Physical Activity by Accelerometer Inversely Associated With Liver Fibrosis; Cross‐Sectional Analysis of a Longitudinal Cohort

Background and Aims Metabolic dysfunction‐associated steatotic liver disease (MASLD) can progress from hepatic steatosis to liver fibrosis and cirrhosis. Advanced fibrosis is associated with increased mortality. Physical activity (PA) is important in treatment and prevention, but its association with hepatic fibrosis is not well characterised. Methods We examined the cross‐sectional association between accelerometer‐measured PA and fibrosis measured by vibration‐controlled transient elastography. Primary covariates included age, sex, cohort, smoking status, alcohol use and accelerometer wear time. Secondary covariates included body mass index (BMI) and hepatic steatosis. The primary dependent variable was continuous liver stiffness measurement (LSM), and the secondary dependent variable was dichotomous liver fibrosis (LSM > 8.2 kPa). We performed sex‐specific, age‐adjusted Pearson correlation coefficients, as well as multivariable‐adjusted linear and logistic regression models. Results In our study sample ( n = 2201, 54.1% women, average age 54 years old, average BMI 27.1 kg/m 2 ) the prevalence of fibrosis was 7.7%. Each additional 30 min spent in moderate‐vigorous PA (MVPA)/day was associated with a lower odds of fibrosis (odds ratio 0.57; 95% confidence interval 0.41, 0.79) even after adjusting for BMI (0.72; 0.53, 0.99) or steatosis (0.70; 0.51, 0.96). Those who achieved at least 150 min/week of MVPA had the lowest odds of hepatic fibrosis (0.51; 0.35, 0.75) even when adjusted for BMI (0.64; 0.44, 0.95) or steatosis (0.61; 0.42, 0.90). Conclusions In our community‐based cross‐sectional cohort study, there was an inverse association between time spent in MVPA and liver fibrosis, even when adjusting for BMI or steatosis. Additional interventional studies are needed to determine if MVPA can reverse liver fibrosis.