The aim of this study was to examine the relationship between deep squatting or ROM of lower limbs, and physical function in typically developing children. 337 elementary school students were recruited for this study. The subjects were performed to squat with their heels down and then were divided into 2 groups: possible squatting and impossible squatting. ROM of lower limbs (hip flexion, knee flexion, and ankle dorsiflexion), circumference of leg, standing long jump, the five-repetition sit-to stand test (FTSST) and a standing test were analyzed. Unpaired t-test or Mann-Whitney U test was used for the two-group comparison. Logistic regression analysis was used to determine variables associated with squatting, and multiple regression analysis was used to determine variables associated with physical function. The rate of impossible squatting was 11.9%. The ROM of the lower limbs was significantly decreased in the impossible group. Multiple regression analysis showed that the ankle dorsiflexion ROM and BMI were correlated with squatting. In physical function, the FTSST and standing test were correlated with squatting. However, in the multiple regression analysis squatting did not significantly affect physical function. In this study, ROM of the ankle dorsiflexion and BMI affected the squatting. It was suggested that the squatting might be useful as a screening for ankle dorsiflexion ROM.

Background/Aims: Metabolic dysfunction-associated steatotic liver disease (MASLD) was recently proposed as an alternative disease concept to nonalcoholic fatty liver disease (NAFLD). We aimed to investigate the prognosis of patients with biopsy-confirmed MASLD using data from a multicenter study. Methods: This was a sub-analysis of the Clinical Outcome Nonalcoholic Fatty Liver Disease (CLIONE) study that included 1,398 patients with NAFLD. Liver biopsy specimens were pathologically diagnosed and histologically scored using the NASH Clinical Research Network system, the FLIP algorithm, and the SAF score. Patients who met at least one cardiometabolic criterion were diagnosed with MASLD. Results: Approximately 99% of cases (n=1,381) were classified as MASLD. Patients with no cardiometabolic risk (n=17) had a significantly lower BMI than patients with MASLD (20.9 kg/m2 vs. 28.0 kg/m2, P<0.001), in addition to significantly lower levels of inflammation, ballooning, NAFLD activity score, and fibrosis stage based on liver histology. These 17 patients had a median follow-up of 5.9 years, equivalent to 115 person-years, with no deaths, liver-related events, cardiovascular events, or extrahepatic cancers. The results showed that the prognosis for pure MASLD was similar to that for the original CLIONE cohort, with 47 deaths and one patient who underwent orthotopic liver transplantation. The leading cause of death was extrahepatic cancer (n=10), while the leading causes of liver-related death were liver failure (n=9), hepatocellular carcinoma (n=8), and cholangiocarcinoma (n=4). Conclusions Approximately 99% of NAFLD cases were considered MASLD based on the 2023 liver disease nomenclature. The NAFLD-only group, which is not encompassed by MASLD, had a relatively mild histopathologic severity and a favorable prognosis. Consequently, the prognosis of MASLD is similar to that previously reported for NAFLD.