ArticleClinics (Sao Paulo, Brazil)2026
Mediation of the association between physical activity and metabolic dysfunction-associated fatty liver disease in children and adolescents by inflammatory markers: an analysis of 2017‒2020 NHANES data.
Article in Clinics (Sao Paulo, Brazil), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundMetabolic dysfunction-Associated Fatty Liver Disease (MAFLD) is a globally prevalent condition that is closely related to Physical Activity (PA). Inflammatory mediators play a pivotal role in the pathophysiology of both MAFLD and PA. This study aimed to elucidate the association between PA and MAFLD in children and adolescents and to assess the mediating role of inflammatory markers in this relationship based on 2017‒2020 National Health and Nutrition Examination Survey (NHANES) data.
methodsIn this cross-sectional study, participants aged < 18 were included, with relevant data derived from the NHANES 2017‒2020 cycles. Weighted univariate and multivariate logistic regression models, together with subgroup analyses, were employed to examine the association between PA and MAFLD prevalence. Mediation analysis was conducted to evaluate the potential intermediary role of inflammatory markers in this relationship.
results979 children and adolescents were included, with an overall MAFLD prevalence of 24.96%. In multivariable-adjusted models, participants who met PA recommendations exhibited a significantly lower prevalence of MAFLD compared with those who did not (OR = 0.45; 95% CI 0.23‒0.87). Mediation analyses revealed that monocyte count, segmented neutrophil count, and lymphocyte count accounted for 7.72%, 8.79%, and 0.52% of the association between PA and MAFLD prevalence, respectively.
conclusionAmong children and adolescents younger than 18, higher levels of PA were significantly and inversely associated with the presence of MAFLD. This association appears to be partially mediated by inflammatory pathways, suggesting that the protective effect of PA against MAFLD may, at least in part, be attributable to its capacity to modulate systemic inflammation.
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