Waist-to-Height Ratio, An Optimal Anthropometric Indicator in Prediction of Metabolic Dysfunction Associated Fatty Liver Disease: Results From A Chinese Male Population Survey

Abstract BackgroundLimited available evidence implicated that the anthropometric indicators of adiposity may contribute to the predictive and diagnosis capability of non-alcoholic fatty liver disease (NAFLD) in a facile, low-cost and noninvasive way while NAFLD had been entitled as metabolic-dysfunction associated fatty liver disease (MAFLD) in 2020. This study aimed to validate and compare the predictive and diagnostic capability of eight anthropometric indicators in MAFLD individuals and determined an optimal diagnostic predictor for MAFLD, which may beneficial for resource scarce regions.MethodsThe retrospective cross-sectional population-based study conducted from Fangchenggang Area Male Health and Examination Survey (FAMHES) involved 2428 participants whose comprehensive questionnaire, detailed data, anthropometric parameters and biochemical measurements were collected. Eight anthropometric indicators including 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) were enrolled into analyzed. Receiver operating characteristic (ROC) curve analysis and the area under the ROC curves (AUCs) were used to compare the diagnostic ability of each indicator for MAFLD and optimal cut-off points fully determined. Binary logistic regression analysis was used to explore associations of all anthropometric indicators and MAFLD by determined the odds ratios (ORs) and 95% confidence interval (CI).ResultsAll selected anthropometric indicators were substantially associated with MAFLD (p < 0.001) and their diagnostic value of MAFLD by AUCs fully above 0.79. WHtR [OR 22.181(95%CI, 16.216–30.340)] had the strongest association with MAFLD, regardless of potential confounders. LAP had the largest AUC [0.868(95%CI 0.853–0.883)], intimately followed by WHtR [0.863(95%CI 0.848–0.879)]. AVI with OR 19.275(95%CI 14.266–26.041) and AUC 0.859 (95% CI 0.843–0.874) ranked second and third respectively among all indicators. The cut-off points of WHtR, LAP and AVI were 0.49, 24.29, and 13.61, separately.ConclusionAll eight anthropometric indicators illustrated the superior diagnostic value of MAFLD. Comparatively, WHtR might stressed as the most powerful diagnostic predictor for MAFLD, follow by LAP and AVI which presented highly potential as well.