Associations of activity, sedentary and sleep behaviors with prevalent steatotic liver disease in middle-aged and older adults : the ELSA-Brasil study

Abstract

Background: Steatotic liver disease (SLD) is a prevalent metabolic disease. While single component movement behaviors have been related to its development, comprehensive assessments of their joint associations are scarce. Objective: To investigate the single-component and multi-component associations of moderate and vigorous physical activity (MVPA), light physical activity (LPA), sedentary behavior (SB), and sleep with prevalent SLD in Brazilian adults. Methods: A cross-sectional analysis using data from the third wave of the ELSA-Brasil cohort (2017–2019). Participants wore an ActiGraph wGT3X-BT in the waist for seven days and completed a sleep diary. SLD was defned by a Fatty Liver Index≥60. To investigate single-component and multi-component associations, we used three exposure modeling approaches based on Poisson models: multivariable-adjusted regression, restricted cubic splines, and compositional data analysis. Results: Among 8569 participants (55.7% women, mean age 59.2±8.60), 43.9% had SLD. Total activity volume adjusted for covariates was inversely associated with prevalent SLD. Every 1 mg/day increase in total activity volume was associated with a PR of 0.95 in individuals sleeping < 7 h/day (95% CI 0.94–0.97) and 0.95 (95% CI 0.93–0.96) in those sleeping ≥ 7 h/day. Increasing 30 min/day of MVPA was associated with decreasing prevalence of SLD (sleep ≥ 7 h/day [PR 0.83; 95% CI 0.77–0.89]; sleep ≥ 7 h/day [PR 0.78; 95% CI 0.74–0.83]). Sleep, SB, and LPA were not associated with SLD. Associations of total activity volume and MVPA were more pronounced among females. Adjustment with adiposity markers attenuated the associations. Conclusions: In adults, total activity volume and MVPA were inversely associated with SLD in a dose–response fashion. Substituting lower-intensity behaviors with MVPA was associated with a lower prevalence of SLD independent of sleep duration, sex, and age.