Sedentary Behavior and CVD in Metabolic Dysfunction-Associated Fatty Liver Disease

An association exists between leisure-time sedentary behavior and increased risk for cardiovascular disease (CVD) in metabolic dysfunction-associated fatty liver disease (MAFLD), although physical activity may alleviate the adverse effects, according to study findings published in Arteriosclerosis, Thrombosis, and Vascular Biology.

Investigators evaluated the association between leisure-time sedentary behavior and physical activity and CVD risk, accounting for genetic predisposition to CVD, among patients with MAFLD. Additionally, the investigators assessed CVD risk by the efficacy in replacing sedentary behavior with physical activity.

The investigators conducted a cohort study using data from the United Kingdom (UK) Biobank to identify 157,794 individuals with MAFLD and free of CVD at baseline. Briefly, the UK Biobank is an ongoing population-based cohort study with more than 500,000 participants aged 39 to 72 years that were recruited across England, Scotland, and Wales between 2006 to 2010. Those with implausible information on leisure-time sedentary behavior (n=5493) were excluded.

Leisure-time physical activities (strenuous sports, light and heavy do-it-yourself activities, pleasure walking, and other exercises) and sedentary behaviors (driving, using a computer, watching TV) were measured by frequency and duration across the 4 weeks prior to assessment.

Across follow-up (median, 12.5 years), the investigators noted 26,355 CVD cases including 7398 cases of heart failure, 4836 cases of stroke, and 19,746 cases of coronary heart disease. Individuals with incident CVD vs those without tended to be predominantly older men with higher body mass index, lower total physical activity, and higher sedentary behavior, and they were more likely to be current smokers.

High physical activity levels were associated with significantly lower risk for heart failure (31%), stroke (15%), coronary heart disease (20%), and CVD (21%). Compared with individuals with no more than 3.5 hours per day of sedentary behavior, those with more than 6.5 hours per day of sedentary behavior experienced a 16% to 21% greater risk for the study outcomes.

The investigators found CVD risk was reduced by 4% to 13% when 30 minutes of daily inactivity were replaced with physical activity, especially strenuous sports. In relation to stroke risk, a significant interaction was noted between genetic predisposition to CVD, sedentary behavior, and physical activity.

Study limitations include the observational design and the lack of serum insulin data in the UK Biobank may have led to underestimation of MAFLD. Additionally, recall bias may exist in self-reporting of sedentary behavior and physical activity.

“Among patients with metabolic dysfunction-associated fatty liver disease, higher leisure-time physical activity levels correlate with reduced CVD risks, while increased sedentary behavior is linked to higher CVD risks,” the investigators concluded. “Replacing sedentary time with physical activity consistently shows benefits in reducing CVD outcomes, irrespective of genetic predisposition.”

This article originally appeared on The Cardiology Advisor