{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T16:21:55Z","timestamp":1792686115479,"version":"4.5.0"},"reference-count":47,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T00:00:00Z","timestamp":1757289600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T00:00:00Z","timestamp":1757289600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100002855","name":"Ministry of Science and Technology of the People's Republic of China","doi-asserted-by":"publisher","award":["2022YFC2304900"],"award-info":[{"award-number":["2022YFC2304900"]}],"id":[{"id":"10.13039\/501100002855","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002855","name":"Ministry of Science and Technology of the People's Republic of China","doi-asserted-by":"publisher","award":["2022YFC2304905"],"award-info":[{"award-number":["2022YFC2304905"]}],"id":[{"id":"10.13039\/501100002855","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Metabolic dysfunction\u2010associated steatotic liver disease (MASLD) is an emerging global health concern, and its presence increases the risk of multi\u2010system diseases. This study aimed to investigate the multimorbidity trajectories of chronic diseases in people living with MASLD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We identified 137\u2009859 MASLD patients in UK Biobank and used \u2018propensity score matching\u2019 to match an equal number of non\u2010MASLD controls. Diseases were reclassified into 472 categories based on the International Classification of Diseases, Tenth Revision (ICD\u201010) chapters. Multimorbidity trajectories post\u2010MASLD diagnosis were mapped using validated trajectory analysis. We introduced the \u2018Multimorbidity Trajectory Position Index (MTPI)\u2019 to denote a disease's position across trajectories, highlighting its temporal pattern.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participants had a median age of 59 (52\u201364) years, with 65.6% being male. Over 13\u2009years of follow\u2010up, Phenome\u2010wide association analysis (PheWAS) identified 128 diseases with elevated risks post\u2010MASLD diagnosis, with obesity (HR: 8.77, 95% CI: 8.37\u20139.18), diabetes (HR: 4.34, 95% CI: 4.15\u20134.53), and sleep disorders (HR: 3.21, 95% CI: 3.01\u20133.42) showing the strongest associations. Trajectory analysis revealed 6637 common trajectories involving 69 diseases, grouped into metabolic, inflammatory, and cardiovascular clusters. These clusters are linked to downstream conditions, with intermediary diseases such as hypertension, diabetes, and inflammatory arthritis, ultimately leading to electrolyte imbalances and sepsis. MTPI demonstrated a gradient in disease progression, with early\u2010stage conditions showing low values, mid\u2010stage conditions moderate values, and late\u2010stage conditions high values.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>People living with MASLD demonstrated multimorbidity trajectories involving co\u2010occurrence of metabolic diseases, chronic inflammation, and cardiovascular diseases. If replicated, these pathways may serve as promising targets to improve late\u2010life health in individuals with MASLD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.70095","type":"journal-article","created":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T11:06:07Z","timestamp":1757329567000},"page":"6968-6978","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Investigating multimorbidity trajectories in people living with\n                    <scp>MASLD<\/scp>\n                    diagnosis: A trajectory analysis using the\n                    <scp>UK<\/scp>\n                    Biobank"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-1194-9784","authenticated-orcid":false,"given":"Fang","family":"Lu","sequence":"first","affiliation":[{"name":"Phase I Clinical Trial Research Ward The Second Affiliated Hospital of Xi'an Jiaotong University  Xi'an Shaanxi Province People's Republic of China"},{"name":"China\u2010Australia Joint Research Center for Infectious Diseases School of Public Health, Xi'an Jiaotong University Health Science Center  Xi'an Shaanxi People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hailin","family":"Yang","sequence":"additional","affiliation":[{"name":"Phase I Clinical Trial Research Ward The Second Affiliated Hospital of Xi'an Jiaotong University  Xi'an Shaanxi Province People's Republic of China"},{"name":"China\u2010Australia Joint Research Center for Infectious Diseases School of Public Health, Xi'an Jiaotong University Health Science Center  Xi'an Shaanxi People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bingyang","family":"She","sequence":"additional","affiliation":[{"name":"Phase I Clinical Trial Research Ward The Second Affiliated Hospital of Xi'an Jiaotong University  Xi'an Shaanxi Province People's Republic of China"},{"name":"China\u2010Australia Joint Research Center for Infectious Diseases School of Public Health, Xi'an Jiaotong University Health Science Center  Xi'an Shaanxi People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qianhui","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, College of Public Health Zhengzhou University  Zhengzhou Henan People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yining","family":"Bao","sequence":"additional","affiliation":[{"name":"Phase I Clinical Trial Research Ward The Second Affiliated Hospital of Xi'an Jiaotong University  Xi'an Shaanxi Province People's Republic of China"},{"name":"China\u2010Australia Joint Research Center for Infectious Diseases School of Public Health, Xi'an Jiaotong University Health Science Center  Xi'an Shaanxi People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wai\u2010Kay","family":"Seto","sequence":"additional","affiliation":[{"name":"Department of Medicine and State Key Laboratory of Liver Research The University of Hong Kong  Pokfulam Hong Kong"},{"name":"Department of Medicine The University of Hong Kong\u2010Shenzhen Hospital  Shenzhen People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2540-4055","authenticated-orcid":false,"given":"William C. W.","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine The University of Hong Kong  Pokfulam Hong Kong"},{"name":"Department of Family Medicine and Primary Care The University of Hong Kong\u2010Shenzhen Hospital  Shenzhen People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Man\u2010Fung","family":"Yuen","sequence":"additional","affiliation":[{"name":"Department of Medicine, Queen Mary Hospital, School of Clinical Medicine, and State Key Laboratory of Liver Research The University of Hong Kong  Hong Kong People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingli","family":"He","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases The First Affiliated Hospital, Xi'an Jiaotong University School of Medicine  Xi'an Shaanxi People's Republic of 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