Abstract
BackgroundNon-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.MethodsThe 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.ResultsAll 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.ConclusionAll 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.
Highlights
Non-alcoholic fatty liver disease (NAFLD) has been entitled as metabolic-dysfunction associated fatty liver disease (MAFLD)
All selected anthropometric indicators were significantly associated with MAFLD (P < 0.001), with an Area under the ROC curves (AUC) above 0.79
waist-to-height ratio (WHtR) was identified as the strongest predictor of MAFLD in young Chinese males, followed by lipid accumulation product (LAP) and abdominal volume index (AVI)
Summary
Non-alcoholic fatty liver disease (NAFLD) has been entitled as metabolic-dysfunction associated fatty liver disease (MAFLD). Anthropometric indicators of adiposity may provide a non-invasive predictive and diagnostic tool for this disease. Non-alcoholic fatty liver disease (NAFLD) is highly prevalent and affects at least a quarter of the worldwide population [1, 2]. Visceral fat accumulation has been reported as a major predictor and risk factor of NAFLD and linked with disease severity, in patients on an excessively high-calorie diet [6,7,8]. Visceral adipose tissue may trigger lipotoxicity, severe insulin resistance (IR) and promote the release of proinflammatory and profibrogenic mediators. These factors eventually activate de novo hepatic lipogenesis, further exacerbating NAFLD [8, 9]
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