Waist to Height Ratio is a Better Predictor of Non-Alcoholic Fatty Liver Disease in the South Asian Population

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Introduction: Numerous obesity indices have been developed that predict non-alcoholic fatty liver disease (NAFLD). We in our study aimed at evaluating a few of these tools including waist to height ratio (WHtR), waist circumferences (WC), body mass index (BMI) and fatty liver index (FLI) and used them to determine their ability in diagnosing NAFLD.
 Methods: This cross sectional study was conducted at the outpatients’ department of our hospital. NAFLD was diagnosed on the basis of ultrasound abdomen. Anthropometric parameters like Height (in), weight(cm), WC (cm), BMI, WHtR were calculated and later the FLI (comprising of BMI,WC, triglyceride and gamma glutamyl transferase) was calculated. The Receiver operating characteristic analysis (ROC) was then conducted to determine the discriminatory ability and related cut-off points and a P value of ≤0.05 was taken as statiscally significant.
 Results: A total of 300 participants were included and the prevalence of NAFLD was 44.8% in men and 54.8% in women. Univariate analysis reported statistical significant association of NAFLD with all of the applied indices (P = 0.00). The WHtR (AUC = 0.87, 95% CI:0.77-0.97) showed slight superior ability as compared to FLI (AUC = 0.86, 95% CI:0.76-0.97) in diagnosing NAFLD. Regression analysis revealed a stronger association of WHtR (OR = 9.3, P = 0.00) with NAFLD compared to FLI (OR = 6.0, P = 0.02).
 The performance of WHtR was similar regardless of gender (AUC = 0.89) while different in FLI with a AUC of 0.88 in men and AUC of 0.85 in female.
 Conclusion: This study showed a strong association of WHtR in prediction of NAFLD and a similar discriminatory ability regardless of gender. WHtR is simple and easily performable modality for NAFLD prediction.