{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T19:40:23Z","timestamp":1757619623938,"version":"3.44.0"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T00:00:00Z","timestamp":1753315200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T00:00:00Z","timestamp":1753315200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["RS-2023-00220894"],"award-info":[{"award-number":["RS-2023-00220894"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100016341","name":"Korea University Guro Hospital","doi-asserted-by":"publisher","award":["Z2300011"],"award-info":[{"award-number":["Z2300011"]}],"id":[{"id":"10.13039\/100016341","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002642","name":"Korea University","doi-asserted-by":"crossref","award":["K2409361, K2428001, K2508621"],"award-info":[{"award-number":["K2409361, K2428001, K2508621"]}],"id":[{"id":"10.13039\/501100002642","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"DOI":"10.1038\/s41598-025-11976-x","type":"journal-article","created":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T15:20:54Z","timestamp":1753370454000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The impact of parity on the risk of nonalcoholic fatty liver disease defined by hepatic steatosis index: A nationwide cohort study"],"prefix":"10.1038","volume":"15","author":[{"given":"So-hyeon","family":"Hong","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soon Young","family":"Hwang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ji Hee","family":"Yu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nam Hoon","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hye Jin","family":"Yoo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ji A","family":"Seo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sin Gon","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nan Hee","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sei Hyun","family":"Baik","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyung Mook","family":"Choi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,7,24]]},"reference":[{"key":"11976_CR1","doi-asserted-by":"publisher","first-page":"1335","DOI":"10.1097\/HEP.0000000000000004","volume":"77","author":"ZM Younossi","year":"2023","unstructured":"Younossi, Z. M. et al. The global epidemiology of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH): a systematic review. Hepatology 77, 1335\u20131347 (2023).","journal-title":"Hepatology"},{"key":"11976_CR2","doi-asserted-by":"publisher","first-page":"1204","DOI":"10.1002\/hep.32228","volume":"75","author":"JM Paik","year":"2022","unstructured":"Paik, J. M. et al. Global burden of NAFLD and chronic liver disease among adolescents and young adults. Hepatology 75, 1204\u20131217 (2022).","journal-title":"Hepatology"},{"key":"11976_CR3","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1016\/j.jhep.2018.09.013","volume":"70","author":"VH Ajmera","year":"2019","unstructured":"Ajmera, V. H. et al. Longer lactation duration is associated with decreased prevalence of non-alcoholic fatty liver disease in women. J. Hepatol. 70, 126\u2013132 (2019).","journal-title":"J. Hepatol."},{"key":"11976_CR4","doi-asserted-by":"publisher","first-page":"2988","DOI":"10.1002\/hep.32034","volume":"74","author":"Y Park","year":"2021","unstructured":"Park, Y. et al. The association between breastfeeding and nonalcoholic fatty liver disease in parous women: A nation-wide cohort study. Hepatology 74, 2988\u20132997 (2021).","journal-title":"Hepatology"},{"key":"11976_CR5","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopha.2022.113808","volume":"156","author":"F Mahboobifard","year":"2022","unstructured":"Mahboobifard, F. et al. Estrogen as a key regulator of energy homeostasis and metabolic health. Biomed. Pharmacother. 156, 113808 (2022).","journal-title":"Biomed. Pharmacother."},{"issue":"1258\u20131266","key":"11976_CR6","volume":"19","author":"J Wang","year":"2021","unstructured":"Wang, J. et al. Associations Between Reproductive and Hormone-Related Factors and Risk of Nonalcoholic Fatty Liver Disease in a Multiethnic Population. Clin. Gastroenterol. Hepatol. 19(1258\u20131266), e1251 (2021).","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"11976_CR7","doi-asserted-by":"publisher","first-page":"1035","DOI":"10.5604\/01.3001.0012.7204","volume":"17","author":"P Golabi","year":"2018","unstructured":"Golabi, P. et al. Association of parity in patients with chronic liver disease. Ann. Hepatol. 17, 1035\u20131041 (2018).","journal-title":"Ann. Hepatol."},{"key":"11976_CR8","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1002\/cld.930","volume":"16","author":"M Eslam","year":"2020","unstructured":"Eslam, M., Chen, F. & George, J. NAFLD in lean asians. Clin. Liver Dis (Hoboken) 16, 240\u2013243 (2020).","journal-title":"Clin. Liver Dis (Hoboken)"},{"key":"11976_CR9","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1093\/ije\/dyt228","volume":"43","author":"S Kweon","year":"2014","unstructured":"Kweon, S. et al. Data resource profile: The Korea national health and nutrition examination survey (KNHANES). Int. J. Epidemiol. 43, 69\u201377 (2014).","journal-title":"Int. J. Epidemiol."},{"key":"11976_CR10","doi-asserted-by":"publisher","first-page":"503","DOI":"10.1016\/j.dld.2009.08.002","volume":"42","author":"JH Lee","year":"2010","unstructured":"Lee, J. H. et al. Hepatic steatosis index: a simple screening tool reflecting nonalcoholic fatty liver disease. Dig. Liver Dis. 42, 503\u2013508 (2010).","journal-title":"Dig. Liver Dis."},{"key":"11976_CR11","doi-asserted-by":"publisher","first-page":"1406","DOI":"10.1002\/hep.26761","volume":"59","author":"JD Yang","year":"2014","unstructured":"Yang, J. D. et al. Gender and menopause impact severity of fibrosis among patients with nonalcoholic steatohepatitis. Hepatology 59, 1406\u20131414 (2014).","journal-title":"Hepatology"},{"key":"11976_CR12","doi-asserted-by":"publisher","first-page":"1404","DOI":"10.1038\/ajg.2014.155","volume":"109","author":"PJ Meffert","year":"2014","unstructured":"Meffert, P. J. et al. Development, external validation, and comparative assessment of a new diagnostic score for hepatic steatosis. Am. J. Gastroenterol. 109, 1404\u20131414 (2014).","journal-title":"Am. J. Gastroenterol."},{"key":"11976_CR13","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2022.926944","volume":"9","author":"MH Sun","year":"2022","unstructured":"Sun, M. H. et al. Parity and Metabolic Syndrome Risk: A Systematic Review and Meta-Analysis of 15 Observational Studies With 62,095 Women. Front. Med. (Lausanne) 9, 926944 (2022).","journal-title":"Front. Med. (Lausanne)"},{"key":"11976_CR14","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1016\/j.jdiacomp.2016.10.005","volume":"31","author":"P Guo","year":"2017","unstructured":"Guo, P., Zhou, Q., Ren, L., Chen, Y. & Hui, Y. Higher parity is associated with increased risk of Type 2 diabetes mellitus in women: A linear dose-response meta-analysis of cohort studies. J. Diabetes Complications 31, 58\u201366 (2017).","journal-title":"J. Diabetes Complications"},{"key":"11976_CR15","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1186\/s12902-020-00674-6","volume":"21","author":"M Shi","year":"2021","unstructured":"Shi, M., Zhou, X., Zheng, C. & Pan, Y. The association between parity and metabolic syndrome and its components in normal-weight postmenopausal women in China. BMC Endocr. Disord 21, 8 (2021).","journal-title":"BMC Endocr. Disord"},{"key":"11976_CR16","doi-asserted-by":"publisher","first-page":"998","DOI":"10.1097\/gme.0b013e3181a03807","volume":"16","author":"GJ Cho","year":"2009","unstructured":"Cho, G. J. et al. The relationship between reproductive factors and metabolic syndrome in Korean postmenopausal women: Korea National Health and Nutrition Survey 2005. Menopause 16, 998\u20131003 (2009).","journal-title":"Menopause"},{"key":"11976_CR17","doi-asserted-by":"publisher","first-page":"442","DOI":"10.1016\/S2213-8587(22)00076-6","volume":"10","author":"RE Nappi","year":"2022","unstructured":"Nappi, R. E., Chedraui, P., Lambrinoudaki, I. & Simoncini, T. Menopause: a cardiometabolic transition. Lancet Diabetes Endocrinol. 10, 442\u2013456 (2022).","journal-title":"Lancet Diabetes Endocrinol."},{"key":"11976_CR18","doi-asserted-by":"publisher","first-page":"1609","DOI":"10.1007\/s40618-022-01766-x","volume":"45","author":"K Pafili","year":"2022","unstructured":"Pafili, K. et al. Non-alcoholic fatty liver disease through the female lifespan: the role of sex hormones. J. Endocrinol. Invest 45, 1609\u20131623 (2022).","journal-title":"J. Endocrinol. Invest"},{"key":"11976_CR19","doi-asserted-by":"crossref","unstructured":"Lee C, Kim J, Jung Y. Potential Therapeutic Application of Estrogen in Gender Disparity of Nonalcoholic Fatty Liver Disease\/Nonalcoholic Steatohepatitis. Cells, 8 (2019).","DOI":"10.3390\/cells8101259"},{"key":"11976_CR20","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1016\/j.jhep.2015.02.029","volume":"63","author":"X Wang","year":"2015","unstructured":"Wang, X. et al. Hepatic estrogen receptor alpha improves hepatosteatosis through upregulation of small heterodimer partner. J. Hepatol. 63, 183\u2013190 (2015).","journal-title":"J. Hepatol."},{"key":"11976_CR21","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1124\/jpet.115.231316","volume":"358","author":"W Rui","year":"2016","unstructured":"Rui, W. et al. Nuclear Factor Erythroid 2-Related Factor 2 deficiency results in amplification of the liver fat-lowering effect of Estrogen. J. Pharmacol. Exp. Ther. 358, 14\u201321 (2016).","journal-title":"J. Pharmacol. Exp. Ther."},{"key":"11976_CR22","doi-asserted-by":"publisher","first-page":"5602","DOI":"10.1096\/fj.201800240R","volume":"32","author":"L Hua","year":"2018","unstructured":"Hua, L. et al. Identification of hepatic fibroblast growth factor 21 as a mediator in 17beta-estradiol-induced white adipose tissue browning. FASEB J. 32, 5602\u20135611 (2018).","journal-title":"FASEB J."},{"key":"11976_CR23","doi-asserted-by":"publisher","first-page":"1287","DOI":"10.1210\/me.2006-0012","volume":"20","author":"H Gao","year":"2006","unstructured":"Gao, H. et al. Long-term administration of estradiol decreases expression of hepatic lipogenic genes and improves insulin sensitivity in ob\/ob mice: a possible mechanism is through direct regulation of signal transducer and activator of transcription 3. Mol. Endocrinol. 20, 1287\u20131299 (2006).","journal-title":"Mol. Endocrinol."},{"key":"11976_CR24","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbc.2024.105661","volume":"300","author":"L Li","year":"2024","unstructured":"Li, L. et al. G protein-coupled estrogen receptor 1 ameliorates nonalcoholic steatohepatitis through targeting AMPK-dependent signaling. J. Biol. Chem. 300, 105661 (2024).","journal-title":"J. Biol. Chem."},{"key":"11976_CR25","doi-asserted-by":"publisher","first-page":"1782","DOI":"10.1136\/gut.2004.053728","volume":"54","author":"T Itagaki","year":"2005","unstructured":"Itagaki, T. et al. Opposing effects of oestradiol and progesterone on intracellular pathways and activation processes in the oxidative stress induced activation of cultured rat hepatic stellate cells. Gut 54, 1782\u20131789 (2005).","journal-title":"Gut"},{"key":"11976_CR26","doi-asserted-by":"publisher","first-page":"805","DOI":"10.1111\/j.1365-2826.2010.02017.x","volume":"22","author":"SR Ladyman","year":"2010","unstructured":"Ladyman, S. R., Augustine, R. A. & Grattan, D. R. Hormone interactions regulating energy balance during pregnancy. J. Neuroendocrinol. 22, 805\u2013817 (2010).","journal-title":"J. Neuroendocrinol."},{"key":"11976_CR27","doi-asserted-by":"publisher","first-page":"490","DOI":"10.1111\/j.1552-6909.2007.00179.x","volume":"36","author":"LO Walker","year":"2007","unstructured":"Walker, L. O. Managing excessive weight gain during pregnancy and the postpartum period. J. Obstet Gynecol. Neonatal Nurs 36, 490\u2013500 (2007).","journal-title":"J. Obstet Gynecol. Neonatal Nurs"},{"key":"11976_CR28","doi-asserted-by":"publisher","first-page":"e13679","DOI":"10.1111\/obr.13679","volume":"25","author":"D Meyer","year":"2024","unstructured":"Meyer, D., Gjika, E., Raab, R., Michel, S. K. F. & Hauner, H. How does gestational weight gain influence short- and long-term postpartum weight retention? An updated systematic review and meta-analysis. Obes Rev. 25, e13679 (2024).","journal-title":"Obes Rev."},{"key":"11976_CR29","doi-asserted-by":"publisher","first-page":"e75679","DOI":"10.1371\/journal.pone.0075679","volume":"8","author":"A Al Mamun","year":"2013","unstructured":"Al Mamun, A. et al. Association between gestational weight gain and postpartum diabetes: evidence from a community based large cohort study. PLoS ONE 8, e75679 (2013).","journal-title":"PLoS ONE"},{"key":"11976_CR30","doi-asserted-by":"publisher","first-page":"1218","DOI":"10.3945\/ajcn.112.055772","volume":"98","author":"CK McClure","year":"2013","unstructured":"McClure, C. K., Catov, J. M., Ness, R. & Bodnar, L. M. Associations between gestational weight gain and BMI, abdominal adiposity, and traditional measures of cardiometabolic risk in mothers 8 y postpartum. Am. J. Clin. Nutr. 98, 1218\u20131225 (2013).","journal-title":"Am. J. Clin. Nutr."},{"issue":"499","key":"11976_CR31","first-page":"e491","volume":"212","author":"JR Walter","year":"2015","unstructured":"Walter, J. R. et al. Associations of trimester-specific gestational weight gain with maternal adiposity and systolic blood pressure at 3 and 7 years postpartum. Am. J. Obstet. Gynecol. 212(499), e491\u2013e412 (2015).","journal-title":"Am. J. Obstet. Gynecol."},{"key":"11976_CR32","doi-asserted-by":"publisher","first-page":"755","DOI":"10.1111\/obr.12538","volume":"18","author":"B Hill","year":"2017","unstructured":"Hill, B. et al. Is parity a risk factor for excessive weight gain during pregnancy and postpartum weight retention? A systematic review and meta-analysis. Obes Rev. 18, 755\u2013764 (2017).","journal-title":"Obes Rev."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-11976-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-11976-x","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-11976-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,7]],"date-time":"2025-09-07T21:41:14Z","timestamp":1757281274000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-11976-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,24]]},"references-count":32,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["11976"],"URL":"https:\/\/doi.org\/10.1038\/s41598-025-11976-x","relation":{},"ISSN":["2045-2322"],"issn-type":[{"type":"electronic","value":"2045-2322"}],"subject":[],"published":{"date-parts":[[2025,7,24]]},"assertion":[{"value":"14 March 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 July 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 July 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"26972"}}