A U-shaped relationship between body mass index and the risk of elevated liver stiffness in older people: evidence from the 5‐year retrospective cohort study
Authors' conclusion
Our study elucidated the U-shaped relationship between BMI and the risk of elevated liver stiffness as measured by TE, and the optimal BMI range from 21.8 to 24.3 kg/m2 for the lowest risk of elevated liver stiffness in older people.
Study context
- Population
- Older people, West China Health and Aging Cohort Study (WCHAC); liver stiffness by transient elastography (TE)
- Participants
- 2,736 people
- Exposure
- Body mass index (BMI) quintiles and BMI trajectories vs lowest-risk category
- Outcome
- Elevated liver stiffness (TE) by 5-year average BMI
- Follow-up
- 5 years
Methodological details5-year, multinomial logistic regression, group-based trajectory model, restricted cubic spline
- 5-year
- Multinomial logistic regression
- Group-based trajectory model
- Restricted cubic spline
Main finding
As reported in the abstract
Elevated liver stiffness
Each group vs BMI Q2Odds ratio (95% CI)
BMI Q4
2.05(1.37–3.11)
BMI Q5
2.82(1.78–4.39)
- U-shaped relationship between BMI and elevated liver stiffness risk; optimal BMI range
- 21.8-24.3 kg/m²
Observational data: associations, not effects.
Further findings
| Outcome | Values | aOR (95% CI) |
|---|---|---|
| Elevated liver stiffness by 5-year BMI trajectory (ref: moderate-normal-weight stable, lowest prevalence) · 5 yearsHigh-level-overweight stable vs Moderate-normal-weight stable | Low-normal-weight stable 7.42% · Moderate-normal-weight stable 29.10% · Low-level-overweight stable 36.22% · High-level-overweight stable 20.32% · Stable obesity 6.94% | 2.02 (1.39–2.97) |
| Elevated liver stiffness by 5-year BMI trajectory (ref: moderate-normal-weight stable, lowest prevalence) · 5 yearsStable obesity vs Moderate-normal-weight stable | 2.83 (1.72–4.64) |
- Elevated liver stiffness by 5-year BMI trajectory (ref: moderate-normal-weight stable, lowest prevalence): per_group values are the share of participants in each trajectory
Original publication
A U-shaped relationship between body mass index and the risk of elevated liver stiffness in older people: evidence from the 5‐year retrospective cohort study. Int J Obes (Lond). Published 8 September 2025. doi:10.
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