Abstract
BackgroundThe relationship between nonalcoholic fatty liver disease (NAFLD) and obesity-related indices has been analyzed separately thus far, and evidence comparing these indices together is still lacking, especially in China. This study aimed to comprehensively evaluate the predictive performance of anthropometric and metabolic indices to identify NAFLD in Chinese adults.MethodsThis study recruited a total of 1748 participants who were 18 years or older in southeastern China. The systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), total cholesterol (TC), triglycerides (TGs), low-density lipoprotein (LDL), waist circumference (WC), a body shape index (ABSI), atherogenic index of plasma (AIP), abdominal volume index (AVI), body adiposity index (BAI), body mass index (BMI), body roundness index (BRI), conicity index (CI), triglyceride glucose (TyG), waist hip ratio (WHR), and waist height ratio (WHtR) were measured. The association between these indices and NAFLD was analyzed via logistic analyses with odds ratios (ORs). Receiver operating characteristic (ROC) curves and areas under the curve (AUCs) were used to compare the predictive performance of these indices to identify NAFLD.ResultsBMI had the greatest total AUC (AUC = 0.841) in the ROC curve analysis. However, BRI and BMI both had the best diagnostic ability in males (AUC = 0.812), and BRI had the best diagnostic ability in females (AUC = 0.849). Furthermore, AVI had the greatest AUC for patients who were ~ 20 (AUC = 0.892) and ~ 40 years old (AUC = 0.831), while TyG showed a higher predictive ability than AVI in those who were ~ 60 years old (AUC = 0.766).ConclusionThis study identified sex- and age-specific indices for predicting NAFLD in Chinese subjects. Compared with indices for all age groups, sex- and age-specific indices can provide more accurate assistance for clinical diagnosis and treatment.
Highlights
The relationship between nonalcoholic fatty liver disease (NAFLD) and obesity-related indices has been analyzed separately far, and evidence comparing these indices together is still lacking, especially in China
This study aimed to evaluate the performance of obesity-related indices, including the systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), total cholesterol (TC), TGs, low-density lipoprotein (LDL), waist circumference (WC), body shape index (ABSI), atherogenic index of plasma (AIP), abdominal volume index (AVI), body adiposity index (BAI), body mass index (BMI), body roundness index (BRI), specificity index (CI), triglyceride glucose (TyG), waist hip ratio (WHR) and waist height ratio (WHtR), in identifying NAFLD in Chinese adults
This study revealed that BMI and BRI had a relatively high association with NAFLD and high diagnostic ability (0.812 in men and 0.849 in women) for NAFLD after considering the influence of sex
Summary
The relationship between nonalcoholic fatty liver disease (NAFLD) and obesity-related indices has been analyzed separately far, and evidence comparing these indices together is still lacking, especially in China. It is well established that nonalcoholic fatty liver disease (NAFLD) has become a major public health problem over the past few decades, with incidences of approximately 30 and 25% in Western and Asian countries, respectively. Oxidative stress and inflammation can promote NAFL D to nonalcoholic steatohepatitis (NASH) or even hepatic cirrhosis in the progression of NAFLD [8]. The pathogenesis of NAFLD is still not fully understood, obesity has been demonstrated to play a major role in most of the pathogenic pathways involved in NAFLD. An obesogenic diet is associated with hepatic oxidative stress and inflammation, which might be due to the activation of anabolic pathways and can eventually lead to abdominal obesity [9]. The intake of polyunsaturated fatty acids (n-3 polyunsaturated fatty acids) can reduce nutritional hepatic steatosis in adults, which favors fatty acid and TG production over fatty acid oxidation [10]
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