Association between menopause, body composition, and nonalcoholic fatty liver disease: A prospective cohort in northern China

• Published in: Maturitas 2025-01, Vol.192, p.108148, Article 108148
• Main Authors: Yang, Chenlu, Chen, Shuohua, Feng, Baoyu, Lu, Ying, Wang, Yanhong, Liao, Wei, Wu, Shouling, Wang, Li
• Format: Article
• Language: English
• Subjects: Adult; Body Composition; Body Mass Index; China - epidemiology; Cohort Studies; Female; Humans; Incidence; Menopause; Menopause - physiology; Middle Aged; Non-alcoholic Fatty Liver Disease - epidemiology; Nonalcoholic fatty liver disease; Obesity, Abdominal - epidemiology; Overweight - epidemiology; Postmenopause; Premenopause; Proportional Hazards Models; Prospective cohort; Prospective Studies; Risk Factors; Weight management
• ISSN: 0378-5122; 1873-4111; 1873-4111
• DOI: 10.1016/j.maturitas.2024.108148

•Menopause increases the risk of nonalcoholic fatty liver disease, especially in lean or non-abdominal obese women.•Increased visceral fat mediates the link between menopause and nonalcoholic fatty liver disease.•Menopause and weight changes are associated with changes in the visceral fat index.•For perimenopausal women, weight control can reduce the menopause-related risk of nonalcoholic fatty liver disease. The association between menopause, changes in body composition, and nonalcoholic fatty liver disease is not clear, and there is a lack of weight management strategies for perimenopausal women from the perspective of preventing nonalcoholic fatty liver disease. A total of 1316 postmenopausal and 3049 premenopausal women in the Kailuan cohort in China between 2006 and 2017 were enrolled and followed up till 2021. Cox regression models, including the causal mediation analyses, were used to estimate the association between menopause and nonalcoholic fatty liver disease and the potential mediation effect of changes in body composition. We also explored the impact of weight changes on the correlation between menopause and nonalcoholic fatty liver disease. Women who experienced menopause had a higher risk of nonalcoholic fatty liver disease than premenopausal women (9-year cumulative incidence: 56.87 % vs. 48.80 %, adjusted hazard ratio = 1.219, 95 % confidence interval: 1.088–1.365). The nine-year cumulative incidence of nonalcoholic fatty liver disease was higher among overweight/obese postmenopausal women (67.24 % vs. 45.74 %, P