Questionnaire- and Accelerometer-Measured Physical Activity, Genetic Susceptibility and Risk of Chronic Liver Disease

Background and Aims: Prior studies on the association between physical activity (PA) and chronic liver disease (CLD) primarily relied on subjective PA data and rarely considered genetic susceptibility. We aimed to comprehensively investigate the associations between different PA categories, volumes, intensities, and patterns and CLD. Methods: This study conducted two cohort studies of 335,522 participants with questionnaire-measured PA data and 80 659 participants with accelerometer-measured PA data. Incident CLD and liver-related events (LRE) were ascertained from linked hospital and death records. Cox proportional hazards regression was used to investigate the associations. Results: Leisure-time PA, housework-related activity and recreational cycling were inversely associated with incident CLD and LRE. Increasing total PA volume, especially moderate to vigorous-intensity PA (MVPA), was correlated with a lower risk of CLD and LRE, regardless of genetic risk. The lowest CLD and LRE risk was achieved at 300 min/week of moderate-intensity PA (MPA) in the questionnaire-based cohort, but further risk reduction was observed when MPA exceeded 300 min/week in the accelerometer-based cohort. Combining > 300 min/week of MPA with 75 to 150 min/week of vigorous-intensity PA (VPA) was related to the greatest risk reduction. Performing recommended MVPA in regular active or weekend warrior patterns conferred similar risk reductions of outcomes. Significant interactions were observed between accelerometer-measured total PA and genetic risk on CLD and LRE risk. Conclusions: Our findings support increasing total PA, especially MVPA, in preventing liver disease and highlight the potential value of achieving greater MPA in daily routines, particularly for those with high genetic risk.