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Background <p>Evidence from cohort studies on the relationship between metabolic dysfunction-associated fatty liver disease (MAFLD) and longitudinal changes in total bile acid (TBA) remains limited. This study aimed to investigate the association of TBA trajectories with new-onset MAFLD and liver fibrosis.</p> Methods <p>A total of 3259 participants who underwent at least three health examinations at a hospital in Zhejiang between 2019 and 2023 were included. MAFLD was diagnosed via abdominal ultrasound, and liver fibrosis was assessed using the NAFLD fibrosis score (NFS) and fibrosis-4 score (FIB-4). Logistic regression models were used to analyse the associations between TBA trajectories and the risk of MAFLD and liver fibrosis.</p> Results <p>During follow-up, 715 participants developed MAFLD. Among them, 15.10% had high NFS status, and 12.17% had high FIB-4 status. Compared with the low-stable TBA trajectory group, the high-stable trajectory group had a significantly higher risk of new-onset MAFLD (adjusted OR = 1.448, 95% CI 1.157–1.812). Subgroup analyses confirmed the robustness of these findings. Multinomial logistic regression revealed that the high-stable trajectory was associated with an increased risk of high NFS (adjusted OR = 2.435, 95% CI 1.568–3.781, <i>P</i> &lt; 0.001) and high FIB-4 (adjusted OR = 3.194, 95% CI 2.006–5.087, <i>P</i> &lt; 0.001).</p> Conclusions <p>TBA trajectories are significantly associated with the risk of new-onset MAFLD and advanced liver fibrosis, as indicated by high NFS and FIB-4 scores. These findings highlight the potential role of TBA dynamics in MAFLD progression and fibrosis risk.</p>

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Longitudinal serum total bile acid trajectories and risk of metabolic dysfunction-associated fatty liver disease: a retrospective cohort study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年7月30日

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  • Huihui Chen,
  • Xinyan Yu,
  • Xueni Wang,
  • Jiaojiao Huang,
  • Jingni Wu,
  • Xinmei Zhou,
  • Kejia Hu,
  • Zhenya Song

摘要

Background

Evidence from cohort studies on the relationship between metabolic dysfunction-associated fatty liver disease (MAFLD) and longitudinal changes in total bile acid (TBA) remains limited. This study aimed to investigate the association of TBA trajectories with new-onset MAFLD and liver fibrosis.

Methods

A total of 3259 participants who underwent at least three health examinations at a hospital in Zhejiang between 2019 and 2023 were included. MAFLD was diagnosed via abdominal ultrasound, and liver fibrosis was assessed using the NAFLD fibrosis score (NFS) and fibrosis-4 score (FIB-4). Logistic regression models were used to analyse the associations between TBA trajectories and the risk of MAFLD and liver fibrosis.

Results

During follow-up, 715 participants developed MAFLD. Among them, 15.10% had high NFS status, and 12.17% had high FIB-4 status. Compared with the low-stable TBA trajectory group, the high-stable trajectory group had a significantly higher risk of new-onset MAFLD (adjusted OR = 1.448, 95% CI 1.157–1.812). Subgroup analyses confirmed the robustness of these findings. Multinomial logistic regression revealed that the high-stable trajectory was associated with an increased risk of high NFS (adjusted OR = 2.435, 95% CI 1.568–3.781, P < 0.001) and high FIB-4 (adjusted OR = 3.194, 95% CI 2.006–5.087, P < 0.001).

Conclusions

TBA trajectories are significantly associated with the risk of new-onset MAFLD and advanced liver fibrosis, as indicated by high NFS and FIB-4 scores. These findings highlight the potential role of TBA dynamics in MAFLD progression and fibrosis risk.