{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T20:07:20Z","timestamp":1790021240947,"version":"4.0.1"},"reference-count":46,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002947","name":"Anhui Medical University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002947","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Annals of Hepatology"],"published-print":{"date-parts":[[2026,9]]},"DOI":"10.1016\/j.aohep.2026.102443","type":"journal-article","created":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T23:35:51Z","timestamp":1789860951000},"page":"102443","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["A cohort study of physical activity, gut microbiota, serum metabolites, and the risk of steatotic liver disease"],"prefix":"10.1016","author":[{"given":"Shaoxian","family":"Liang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaling","family":"Shao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hairui","family":"Qin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meiling","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junyi","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zisuo","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongjuan","family":"Cao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinsheng","family":"Qin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhuang","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7365-2689","authenticated-orcid":false,"given":"Wanshui","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"6","key":"10.1016\/j.aohep.2026.102443_bib0001","doi-asserted-by":"crossref","first-page":"1542","DOI":"10.1016\/j.jhep.2023.06.003","article-title":"A multisociety Delphi consensus statement on new fatty liver disease nomenclature","volume":"79","author":"Rinella","year":"2023","journal-title":"J Hepatol"},{"issue":"10464","key":"10.1016\/j.aohep.2026.102443_bib0002","doi-asserted-by":"crossref","first-page":"1761","DOI":"10.1016\/S0140-6736(24)01811-7","article-title":"Steatotic liver disease","volume":"404","author":"Israelsen","year":"2024","journal-title":"Lancet"},{"issue":"4","key":"10.1016\/j.aohep.2026.102443_bib0003","doi-asserted-by":"crossref","first-page":"841","DOI":"10.3350\/cmh.2022.0239","article-title":"Forecasted 2040 global prevalence of nonalcoholic fatty liver disease using hierarchical bayesian approach","volume":"28","author":"Le","year":"2022","journal-title":"Clin Mol Hepatol"},{"issue":"3","key":"10.1016\/j.aohep.2026.102443_bib0004","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1016\/j.cgh.2020.05.064","article-title":"Nonalcoholic Steatohepatitis Is the Most Rapidly Increasing Indication for Liver Transplantation in the United States","volume":"19","author":"Younossi","year":"2021","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"11","key":"10.1016\/j.aohep.2026.102443_bib0005","doi-asserted-by":"crossref","first-page":"2375","DOI":"10.1007\/s00125-024-06196-3","article-title":"European Association for the Study of Diabetes, European Association for the Study of Obesity. EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD): Executive Summary","volume":"67","year":"2024","journal-title":"Diabetologia"},{"issue":"1","key":"10.1016\/j.aohep.2026.102443_bib0006","doi-asserted-by":"crossref","DOI":"10.1186\/s12916-024-03618-2","article-title":"Accelerometer-derived moderate-to-vigorous physical activity and incident nonalcoholic fatty liver disease","volume":"22","author":"Liu","year":"2024","journal-title":"BMC Medicine"},{"key":"10.1016\/j.aohep.2026.102443_bib0007","doi-asserted-by":"crossref","DOI":"10.3389\/fphys.2024.1359476","article-title":"Exercise, weight maintenance, and nonalcoholic fatty liver disease risk: a Chinese cohort study","volume":"15","author":"Yang","year":"2024","journal-title":"Frontiers in Physiology"},{"issue":"12","key":"10.1016\/j.aohep.2026.102443_bib0008","doi-asserted-by":"crossref","first-page":"2683","DOI":"10.1111\/liv.15439","article-title":"Isotemporal substitution of different behaviour patterns with the presence of MAFLD in Chinese adults","volume":"42","author":"Wang","year":"2022","journal-title":"Liver Int"},{"issue":"13","key":"10.1016\/j.aohep.2026.102443_bib0009","doi-asserted-by":"crossref","first-page":"3444","DOI":"10.1016\/j.cgh.2023.01.011","article-title":"Physical Activity Intensity, Genetic Predisposition, and Risk of Nonalcoholic Fatty Liver Disease: A Prospective Cohort Study","volume":"21","author":"Lv","year":"2023","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"5","key":"10.1016\/j.aohep.2026.102443_bib0010","doi-asserted-by":"crossref","first-page":"1556","DOI":"10.1002\/hep.31158","article-title":"Inadequate Physical Activity and Sedentary Behavior Are Independent Predictors of Nonalcoholic Fatty Liver Disease","volume":"72","author":"Kim","year":"2020","journal-title":"Hepatology"},{"key":"10.1016\/j.aohep.2026.102443_bib0011","article-title":"Objectively Measured Physical Activity Is Inversely Associated With Nonalcoholic Fatty Liver Disease: The Rotterdam Study","author":"van Kleef","year":"2021","journal-title":"American Journal of Gastroenterology"},{"issue":"14","key":"10.1016\/j.aohep.2026.102443_bib0012","doi-asserted-by":"crossref","first-page":"2788","DOI":"10.1007\/s11606-024-08804-9","article-title":"Leisure-Time Physical Activity, Time Spent Sitting and Risk of Non-alcoholic Fatty Liver Disease: A Cross-Sectional Study in Puglia","volume":"39","author":"Franco","year":"2024","journal-title":"Journal of General Internal Medicine"},{"issue":"1","key":"10.1016\/j.aohep.2026.102443_bib0013","article-title":"Associations of physical activity domains and muscle strength exercise with non-alcoholic fatty liver disease: a nation-wide cohort study","volume":"13","author":"Park","year":"2023","journal-title":"Scientific Reports"},{"issue":"9-10","key":"10.1016\/j.aohep.2026.102443_bib0014","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1007\/s00508-023-02314-0","article-title":"Association of physical activity with MAFLD\/MASLD and LF among adults in NHANES, 2017-2020","volume":"136","author":"Li","year":"2024","journal-title":"Wien Klin Wochenschr"},{"issue":"6","key":"10.1016\/j.aohep.2026.102443_bib0015","doi-asserted-by":"crossref","DOI":"10.1016\/j.cgh.2021.06.029","article-title":"Physical Activity Is Associated With Nonalcoholic Fatty Liver Disease and Significant Fibrosis Measured by FibroScan","volume":"20","author":"Kim","year":"2022","journal-title":"Clin Gastroenterol Hepatol"},{"key":"10.1016\/j.aohep.2026.102443_bib0016","article-title":"Dose-response relationship between physical activity and nonalcoholic fatty liver disease: A prospective cohort study","author":"Li","year":"2023","journal-title":"Chinese Medical Journal"},{"issue":"3","key":"10.1016\/j.aohep.2026.102443_bib0017","doi-asserted-by":"crossref","first-page":"487","DOI":"10.3945\/ajcn.112.046854","article-title":"Physical activity and sedentary leisure time and their associations with BMI, waist circumference, and percentage body fat in 0.5 million adults: the China Kadoorie Biobank study","volume":"97","author":"Du","year":"2013","journal-title":"Am J Clin Nutr"},{"key":"10.1016\/j.aohep.2026.102443_bib0018","doi-asserted-by":"crossref","first-page":"l4570","DOI":"10.1136\/bmj.l4570","article-title":"Dose-response associations between accelerometry measured physical activity and sedentary time and all cause mortality: systematic review and harmonised meta-analysis","volume":"366","author":"Ekelund","year":"2019","journal-title":"Bmj"},{"issue":"12","key":"10.1016\/j.aohep.2026.102443_bib0019","doi-asserted-by":"crossref","DOI":"10.3390\/nu14122456","article-title":"How Diet and Physical Activity Modulate Gut Microbiota: Evidence, and Perspectives","volume":"14","author":"Campaniello","year":"2022","journal-title":"Nutrients"},{"issue":"15","key":"10.1016\/j.aohep.2026.102443_bib0020","doi-asserted-by":"crossref","DOI":"10.3390\/ijms21155214","article-title":"Gut Microbiota Metabolites in NAFLD Pathogenesis and Therapeutic Implications","volume":"21","author":"Chen","year":"2020","journal-title":"Int J Mol Sci"},{"key":"10.1016\/j.aohep.2026.102443_bib0021","doi-asserted-by":"crossref","DOI":"10.1016\/j.ebiom.2024.104989","article-title":"Accelerometer-based physical activity is associated with the gut microbiota in 8416 individuals in SCAPIS","volume":"100","author":"Baldanzi","year":"2024","journal-title":"EBioMedicine"},{"issue":"1","key":"10.1016\/j.aohep.2026.102443_bib0022","doi-asserted-by":"crossref","first-page":"2555","DOI":"10.1038\/s41467-022-29968-0","article-title":"A randomized controlled trial for response of microbiome network to exercise and diet intervention in patients with nonalcoholic fatty liver disease","volume":"13","author":"Cheng","year":"2022","journal-title":"Nat Commun"},{"issue":"5","key":"10.1016\/j.aohep.2026.102443_bib0023","doi-asserted-by":"crossref","first-page":"892","DOI":"10.1007\/s11427-022-2272-3","article-title":"Exercise-induced microbial changes in preventing type 2 diabetes","volume":"67","author":"Yao","year":"2024","journal-title":"Sci China Life Sci"},{"issue":"4","key":"10.1016\/j.aohep.2026.102443_bib0024","doi-asserted-by":"crossref","DOI":"10.1096\/fj.202201571R","article-title":"Physical activity-induced alterations of the gut microbiota are BMI dependent","volume":"37","author":"Shah","year":"2023","journal-title":"FASEB J"},{"issue":"5","key":"10.1016\/j.aohep.2026.102443_bib0025","doi-asserted-by":"crossref","first-page":"1142","DOI":"10.1111\/liv.15860","article-title":"Red meat intake, faecal microbiome, serum trimethylamine N-oxide and hepatic steatosis among Chinese adults","volume":"44","author":"Huang","year":"2024","journal-title":"Liver Int"},{"issue":"13","key":"10.1016\/j.aohep.2026.102443_bib0026","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.123.034126","article-title":"Urinary Equol and Equol-Predicting Microbial Species Are Favorably Associated With Cardiometabolic Risk Markers in Chinese Adults","volume":"13","author":"Liang","year":"2024","journal-title":"Journal of the American Heart Association"},{"issue":"3","key":"10.1016\/j.aohep.2026.102443_bib0027","doi-asserted-by":"crossref","first-page":"654","DOI":"10.1016\/j.ajcnut.2025.01.018","article-title":"Gut microbiota may modify the association between dietary polyphenol intake and serum concentrations of hippuric acid: results from a 1-year longitudinal study in China","volume":"121","author":"Pan","year":"2025","journal-title":"Am J Clin Nutr"},{"key":"10.1016\/j.aohep.2026.102443_bib0028","doi-asserted-by":"crossref","DOI":"10.1016\/j.ajcnut.2025.02.029","article-title":"Validation of a food frequency questionnaire for measuring dietary intake of isoflavones and lignans using the method of triads","author":"Zhang","year":"2025","journal-title":"Am J Clin Nutr"},{"key":"10.1016\/j.aohep.2026.102443_bib0029","doi-asserted-by":"crossref","DOI":"10.1093\/aje\/kwaf087","article-title":"Reproducibility and validity of low-carbohydrate diet and low-fat diet scores derived from 24-hour dietary recalls","author":"Li","year":"2025","journal-title":"Am J Epidemiol"},{"issue":"8","key":"10.1016\/j.aohep.2026.102443_bib0030","doi-asserted-by":"crossref","first-page":"1575","DOI":"10.1249\/MSS.0b013e31821ece12","article-title":"2011 Compendium of Physical Activities: a second update of codes and MET values","volume":"43","author":"Ainsworth","year":"2011","journal-title":"Med Sci Sports Exerc"},{"issue":"5","key":"10.1016\/j.aohep.2026.102443_bib0031","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1097\/00005768-199805000-00021","article-title":"Calibration of the Computer Science and Applications, Inc. accelerometer","volume":"30","author":"Freedson","year":"1998","journal-title":"Med Sci Sports Exerc"},{"issue":"5","key":"10.1016\/j.aohep.2026.102443_bib0032","doi-asserted-by":"crossref","first-page":"1433","DOI":"10.1093\/ije\/dyw033","article-title":"Objectively measured physical activity and plasma metabolomics in the Shanghai Physical Activity Study","volume":"45","author":"Xiao","year":"2016","journal-title":"International Journal of Epidemiology"},{"key":"10.1016\/j.aohep.2026.102443_bib0033","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1186\/1471-230X-6-33","article-title":"The Fatty Liver Index: a simple and accurate predictor of hepatic steatosis in the general population","volume":"6","author":"Bedogni","year":"2006","journal-title":"BMC Gastroenterol"},{"issue":"1","key":"10.1016\/j.aohep.2026.102443_bib0034","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1093\/ajcn\/82.1.163","article-title":"Diet-quality scores and plasma concentrations of markers of inflammation and endothelial dysfunction","volume":"82","author":"Fung","year":"2005","journal-title":"Am J Clin Nutr"},{"issue":"11","key":"10.1016\/j.aohep.2026.102443_bib0035","doi-asserted-by":"crossref","first-page":"1255","DOI":"10.1038\/s41564-018-0257-9","article-title":"Recovery of gut microbiota of healthy adults following antibiotic exposure","volume":"3","author":"Palleja","year":"2018","journal-title":"Nat Microbiol"},{"issue":"1","key":"10.1016\/j.aohep.2026.102443_bib0036","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1186\/s12937-024-01067-4","article-title":"Indole derivatives and their associated microbial genera are associated with the 1-year changes in cardiometabolic risk markers in Chinese adults","volume":"23","author":"Pan","year":"2024","journal-title":"Nutr J"},{"key":"10.1016\/j.aohep.2026.102443_bib0037","article-title":"Is light-to-moderate alcohol drinking associated with the onset of metabolic dysfunction-associated steatotic liver disease in a Chinese cohort?","author":"Chen","year":"2025","journal-title":"The American journal of clinical nutrition"},{"issue":"14","key":"10.1016\/j.aohep.2026.102443_bib0038","doi-asserted-by":"crossref","first-page":"5709","DOI":"10.1021\/acs.analchem.0c04686","article-title":"A Metabolite Array Technology for Precision Medicine","volume":"93","author":"Xie","year":"2021","journal-title":"Analytical chemistry"},{"issue":"5","key":"10.1016\/j.aohep.2026.102443_bib0039","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.1016\/j.jhep.2016.12.022","article-title":"Individual patient data meta-analysis of controlled attenuation parameter (CAP) technology for assessing steatosis","volume":"66","author":"Karlas","year":"2017","journal-title":"J Hepatol"},{"issue":"18","key":"10.1016\/j.aohep.2026.102443_bib0040","doi-asserted-by":"crossref","first-page":"1024","DOI":"10.1136\/bjsports-2020-102174","article-title":"Association of physical activity with risk of hepatobiliary diseases in China: a prospective cohort study of 0.5 million people","volume":"55","author":"Pang","year":"2021","journal-title":"Br J Sports Med"},{"issue":"5","key":"10.1016\/j.aohep.2026.102443_bib0041","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0019657","article-title":"Trends over 5 decades in U.S. occupation-related physical activity and their associations with obesity","volume":"6","author":"Church","year":"2011","journal-title":"PLoS One"},{"issue":"9","key":"10.1016\/j.aohep.2026.102443_bib0042","doi-asserted-by":"crossref","first-page":"4832","DOI":"10.1039\/D3FO04642G","article-title":"The synergism of Lactobacillaceae, inulin, polyglucose, and aerobic exercise ameliorates hyperglycemia by modulating the gut microbiota community and the metabolic profiles in db\/db mice","volume":"15","author":"Li","year":"2024","journal-title":"Food & Function"},{"issue":"8","key":"10.1016\/j.aohep.2026.102443_bib0043","doi-asserted-by":"crossref","DOI":"10.3390\/jfb15080236","article-title":"Chitosan-Stabilized Selenium Nanoparticles Alleviate High-Fat Diet-Induced Non-Alcoholic Fatty Liver Disease (NAFLD) by Modulating the Gut Barrier Function and Microbiota","volume":"15","author":"Luo","year":"2024","journal-title":"J Funct Biomater"},{"issue":"4","key":"10.1016\/j.aohep.2026.102443_bib0044","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1097\/JES.0b013e3182a4e6b6","article-title":"Potential role of branched-chain amino acid catabolism in regulating fat oxidation","volume":"41","author":"Kainulainen","year":"2013","journal-title":"Exerc Sport Sci Rev"},{"key":"10.1016\/j.aohep.2026.102443_bib0045","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1016\/j.nutres.2024.06.009","article-title":"Dietary and circulating branched chain amino acids are unfavorably associated with body fat measures among Chinese adults","volume":"128","author":"Zhang","year":"2024","journal-title":"Nutrition Research"},{"issue":"5","key":"10.1016\/j.aohep.2026.102443_bib0046","doi-asserted-by":"crossref","first-page":"1835","DOI":"10.1007\/s00394-024-03432-9","article-title":"Dietary intake of branched-chain amino acids (BCAAs), serum BCAAs, and cardiometabolic risk markers among community-dwelling adults","volume":"63","author":"Rao","year":"2024","journal-title":"Eur J Nutr"}],"container-title":["Annals of Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1665268126002632?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1665268126002632?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T19:29:34Z","timestamp":1790018974000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1665268126002632"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":46,"alternative-id":["S1665268126002632"],"URL":"https:\/\/doi.org\/10.1016\/j.aohep.2026.102443","relation":{},"ISSN":["1665-2681"],"issn-type":[{"value":"1665-2681","type":"print"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"A cohort study of physical activity, gut microbiota, serum metabolites, and the risk of steatotic liver disease","name":"articletitle","label":"Article Title"},{"value":"Annals of Hepatology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.aohep.2026.102443","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 Fundaci\u00f3n Cl\u00ednica M\u00e9dica Sur, A.C. Published by Elsevier Espa\u00f1a, S.L.U.","name":"copyright","label":"Copyright"}],"article-number":"102443"}}