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Purpose <p>Hydration status is linked to metabolic syndrome, hypertension, and obesity in adults, and dehydration is associated with metabolic dysfunction-associated steatotic liver disease (MASLD) in children. However, the relationship between serum osmolality (OSM) and MASLD odds in adults remains unclear.</p> Methods <p>This cross-sectional study analyzed NHANES data (2017–March 2020). MASLD was defined as hepatic steatosis (controlled attenuation parameter &gt;248 dB/m) plus at least one metabolic risk factor. Serum OSM was calculated using the ESPEN-recommended equation. Restricted cubic spline (RCS) and weighted logistic regression analyses were performed, adjusting for age, sex, poverty-income ratio (PIR), race, smoking, drinking, energy intake, and physical activity. Subgroup analyses were conducted to enhance the robustness of the results.</p> Results <p>Among 3,799 participants, higher serum OSM (Q4 vs. Q1) was associated with increased odds of MASLD in unadjusted (OR=2.02, 95% CI 1.29–3.16), partially adjusted (OR=1.64, 95% CI 1.08–2.49), and fully adjusted models (OR=1.60, 95% CI 1.02–2.50). RCS analysis revealed a positive linear correlation (<i>P</i><sub>nonlinear</sub>=0.844). A significant interaction between PIR and OSM was observed (<i>P</i><sub>interaction</sub>=0.019).</p> Conclusion <p>Serum OSM is positively and linearly associated with MASLD odds in US adults. Measuring OSM may help identify high-risk groups, enabling early intervention and informing public health strategies.</p>

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Association of serum osmolality with metabolic dysfunction-associated steatotic liver disease in adults

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月6日

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  • Liping Peng,
  • Minghua Ai

摘要

Purpose

Hydration status is linked to metabolic syndrome, hypertension, and obesity in adults, and dehydration is associated with metabolic dysfunction-associated steatotic liver disease (MASLD) in children. However, the relationship between serum osmolality (OSM) and MASLD odds in adults remains unclear.

Methods

This cross-sectional study analyzed NHANES data (2017–March 2020). MASLD was defined as hepatic steatosis (controlled attenuation parameter >248 dB/m) plus at least one metabolic risk factor. Serum OSM was calculated using the ESPEN-recommended equation. Restricted cubic spline (RCS) and weighted logistic regression analyses were performed, adjusting for age, sex, poverty-income ratio (PIR), race, smoking, drinking, energy intake, and physical activity. Subgroup analyses were conducted to enhance the robustness of the results.

Results

Among 3,799 participants, higher serum OSM (Q4 vs. Q1) was associated with increased odds of MASLD in unadjusted (OR=2.02, 95% CI 1.29–3.16), partially adjusted (OR=1.64, 95% CI 1.08–2.49), and fully adjusted models (OR=1.60, 95% CI 1.02–2.50). RCS analysis revealed a positive linear correlation (Pnonlinear=0.844). A significant interaction between PIR and OSM was observed (Pinteraction=0.019).

Conclusion

Serum OSM is positively and linearly associated with MASLD odds in US adults. Measuring OSM may help identify high-risk groups, enabling early intervention and informing public health strategies.