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已发表论文
生活方式干预后体重反弹与较高肝脏炎症风险相关：一项回顾性观察研究
Authors Zou Y, Cao Z, Chen Y, Yuan M, Zhang Z, Gu W, Wang J, Zhao S , Hong J
Received 21 October 2025
Accepted for publication 5 February 2026
Published 12 February 2026 Volume 2026:19 573217
DOI https://doi.org/10.2147/DMSO.S573217
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Donald McClain
Yuyao Zou,1,2,* Zhiwen Cao,1,2,* Yufei Chen,1,2,* Miaomiao Yuan,1,2 Zhenxi Zhang,1,2 Weiqiong Gu,1,2 Jiqiu Wang,1,2 Shaoqian Zhao,1,2 Jie Hong1,2
1Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; 2Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Shanghai, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Jie Hong; Shaoqian Zhao, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, People’s Republic of China, Tel +86-21-64370045 ext. 610915, Fax +86-21-64373514, Email hj10887@rjh.com.cn; zsq12428@rjh.com.cn
Background: Lifestyle-induced weight loss improves metabolic health, but weight regain is common. Its hepatic consequences, particularly in relation to metabolic dysfunction–associated steatotic liver disease (MASLD), remain insufficiently characterized.
Methods: This retrospective observational study included 213 patients categorized as weight regain (≥ 5% lifestyle-induced weight loss followed by return to or exceeding baseline weight) or weight sustain (weight change within ± 5% of baseline) over 3 years. Propensity score matching (PSM) balanced age, sex, weight, and body mass index. Clinical, biochemical, and noninvasive liver indices were compared. In a bariatric surgery subset, liver histology, transcriptomics, quantitative PCR, and immunohistochemistry were performed.
Results: No significant differences were found in metabolic parameters between groups. After PSM, the weight regain group showed higher alanine aminotransferase (ALT) (median 59.00 vs 41.00 IU/L, P=0.007) and aspartate aminotransferase (AST) (33.50 vs 26.00 IU/L, P=0.041). In males, ALT (88.00 vs 47.00 IU/L, P< 0.001) and AST (46.00 vs 30.00 IU/L, P=0.004) remained higher. Noninvasive indices of hepatic steatosis (Dallas Steatosis Index, DSI) and fibrosis (NFS, FIB-4) did not differ. In male patients with liver biopsy samples available, liver histology showed comparable NAFLD Activity Scores (NAS) and fibrosis stages, whereas transcriptomic analysis revealed immune-related pathway enrichment. Increased hepatic CD11B and CD68 expression was confirmed by quantitative PCR and immunohistochemistry.
Conclusion: Weight regain after lifestyle-induced weight loss is associated with early liver-related biochemical abnormalities and hepatic innate immune activation in the absence of advanced fibrosis, underscoring the need for early liver risk assessment in individuals with weight cycling.
Keywords: weight regain, obesity, lifestyle modifications, masld, inflammation
1Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; 2Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Shanghai, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Jie Hong; Shaoqian Zhao, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, People’s Republic of China, Tel +86-21-64370045 ext. 610915, Fax +86-21-64373514, Email hj10887@rjh.com.cn; zsq12428@rjh.com.cn
Background: Lifestyle-induced weight loss improves metabolic health, but weight regain is common. Its hepatic consequences, particularly in relation to metabolic dysfunction–associated steatotic liver disease (MASLD), remain insufficiently characterized.
Methods: This retrospective observational study included 213 patients categorized as weight regain (≥ 5% lifestyle-induced weight loss followed by return to or exceeding baseline weight) or weight sustain (weight change within ± 5% of baseline) over 3 years. Propensity score matching (PSM) balanced age, sex, weight, and body mass index. Clinical, biochemical, and noninvasive liver indices were compared. In a bariatric surgery subset, liver histology, transcriptomics, quantitative PCR, and immunohistochemistry were performed.
Results: No significant differences were found in metabolic parameters between groups. After PSM, the weight regain group showed higher alanine aminotransferase (ALT) (median 59.00 vs 41.00 IU/L, P=0.007) and aspartate aminotransferase (AST) (33.50 vs 26.00 IU/L, P=0.041). In males, ALT (88.00 vs 47.00 IU/L, P< 0.001) and AST (46.00 vs 30.00 IU/L, P=0.004) remained higher. Noninvasive indices of hepatic steatosis (Dallas Steatosis Index, DSI) and fibrosis (NFS, FIB-4) did not differ. In male patients with liver biopsy samples available, liver histology showed comparable NAFLD Activity Scores (NAS) and fibrosis stages, whereas transcriptomic analysis revealed immune-related pathway enrichment. Increased hepatic CD11B and CD68 expression was confirmed by quantitative PCR and immunohistochemistry.
Conclusion: Weight regain after lifestyle-induced weight loss is associated with early liver-related biochemical abnormalities and hepatic innate immune activation in the absence of advanced fibrosis, underscoring the need for early liver risk assessment in individuals with weight cycling.
Keywords: weight regain, obesity, lifestyle modifications, masld, inflammation