Body weight variability and the risk of incident metabolic dysfunction–associated steatotic liver disease (MASLD): a retrospective cohort study from the Kangbuk Samsung Health Study
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: Metabolic dysfunction–associated steatotic liver disease (MASLD) is closely associated with obesity, and weight loss remains a cornerstone of its management. However, whether body weight variability—repeated cycles of weight loss and regain—independently predicts MASLD development remains unclear. We examined whether body weight variability across serial health examinations was associated with incident MASLD in healthy adults.Methods: This study included 1,664 participants from the Kangbuk Samsung Health Study (2007–2019) who underwent at least five serial health examinations and were free of MASLD at the first visit. Body weight variability was quantified as the average successive variability (ASV) of weight across the five visits and categorized into quartiles (Q1–Q4). Incident MASLD was defined as hepatic steatosis on ultrasonography plus at least one cardiometabolic risk factor.Results: During a median follow-up of 8.9 years (13,897 person-years), 525 participants (31.5%) developed MASLD, corresponding to an incidence rate of 37.8 per 1,000 person-years. MASLD incidence increased across ASV quartiles, from 21.0% in Q1 to 45.5% in Q4. After adjustment for age, sex, baseline body mass index, systolic blood pressure, and fasting glucose, participants in the highest ASV quartile had a higher risk of MASLD than those in the lowest quartile (adjusted hazard ratio [aHR], 1.64; 95% confidence interval [CI], 1.25–2.14). This association persisted after further adjustment for net weight change (aHR, 1.40; 95% CI, 1.06–1.84; P for trend=0.022) and was attenuated but remained directionally consistent after additional adjustment for lifestyle and laboratory factors (aHR, 1.33; 95% CI, 1.00–1.77).Conclusions: In this exploratory analysis, higher body weight variability was associated with incident MASLD, independent of baseline adiposity and net weight change. These findings suggest that weight stability, rather than repeated weight cycling, may be relevant to MASLD prevention and warrant confirmation in prospective studies.
Authors: Eun-Jung Rhee, Won-Young Lee
Institutions: Kangbuk Samsung Hospital, Sungkyunkwan University
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7171404596