLD and 1.42 [1.23, 1.65] for LREs in males and 1.92 [1.61, 2.28] for MASLD and 1.68 [1.32, 2.14] for LREs in females) and hyperglycemia (HR [95% CI]: 1.36 [1.06, 1.74] for MASLD and 1.31 [1.01, 1.70] for LREs in males and 1.62 [1.27, 2.08] for MASLD and 1.80 [1.31, 2.47] for LREs in females) had higher risks of liver outcomes compared with the concordant profile. In contrast, we observed a lower risk of MASLD (0.71; 0.60, 0.84) in females with discordantly high blood pressure relative to their BMI. For discordant adverse lipid profile and discordant inflammatory profile, no significant associations were observed. In addition, the BMI subclassification profiles had better predictive ability among males.</p><p>CONCLUSIONS: Metabolically distinct BMI subgroups exhibit heterogeneous risks of MASLD and LREs.</p>}},
author = {{Zhang, Shunming and Coral, Daniel E and Huo, Zhenyu and Borné, Yan and Zheng, Ming-Hua and Huang, Tao and Qi, Lu}},
issn = {{1541-6100}},
language = {{eng}},
month = {{01}},
publisher = {{Oxford University Press}},
series = {{The Journal of nutrition}},
title = {{BMI subclassification and future risk of metabolic dysfunction-associated steatotic liver disease and liver-related events}},
url = {{http://dx.doi.org/10.1016/j.tjnut.2026.101386}},
doi = {{10.1016/j.tjnut.2026.101386}},
year = {{2026}},
}