Associations of fluid intake patterns, hydration status, and metabolic dysfunction-associated steatotic liver disease (MASLD): a cross-sectional study in older adults.

Authors

Guotian Lin, Yingzi Liang, Qi Wang, Miaomiao Cui, Qingqing Wang, Lingyun Qu

Published in

Scientific reports. Volume 16. Issue 1. Aug 08, 2026. Epub Aug 08, 2026.

Abstract

This study examined associations between fluid intake characteristics, consumption patterns, hydration status, and MASLD among community-dwelling older adults, exploring whether hydration status shows statistical associations consistent with an indirect pathway in cross-sectional analyses. This cross-sectional study enrolled 876 community-dwelling adults aged ≥ 65 years recruited from community health centers. Fluid intake was assessed using 3-day beverage records, including two weekdays and one weekend day. First-morning urine osmolality was used as the overnight hydration indicator. MASLD was diagnosed based on ultrasound-detected hepatic steatosis and metabolic dysfunction criteria. Principal component analysis (PCA) was used to identify beverage patterns. Bootstrap-based exploratory analyses with 5000 resamples were performed as secondary descriptive decompositions to examine whether first-morning urine osmolality showed statistical associations consistent with an indirect association in cross-sectional data. These analyses are descriptive and hypothesis-generating only, and do not imply causality or temporal ordering. Mean total fluid intake was 1385 ± 355 mL/day, with plain water comprising 85.2% (1180 ± 285 mL/day) of consumption. Overall MASLD prevalence was 36.1% (316/876). In the fully adjusted model (adjusted for age, sex, education, physical activity, total energy intake, smoking, DII, red meat, vegetables, whole grains, fruit, season, and diuretic use), lower fluid intake (< 1500 mL/day) was associated with higher odds of MASLD (OR 2.31, 95% CI 1.74-3.08, P < 0.001), and dehydration (urine osmolality > 800 mOsm/kg) was also associated with higher odds (OR 2.55, 95% CI 1.89-3.43, P < 0.001). PCA identified three beverage patterns that cumulatively explained 49.9% of the total variance. In fully adjusted models, the Sweet Beverage Preference pattern was positively associated with MASLD (OR 2.00, 95% CI 1.52-2.63, P < 0.001); after additional adjustment for total added sugar intake, this OR attenuated to 1.76 (95% CI 1.31-2.36). The Basic Hydration pattern was inversely associated with MASLD (OR 0.67, 95% CI 0.51-0.89, P = 0.005). The Basic Hydration pattern was inversely associated with MASLD (OR 0.67, 95% CI 0.51-0.89, P = 0.005). The fully adjusted model showed good calibration (Hosmer-Lemeshow P = 0.420) and acceptable discrimination (AUC = 0.782). The Sweet Beverage Preference pattern should be interpreted primarily as a marker of broader unhealthy dietary behavior and cardiometabolic risk rather than as evidence that minimal SSB intake directly increases MASLD risk. In older adults with plain water-dominant reported beverage intake, lower reported beverage intake, higher first-morning urine osmolality, and a Sweet Beverage Preference pattern were associated with MASLD. The Sweet Beverage Preference pattern should be interpreted primarily as a marker of broader dietary and metabolic risk rather than as a beverage-specific risk signal. These findings should be interpreted as exploratory cross-sectional associations and may reflect broader cardiometabolic and dietary-pattern differences rather than direct causal effects.

PMID:
42686897
Bibliographic data and abstract were imported from PubMed on 03 Sep 2026.

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