Association between muscular strength, abdominal obesity, and incident nonalcoholic fatty liver disease in a Korean population.

This study aimed to examine the association between relative handgrip strength (rHGS) and nonalcoholic fatty liver disease (NAFLD) incidence, considering abdominal obesity (ABO) status. This nationwide Korean cohort included 24,297 participants without NAFLD at baseline. Participants were categorized into sex-specific tertiles of rHGS (low, mid, and high). Multivariate Cox proportional hazards regression models were used to evaluate NAFLD incidence in relation to rHGS levels and/or ABO status. Over 100,381 person-years of follow-up, 1,735 participants (10.81% men and 6.01% women) developed NAFLD. High rHGS was associated with a 29% and 60% risk reduction for incident NAFLD in men and women, respectively, compared with low rHGS, despite men having significantly higher rHGS than women. Conversely, ABO increased NAFLD risk by 2.3 and 3.8 times in men and women, respectively. Even among women with ABO, mid and high rHGS were associated with a 23% and 36% risk reduction in incident NAFLD, respectively, compared with low rHGS. However, there was no significant relationship between rHGS levels and NAFLD incidence in men with ABO. Higher rHGS levels may prevent NAFLD, particularly in women. In individuals with ABO, high rHGS markedly decreased NAFLD risk in women but not in men.