Body Roundness Index and Waist-to-Height Ratio are Strongly Associated With Non-Alcoholic Fatty Liver Disease: A Population-Based Study

Abstract

BackgroundA strong association between obesity and non-alcoholic fatty liver disease (NAFLD) has been reported.ObjectivesThis study was conducted to evaluate if new obesity indices, including a body shape index (ABSI) and body roundness index (BRI), have stronger associations with NAFLD than waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR).MethodsIn this cross-sectional study, we utilized the data of 4,872 participants aged 18 - 74 years from a cohort study conducted among 6,143 subjects in northern Iran. Logistic regression analysis was performed on NAFLD as the outcome and obesity measures (based on Z-score values) as potential predictors. Receiver operating characteristic (ROC) analyses were conducted, in which NAFLD was considered as a reference variable and obesity measures as classification variables. The discriminatory ability of the obesity measures was reported based on area-under-the-curves, and the related cut-off points of BRI and WHtR were determined using the Youden index (YI).ResultsBased on our results, BRI (OR = 5.484 for men and OR = 3.482 for women) and WHtR (OR = 5.309 for men and OR = 3.854 for women) showed a higher association with NAFLD than ABSI (OR = 1.363 for men and OR = 1.003 for women) and WHR (OR = 3.123 for men and OR = 1.628 for women). The optimal cut-off points for BRI were 4.00 (sensitivity = 82.7%, specificity = 70.8%) for men and 5.00 (sensitivity = 83.3%, specificity = 71.7%) for women. The optimal cut-off points for WHtR were 0.533 (sensitivity = 82.7%, specificity = 70.8%) for men and 0.580 (sensitivity = 83.3%, specificity = 71.7%) for women.ConclusionsWhile BRI and WHtR have equally strong associations with NAFLD, ABSI and WHR have weaker associations with NAFLD than BRI and WHtR.

Height predict incident non-alcoholic fatty liver disease among general adult population in Tianjin, China, independent of body mass index, waist circumference, waist-to-height ratio, and metabolic syndrome

“…In addition, WC was reported to predict NAFLD with a similar performance with fatty liver index (36). A populationbased study also pointed out that body roundness index and waist-to-height ratio were strongly associated with NAFLD (28). Results in our current study indicated a substantial inverse association between height and NAFLD risk, regardless of BMI, waist circumference and waist-to-height ratio.…”

Height predict incident non-alcoholic fatty liver disease among general adult population in Tianjin, China, independent of body mass index, waist circumference, waist-to-height ratio, and metabolic syndrome

“…In addition, WC was reported to predict NAFLD with a similar performance with fatty liver index [36]. A population-based study also pointed out that body roundness index and waist-to-height ratio were strongly associated with NAFLD [28]. Results in our current study indicated a substantial inverse association between height and NAFLD risk, regardless of BMI, waist circumference and waist-to-height ratio.…”

“…This adjustment made the association less obvious in both males and females, suggesting that BMI play an important role in association between height and NAFLD. In addition, because waist-to-height ratio has been reported to have a strong association with NAFLD [28], we further adjusted waist-to-height ratio in model 5. The enhanced associations indicated the confounding effect of waist-to-height ratio.…”

The role of anthropometric indices in the prediction of non-alcoholic fatty liver disease in the PERSIAN Guilan Cohort study (PGCS)

“…Taller people, unlike obese people, might have a lower risk for cardiometabolic diseases [ 48 ]. Many studies revealed that there is a strong relationship between NAFLD and WHtR, and referred to WHtR as a useful parameter in predicting NAFLD [ 47 , 49 , 50 ].…”