Abstract
Non-alcoholic fatty liver disease (NAFLD) is a common chronic liver metabolic disease worldwide. Up to 70%–80% of patients with NAFLD were obese, especially abdominal obesity. Many indicators of abdominal obesity have been reported, including waist circumference (WC), visceral obesity index (VAI), lipid accumulation (LAP), and Chinese VAI (CVAI). However, few studies investigated the associations between these indices with NAFLD. This present study aims to explore the associations between abdominal obesity indices with NAFLD. A total of 7,238 participants were involved in the cross-sectional study, and 1,584 participants were included in the longitudinal study from Jidong communities. NAFLD was assessed by abdominal ultrasonography. The trajectory of WC, VAI, LAP, and CVAI during 2013–2016 was identified by a group-based trajectory model. The logistic regression and Cox proportional hazards models analyzed the correlations and causality between abdominal obesity indices with NAFLD. In this study, the prevalence and incidence of NAFLD are approximately 44% and 26%, respectively. In the cross-sectional study, WC, VAI, LAP, and CVAI are associated with NAFLD. After adjustment for potential confounders, the moderate-rising and high-rising groups of CVAI had the highest risk of NAFLD in longitudinal analysis (hazard ratio (HR): 3.903, 95%CI: 2.434–6.259; HR: 5.694 95%CI: 3.098–10.464, respectively). Receiving operating characteristic curves show that CVAI has the best diagnostic value for NAFLD (area under the curve (AUC) = 0.868). CVAI is independently associated with the risk of NAFLD and may also have an important value to the diagnosis of NAFLD.
Highlights
Obesity is a significant public health issue associated with increased morbidity and disease burden worldwide
We aimed to investigate the relationships between abdominal obesity indices, including waist circumference (WC), visceral obesity index (VAI), LAP, and Chinese VAI (CVAI), with the prevalence of Non-alcoholic fatty liver disease (NAFLD)
We identified that CVAI had the strongest associations with the incidence of NAFLD among these abdominal obesity indices in the longitudinal study, and all the associations were independent of BMI
Summary
Obesity is a significant public health issue associated with increased morbidity and disease burden worldwide. In 2016, over 1.9 billion people worldwide were overweight, and over 650 million were obese [1]. Obesity is becoming increasingly prevalent with multiple adverse consequences. Obesity is linked to many metabolic diseases and is correlated with non-alcoholic fatty liver disease (NAFLD) in some epidemiological studies [2, 3]. The national prevalence of NAFLD was estimated to be 29.2% in China, which has imposed substantial health and economic burden on patients and society [4]. NAFLD is a common chronic liver metabolic disease characterized by excessive fat accumulation in the liver, which affects over 30% of the adult and 70%–80% of the obese population [5]. The clinical–histologic phenotype of NAFLD ranges from fatty liver to non-alcoholic steatohepatitis (NASH) to cirrhosis [6]
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