Waist-to-height ratio, an optimal anthropometric indicator for metabolic dysfunction associated fatty liver disease in the Western Chinese male population

Abstract

Background Non-alcoholic fatty liver disease (NAFLD) has been entitled as metabolic-dysfunction associated fatty liver disease (MAFLD). Therefore anthropometric indicators of adiposity may provide a non-invasive predictive and diagnostic tool for this disease. This study intended to validate and compare the MAFLD predictive and diagnostic capability of eight anthropometric indicators. Methods The study involved a population-based retrospective cross-sectional design. The Fangchenggang area male health and examination survey (FAMHES) was used to collect data of eight anthropometric indicators, involving body mass index (BMI), waist-to-height ratio (WHtR), waist-hip ratio (WHR), body adiposity index (BAI), cardiometabolic index (CMI), lipid accumulation product (LAP), visceral adiposity index (VAI), and abdominal volume index (AVI). Receiver operating characteristics (ROC) curves and the respective areas under the curves (AUCs) were utilized to compare the diagnostic capacity of each indicator for MAFLD and to determine the optimal cutoff points. Binary logistic regression analysis was applied to identify the odds ratios (OR) with 95% confidence intervals (95% CI) for all anthropometric indicators and MAFLD. The Spearman rank correlation coefficients of anthropometric indicators, sex hormones, and MAFLD were also calculated. Results All selected anthropometric indicators were significantly associated with MAFLD (P < 0.001), with an AUC above 0.79. LAP had the highest AUC [0.868 (95% CI, 0.853–0.883)], followed by WHtR [0.863 (95% CI, 0.848–0.879)] and AVI [0.859 (95% CI, 0.843–0.874)]. The cutoff values for WHtR, LAP and AVI were 0.49, 24.29, and 13.61, respectively. WHtR [OR 22.181 (95% CI, 16.216–30.340)] had the strongest association with MAFLD, regardless of potential confounders. Among all the anthropometric indicators, the strongest association was seen between LAP and sex hormones. Conclusion All anthropometric indicators were associated with MAFLD. WHtR was identified as the strongest predictor of MAFLD in young Chinese males, followed by LAP and AVI. The strongest association was found between LAP and sex hormones.

Chinese Visceral Adipose Index Shows Superior Diagnostic Performance in Predicting the Risk of Metabolic Dysfunction Associated Fatty Liver Disease in Early Postmenopausal Chinese Women

“…31 Additionally, studies also indicated that WHR and WHtR had been suggested as most useful predictor of MAFLD only in relatively young Chinese males; Furthermore, BAI represents the overall adipose accumulation and does not reflect the characteristics of abdominal fat accumulation. Although previous studies demonstrated the relative association of BMI and BAI with fatty liver disease, 30 the diagnostic performance of both BMI and BAI was inferior compared to the other visceral obesity indices in the early postmenopausal women. Furthermore, characteristics such as sex, age or ethnicity can influence the prediction of MAFLD.…”

“…Moreover, the AUC of BMI in subgroup analysis was greater than 0.8, and represented its good predictive performance in most populations. 30 However, previous study had not explored its predictive value of MAFLD among early postmenopausal women, and BMI may not reflect the abdominal adipose tissue accumulation among women after menopause. Besides, the validity of BMI as a valuable indicator of regional adipose distribution remains controversial because of its inability to distinguish between fat mass and lean body mass.…”

Association between Chinese visceral adiposity index and metabolic-associated fatty liver disease in Chinese adults with type 2 diabetes mellitus

“…The accumulation of visceral fat was regarded as a key risk factor and predictor of NAFLD ( 33 , 34 ). Excessive visceral adipose tissue may result in lipotoxicity, insulin resistance and the increase of pro-inflammatory mediators ( 35 ). An increase in interleukin-6, C-reactive protein, interleukin-1β, and tumor necrosis factor-α was found in the population of MAFLD ( 36 ).…”

Cardiometabolic index: A new predictor for metabolic associated fatty liver disease in Chinese adults

“…Among them, the TG/HDL-C was confirmed as the predictor of nonalcoholic fatty liver disease, and it can identify insulin resistance, abdominal obesity, metabolic disorders, and cardiometabolic risk (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25). The WHtR was identified as an optimal anthropometric indicator for MAFLD in the Western Chinese male population (17).…”

“…Studies found that MAFLD was closely related to body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), aminotransferase, fatty acid, serum levels of triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and the ratio of TG and HDL-C (TG/HDL-C) (17)(18)(19)(20). Among them, the TG/HDL-C was confirmed as the predictor of nonalcoholic fatty liver disease, and it can identify insulin resistance, abdominal obesity, metabolic disorders, and cardiometabolic risk (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25). The WHtR was identified as an optimal anthropometric indicator for MAFLD in the Western Chinese male population (17).…”