Chinese Hepatolgy ›› 2026, Vol. 31 ›› Issue (6): 873-878.

• Other Liver Diseases • Previous Articles     Next Articles

Association between metabolic factors and the risk of chronic liver disease in middle-aged and older adults: a cohort study based on CHARLS data

Bao Huiwei1, Jiang Siyu2, Guo Kefen3, Yuan Liuyuan2   

  1. 1. Department of Electrocardiography, Shanghai Geriatric Medical Center, Shanghai 201104, China;
    2. Department of Gastroenterology and Hepatology, Shanghai Geriatric Medical Center, Shanghai 201104, China;
    3. Department of Cardiology, Shanghai Geriatric Medical Center, Shanghai 201104, China
  • Received:2026-02-25 Online:2026-06-30 Published:2026-07-29
  • Contact: Jiang Siyu

PDF (PC)

1

Abstract: Objective To explore the association of metabolic syndrome and dynamic trajectories of metabolic syndrome scores with the risk of chronic liver disease among middle-aged and older adults in China. Methods Based on data from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2020, 8 479 middle-aged and elderly individuals (≥45 years) without a prior history of chronic liver disease were included. The Cox proportional hazards regression model was used to analyze the independent risk factors for the occurrence of chronic liver disease. The k-means clustering algorithm was applied to identify trajectories of changes in metabolic syndrome scores from 2011 to 2015, and Kaplan-Meier curves were used to evaluate the relationship between different metabolic syndrome score trajectories and the occurrence of chronic liver disease. Results During the 9-year follow-up period, a total of 839 participants (9.90%) newly developed chronic liver disease. Multivariate Cox regression analysis showed that a baseline diagnosis of metabolic syndrome (HR=1.24, 95% CI: 1.07~1.43, P=0.004), a higher baseline metabolic syndrome score (HR=1.19, 95% CI: 1.11-1.27, P<0.001), and a higher metabolic syndrome score in 2015 (HR=1.16, 95% CI: 1.05~1.28, P=0.004) were independent risk factors for the occurrence of chronic liver disease. The trajectories of metabolic syndrome score changes from 2011 to 2015 were further plotted, and based on the trajectory curves, the population was divided into three groups: the high-baseline improvement group, the stable group, and the low-baseline deterioration group. Kaplan-Meier curves showed that the high-baseline improvement group had the highest cumulative incidence of chronic liver disease within 9 years (12.74% vs. 7.88% vs. 7.46%, P=0.002). Conclusion An elevated metabolic syndrome score significantly increases the risk of chronic liver disease in the middle-aged and older adults. Monitoring the dynamic changes of the score and stratifying the population by risk can guide clinical diagnosis and treatment and reduce the risk of liver disease.

Key words: Metabolic syndrome, Chronic liver disease, Middle-aged and elderly, CHARLS, Cohort study