{
  "abstract": "Background and aims: Thyroid-stimulating hormone (TSH) and body mass index (BMI) are potential prognostic factors in metabolic dysfunction-associated steatotic liver disease (MASLD). We investigated whether a combined TSH–BMI profile could refine risk stratification and identify lifestyle patterns associated with favorable outcomes in adults with MASLD.\n\nMethods: We analyzed 4,225 adults with MASLD from NHANES III, stratified into three age groups: young (<40 years; n = 1,445), midlife (40–60 years; n = 1,616), and elderly (>60 years; n = 1,164). The TSH cutoff that best stratified all-cause mortality was identified using univariable Cox analysis. Among participants with favorable TSH levels, restricted cubic spline models estimated the BMI range associated with lower mortality. Associations between lifestyle patterns and prognosis were assessed across TSH–BMI profiles.\n\nResults: Favorable ranges were TSH ≤ 1.4 mIU/L and BMI 24.5–27.5 kg/m2 in young participants (hazard ratio [HR] = 0.37, 95% confidence interval [CI]: 0.16–0.84, p = 0.017); TSH ≥ 1.0 mIU/L and BMI 25.0–29.5 kg/m2 in midlife participants (HR = 0.52, 95% CI: 0.32–0.82, p = 0.005); and TSH ≤ 2.1 mIU/L and BMI 28.9–33.9 kg/m2 in elderly participants (HR = 0.48, 95% CI: 0.34–0.66, p < 0.001). Higher diet quality was associated with better prognosis across age groups (all p < 0.05). Appropriate moderate-to-vigorous exercise was associated with better survival in specific subpopulations, including midlife participants with unfavorable TSH and BMI ranges (≥5 times/week). Sensitivity analyses were consistent.\n\nConclusion: The TSH–BMI profile may inform mortality risk assessment and identification of favorable lifestyle patterns in adults with MASLD.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Interventional Oncology, Liver Cancer Study and Service Group, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou 510060, China",
    "Department of VIP Region, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou 510060, China",
    "Department of Pathology, State Key Laboratory of Liver Research, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 19,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Jie Xu"
    },
    {
      "affs": [
        0
      ],
      "name": "Jun-Zhe Yi"
    },
    {
      "affs": [
        1
      ],
      "name": "Ping Chen"
    },
    {
      "affs": [
        0
      ],
      "name": "Yu-Nan Zhang"
    },
    {
      "affs": [
        0
      ],
      "name": "Jiong-Liang Wang"
    },
    {
      "affs": [
        0
      ],
      "name": "Xin-Tong Wu"
    },
    {
      "affs": [
        0
      ],
      "name": "Yi-Min Zhang"
    },
    {
      "affs": [
        0
      ],
      "name": "Song Chen"
    },
    {
      "affs": [
        0
      ],
      "name": "Wei-Jie Wu"
    },
    {
      "affs": [
        0
      ],
      "name": "Zu-Qing Gao"
    },
    {
      "affs": [
        0
      ],
      "name": "Zi-Xi Ou-Yang"
    },
    {
      "affs": [
        0
      ],
      "name": "Gen-Jun Tan"
    },
    {
      "affs": [
        0
      ],
      "name": "Yu-Jia Song"
    },
    {
      "affs": [
        2
      ],
      "name": "Hai-Jing Deng"
    },
    {
      "affs": [
        0
      ],
      "name": "Meng He"
    },
    {
      "affs": [
        0
      ],
      "name": "Yi-Quan Jiang"
    },
    {
      "affs": [
        0
      ],
      "name": "Qi-Feng Chen"
    },
    {
      "affs": [
        0
      ],
      "name": "Ming Zhao"
    },
    {
      "affs": [
        0
      ],
      "name": "Ning Lyu"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/6hcn3t40wazex.bib",
  "cited_by": 0,
  "doi": "10.1016/j.iliver.2026.100279",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13738111/",
  "id": "6hcn3t40wazex",
  "issns": [
    "2772-9478"
  ],
  "landing_url": "https://doi.org/10.1016/j.iliver.2026.100279",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Article"
    ],
    [
      "openalex",
      "2721|Liver Disease Diagnosis and Treatment"
    ]
  ],
  "openalex": "W7221538067",
  "pdf_url": null,
  "pmcid": "PMC13738111",
  "pmid": "42992158",
  "published": "2026-10-12",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/6hcn3t40wazex.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T12:23:09Z",
      "native_id": "PMC13738111",
      "source": "pmc",
      "url": "https://doi.org/10.1016/j.iliver.2026.100279"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2721|Liver Disease Diagnosis and Treatment",
      "subfield": "general"
    }
  ],
  "title": "Thyroid-stimulating hormone–body mass index profile and mortality in metabolic dysfunction-associated steatotic liver disease",
  "title_text": "Thyroid-stimulating hormone–body mass index profile and mortality in metabolic dysfunction-associated steatotic liver disease",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T12:23:09Z",
  "url": "https://research.draconitic.com/paper/6hcn3t40wazex",
  "venue": "ILIVER",
  "versions": []
}