{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T05:56:25Z","timestamp":1781762185226,"version":"3.54.5"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:00:00Z","timestamp":1781740800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Rural communities in Southwest China are undergoing rapid nutrition and lifestyle transitions, with sustained positive energy balance and long-term weight gain. These settings are often ethnic minority-dominant and characterized by higher habitual alcohol consumption than most other Chinese populations. Evidence on how life-course adiposity relates to metabolic liver fat burden in such a rural community with varying alcohol drinking frequency remains limited. We examined associations of current BMI, life-course BMI trajectories, and long-term BMI change with controlled attenuation parameter (CAP)-defined hepatic steatosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort analysis embedded within a routine health examination program in Ning\u2019er County, Yunnan Province, China. Adults who underwent an index examination including vibration-controlled transient elastography (VCTE) were included. Hepatic steatosis and severe steatosis were defined as CAP \u2265238 and \u2265292\u202fdB\/m, respectively. Body weight and height at ages 18, 30 and 40\u202fyears were extracted from prior health examination records, and BMI at each time point was calculated and categorized using Chinese cut-offs to construct life-course trajectory patterns. Multivariable logistic regression estimated odds ratios (ORs) for CAP-defined outcomes adjusting for age, sex, ethnicity, smoking, and past-year alcohol drinking frequency, with further adjustment for waist circumference and metabolic and liver biomarkers. Restricted cubic splines evaluated dose\u2013response associations between long-term BMI change (\u0394BMI from age 18 to the index examination) and steatosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 956 adults (predominantly ethnic minorities), the prevalence of CAP-defined steatosis and severe steatosis was 52.9 and 18.2%, respectively. Higher current BMI and weight-gain or persistent-obesity trajectory patterns were associated with greater odds of steatosis and severe steatosis. After additional adjustment, BMI\u202f\u2265\u202f28.0\u202fkg\/m\n                      <jats:sup>2<\/jats:sup>\n                      remained independently associated with steatosis (OR 2.08; 95% CI 1.05\u20134.14), whereas associations with severe steatosis were attenuated. Long-term BMI gain was monotonically associated with steatosis, with the OR becoming statistically significant at \u0394BMI 6.64\u202fkg\/m\n                      <jats:sup>2<\/jats:sup>\n                      . Alcohol drinking frequency showed no strong independent association with CAP-defined outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this ethnic minority-dominant rural population with relatively frequent self-reported alcohol use, sustained weight gain across adulthood and adverse life-course BMI trajectories were associated with a higher burden of CAP-defined hepatic steatosis and severe steatosis. These findings support the importance of life-course weight maintenance for reducing liver fat accumulation in rural community settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1824255","type":"journal-article","created":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T05:36:23Z","timestamp":1781760983000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Life-course BMI trajectories and long-term weight gain in relation to hepatic steatosis in a rural community-based cohort in Southwest China"],"prefix":"10.3389","volume":"14","author":[{"given":"Xian","family":"Cui","sequence":"first","affiliation":[{"name":"Diagnostic Imaging Center, Shanghai Children\u2019s Medical Center, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]},{"name":"Department of Ultrasound Medicine, Ning\u2019er County People\u2019s Hospital, Ning\u2019er Hani and Yi Autonomous County","place":["Puer, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinjie","family":"Xu","sequence":"additional","affiliation":[{"name":"Yantai Center for Disease Control and Prevention","place":["Yantai, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Medicine, Ning\u2019er County People\u2019s Hospital, Ning\u2019er Hani and Yi Autonomous County","place":["Puer, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lanfang","family":"Xia","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Medicine, Ning\u2019er County People\u2019s Hospital, Ning\u2019er Hani and Yi Autonomous County","place":["Puer, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Medicine, Ning\u2019er County People\u2019s Hospital, Ning\u2019er Hani and Yi Autonomous County","place":["Puer, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liying","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Medicine, Ning\u2019er County People\u2019s Hospital, Ning\u2019er Hani and Yi Autonomous County","place":["Puer, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simei","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Medicine, Ning\u2019er County People\u2019s Hospital, Ning\u2019er Hani and Yi Autonomous County","place":["Puer, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deli","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Medicine, Ning\u2019er County People\u2019s Hospital, Ning\u2019er Hani and Yi Autonomous County","place":["Puer, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiuyan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Medicine, Ning\u2019er County People\u2019s Hospital, Ning\u2019er Hani and Yi Autonomous County","place":["Puer, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shan","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Medicine, Ning\u2019er County People\u2019s Hospital, Ning\u2019er Hani and Yi Autonomous County","place":["Puer, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiuyu","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Medicine, Ning\u2019er County People\u2019s Hospital, Ning\u2019er Hani and Yi Autonomous County","place":["Puer, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yao","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Medicine, Ning\u2019er County People\u2019s Hospital, Ning\u2019er Hani and Yi Autonomous County","place":["Puer, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Medicine, Ning\u2019er County People\u2019s Hospital, Ning\u2019er Hani and Yi Autonomous County","place":["Puer, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Dao","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Medicine, Ning\u2019er County People\u2019s Hospital, Ning\u2019er Hani and Yi Autonomous County","place":["Puer, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Medicine, Ning\u2019er County People\u2019s Hospital, Ning\u2019er Hani and Yi Autonomous County","place":["Puer, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiqin","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Medicine, Ning\u2019er County People\u2019s Hospital, Ning\u2019er Hani and Yi Autonomous County","place":["Puer, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Shi","sequence":"additional","affiliation":[{"name":"Diagnostic Imaging Center, Shanghai Children\u2019s Medical Center, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunbei","family":"Yi","sequence":"additional","affiliation":[{"name":"Diagnostic Imaging Center, Shanghai Children\u2019s Medical Center, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Wang","sequence":"additional","affiliation":[{"name":"Diagnostic Imaging Center, Shanghai Children\u2019s Medical Center, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Du","sequence":"additional","affiliation":[{"name":"Diagnostic Imaging Center, Shanghai Children\u2019s Medical Center, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, 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