What this means
Metabolic dysfunction-associated steatotic liver disease (MASLD) is closely linked to metabolic dysfunction. Lactate and the glucose-lactate index may reflect systemic glucose-lactate metabolic dysregulation, but their associations with MASLD and the potential mediating role of accelerated biological aging remain unclear.
A plain-English summary is on its way. Until then, this is the start of the authors' own summary.
- Who it was tested in
- People
- Kind of research
- A study
The science
- Original title
- Accelerated biological aging mediates the associations of plasma lactate and the glucose-lactate index with MASLD: a prospective cohort study.
- Authors
- Pu X, Bai B, Yu J et al.
- Journal
- Clinical epigenetics
- Published
- Oct 27, 2026
- Study type
- Study · in humans
- PMID
- 42934809 ↗
Abstract
Background
Metabolic dysfunction-associated steatotic liver disease (MASLD) is closely linked to metabolic dysfunction. Lactate and the glucose-lactate index may reflect systemic glucose-lactate metabolic dysregulation, but their associations with MASLD and the potential mediating role of accelerated biological aging remain unclear.
What they did
This cohort study included 175,612 UK Biobank participants. Plasma metabolites were quantified by nuclear magnetic resonance spectroscopy. Cox models assessed associations with incident MASLD, and mediation analyses evaluated PhenoAge acceleration (PhenoAge Accel), KDM-BA acceleration (KDM-BA Accel), and relative leukocyte telomere length (rLTL). Complementary transcriptomic analyses were conducted using GSE126848, and the co-expression of selected gene pairs was further assessed using the ChIPBase v3.0 Co-Expression tool.
What they found
Higher lactate and the glucose-lactate index were associated with increased MASLD risk (tertile 3 vs. 1 hazard ratios: 1.19 [95% CI, 1.07-1.32; P = 0.001] and 1.29 [95% CI, 1.16-1.43; P < 0.001], respectively). Both biomarkers were associated with higher PhenoAge Accel and KDM-BA Accel and lower rLTL. PhenoAge Accel mediated 32.3% and 20.8% of the respective associations, whereas KDM-BA Accel mediated 8.2% and 11.8%; rLTL mediation was not significant. Seven lactate metabolism-related genes and 20 representative aging-related genes were differentially expressed between healthy and MASLD liver tissues, and the corresponding transcriptional scores were positively correlated. Selected gene pairs also showed significant co-expression in the ChIPBase v3.0 Co-Expression analysis. Elevated lactate and the glucose-lactate index were associated with higher MASLD risk, with these associations partly mediated by accelerated biological aging. These findings provide prospective population-based and tissue-level evidence suggesting potential interrelationships among metabolic dysregulation, accelerated aging, and MASLD risk.
The authors' abstract, grouped under plain headings from its own section labels.
Pu X, Bai B, Yu J et al. Accelerated biological aging mediates the associations of plasma lactate and the glucose-lactate index with MASLD: a prospective cohort study. Clinical epigenetics. 2026. doi:10.1186/s13148-026-02219-5. PMID: 42934809. https://pubmed.ncbi.nlm.nih.gov/42934809/