NEW findings demonstrate that the risk of metabolic dysfunction-associated steatotic liver disease (MASLD) in early adulthood increased by close to threefold in children born to overweight parents. MASLD is a disease with a lack of widely adopted screening protocols for young patients as it is mainly silent, manifesting later in adulthood; however, hepatic steatosis can begin in early childhood. Therefore, researchers conducted a prospective case-cohort study to investigate the developmental origins of MASLD by examining specific trajectories of growth through childhood, specifically the relationship between parental obesity and MASLD risk.
The prospective case-cohort study utilised the Avon Longitudinal Study of Parents and Children UK birth cohort. This cohort comprises over 14,000 pregnancies from 1990-92 in Avon, UK. Participants were followed from childhood to adulthood, lifestyle was monitored, and clinical measurements and biological specimens were collected, with plasma and serum biomarkers measured at 24 years of age. Diagnosis of MASLD was based on S1 steatosis on transient elastography and at least one cardiometabolic risk factor, e.g., hypertension, diabetes or body mass index [BMI] ≥25 kg/m2. Data analysis included 2,000 offspring, 350 of whom were diagnosed with MASLD by age 24 (18.2%; mean BMI, 30.4; 47.4% women). Logistic regression analysis was employed to examine the association between parental BMI during pregnancy adjusted for parental characteristics (i.e., parental age and diet) and early life factors such as mode of delivery, birthweight, duration of breastfeeding, early antibiotic exposure, and diet at age 7.
Results revealed that for every 5 kg/m2 increase in maternal BMI, the risk of MASLD in offspring increased by 55% (adjusted odd ratio [aOR] = 1.55; 95% confidence interval [CI], 1.29-1.86), while every 5 kg/m2 in paternal BMI was associated with a 44% increase (aOR = 1.44; 95% CI, 1.16-1.78). Moreover, children with both parents classified as overweight with BMI ≥25 kg/m2 had a 2.91 times higher risk for MASLD in early adulthood compared with children with normal-weight parents.
Researchers concluded that parental BMI during pregnancy is a potential MASLD risk factor in offspring by age 24, with maternal BMI more strongly associated with MASLD and dual parental obesity being the most significant risk factor. Hence, researchers called on doctors to consider family history of obesity, particularly for parents, in MASLD risk stratification and managing parental obesity to target MASLD in younger generations.
Reference:
Tica S, et al. Parental overweight status around pregnancy and offspring risk of metabolic dysfunction-associated steatotic liver disease in young adulthood. Presented at: Digestive Disease Week; May 18-21, 2024; Washington (hybrid).
