Causal effect of lower birthweight on nonalcoholic fatty liver disease and mediating roles of insulin resistance and metabolites.

This MR study elucidated the causal impact of lower birthweight on subsequent risk of NAFLD, independently of later life adiposity, and identified mediators including insulin resistance, branched-chain amino acids, alanine, and MUFA in this association pathway. Our findings shed light on the pathogenesis of NAFLD and imply additional targets for prevention and intervention of NAFLD attributed to low birthweight.