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. 2021 Oct 27;20(1):145.
doi: 10.1186/s12944-021-01568-9.

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

Jinwei Cai #  1   2   3 , Cuiting Lin #  4   5 , Shuiqing Lai  2 , Yingshan Liu  1   2 , Min Liang  3 , Yingfen Qin  3 , Xinghuan Liang  3 , Aihua Tan  6 , Yong Gao  6 , Zheng Lu  6 , Chunlei Wu  6 , Shengzhu Huang  1   5   7 , Xiaobo Yang  6 , Haiying Zhang  6 , Jian Kuang  8   9 , Zengnan Mo  6   7   10   11
Affiliations
Free PMC article

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

Jinwei Cai et al. Lipids Health Dis. .
Free PMC article

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.

Keywords: Abdominal volume index; Anthropometric indicator; Lipid accumulation product; Metabolic-dysfunction associated fatty liver disease; Non-alcoholic fatty liver disease; Visceral fat; Waist-to-height ratio.

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Conflict of interest statement

The authors have declared no potential conflicts of interest exist.

Figures

Fig. 1
Fig. 1
Flowchart of the study participants and exclusions
Fig. 2
Fig. 2
ROC-curves of different adipose tissue accumulation indicators and HOMA-index associate with MAFLD. Abbreviations: MAFLD: Metabolic-dysfunction associated fatty liver disease; BMI: Body; mass index; WHtR: Waist to height ratio; WHR: Waist to hip ratio; BAI: Body adiposity; index; CMI: Cardiometabolic index; LAP: Lipid accumulation product; VAI: Visceral; adiposity index; AVI: Abdominal volume index; HOMA: Homeostatic model assessment; IR: Insulin resistance
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