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Body mass index (BMI) and waist\u2010to\u2010height ratio (WHtR) were exposures; alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma\u2010glutamyl transferase (GGT) were outcomes. Resting mean heart rate and heart rate variability (HRV) were assessed as cardiac autonomic markers. Multivariable regression and mediation analyses were performed. Supportive analyses included 21\u2009383 UK Biobank participants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Higher BMI and WHtR were associated with higher liver enzyme levels, higher resting mean heart rate and lower HRV in the clinical cohort. Resting mean heart rate was the most consistent cardiac autonomic mediator, accounting for 16.6%\u201327.5% of the associations between BMI and liver enzyme levels and 17.8%\u201336.9% of those for WHtR. HRV indices accounted for 10.1%\u201328.2% and 8.8%\u201329.9% of the corresponding associations, respectively. After inclusion of the homeostatic model assessment of insulin resistance (HOMA\u2010IR) as a parallel mediator, indirect effects through cardiac autonomic markers remained statistically significant, particularly for ALT. In UK Biobank, resting pulse rate accounted for 5.83%\u20139.47% of the associations between adiposity and liver enzyme levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Higher resting heart rate and lower HRV partly accounted for cross\u2010sectional associations between adiposity and liver enzyme levels. Cardiac autonomic markers warrant further evaluation as complementary physiological measures in studies of obesity\u2010related liver enzyme variation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.71238","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T04:23:52Z","timestamp":1787631832000},"page":"10399-10408","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cardiac Autonomic Markers Partly Account for Adiposity\u2010Related Liver Enzyme Variation in Non\u2010Diabetic Adults With Overweight or Obesity"],"prefix":"10.1111","volume":"28","author":[{"given":"Lu","family":"Gao","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Endocrine and Metabolic Disease Medical Center Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University  Nanjing China"},{"name":"Branch of National Clinical Research Centre for Metabolic 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