Anthropometric clinical indicators of visceral adiposity as predictors of nonalcoholic fatty liver disease

Almeida, Naiade Silveira; Rocha, Raquel; Daltro, Carla; Souza, Claudineia Almeida de; Silva, Rafael Leiróz Pereira Duarte; Sarno, Manoel Alfredo Curvelo; Cotrim, Helma Pinchemel

doi:10.1590/1806-9282.20210316

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Revista da Associação Médica Brasileira

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Original Article • Rev. Assoc. Med. Bras. 67 (11) • Nov 2021 • https://doi.org/10.1590/1806-9282.20210316 copy

Anthropometric clinical indicators of visceral adiposity as predictors of nonalcoholic fatty liver disease

Authorship SCIMAGO INSTITUTIONS RANKINGS

SUMMARY

OBJECTIVE:

This study aims to evaluate the role of anthropometric clinical indicators of visceral adiposity as predictors of NAFLD, identifying the cutoff points based on gender.

METHODS:

This was a cross-sectional study conducted in patients with or without NAFLD. Waist circumference (WC), body mass index (BMI), waist-to-height ratio (WHtR), Conicity Index (C Index), and lipid accumulation product (LAP) were evaluated.

RESULTS:

A total of 107 individuals were evaluated, of which 46.7% were diagnosed with NAFLD. Individuals with NAFLD presented higher values of WC, BMI, C Index, LAP, and WHtR when compared with those without NAFLD (p<0.05). For the total sample, the indicators WC, BMI, WHtR, LAP, and C Index had an area under the receiver operator characteristic curve (AUC) above 0.87, with no difference in the prediction of NAFLD in both sexes. WHtR (AUC=0.934) was the indicator of visceral adiposity with the best discriminatory power for NAFLD, followed by LAP (0.919), WC (0.912), C Index (0.907), and BMI (0.877).

CONCLUSIONS:

The anthropometric clinical indicators of visceral adiposity showed high performance, especially the WHtR indicator, as NAFLD predictors.

KEYWORDS:
Anthropometry; Non-alcoholic fatty liver disease; Adiposity; Health status indicators; Abdominal fat; Adult

Variable		NAFLD (n=50)	Comparison group (n=57)	p
Sex, n (%)
	Female	34.0 (68.0)	26.0 (45.6)	0.02^* * Pearson’s chi-square test
	Male	16.0 (32.0)	31.0 (54.4)	0.02^* * Pearson’s chi-square test
	Age (years)^† † Results presented in Median and Interquartile range	48.5 (39.0–55.0)	32.0 (28.0–36.5)	<0.01^‡ ‡ Mann-Whitney test.
	WC (cm)^† † Results presented in Median and Interquartile range	97.7 (91.0–107.1)	78.0 (71.5–85.0)	<0.01^‡ ‡ Mann-Whitney test.
	BMI (kg/m²2 Moore JB. Non-alcoholic fatty liver disease: the hepatic consequence of obesity and the metabolic syndrome. Proc Nutr Soc. 2010;69(2):211-20. https://doi.org/10.1017/S0029665110000030 https://doi.org/10.1017/S002966511000003... )^† † Results presented in Median and Interquartile range	30.1 (27.1–33.8)	24.0 (22.4–26.2)	<0.01^‡ ‡ Mann-Whitney test.
	C Index^† † Results presented in Median and Interquartile range	1.2 (1.2–1.3)	1.1 (1.0–1.1)	<0.01^‡ ‡ Mann-Whitney test.
	LAP^† † Results presented in Median and Interquartile range	61.1 (40.6–85.7)	14.1 (9.2–24.2)	<0.01^‡ ‡ Mann-Whitney test.
	WHtR^† † Results presented in Median and Interquartile range	0.6 (0.5–0.6)	0.4 (0.4–0.5)	<0.01^‡ ‡ Mann-Whitney test.

Indicator		Cutoff	Youden’s Index	Sensitivity (%)	Specificity (%)	PPV	NPV	Accuracy
WC
	Sample	86.7	0.74	87	87	0.87	0.94	0.90
	Male	90.1	0.86	93	93	0.87	0.93	0.91
	Female	82.5	0.81	93	88	0.86	0.95	0.90
WHtR
	Sample	0.5	0.82	95	87	0.82	0.95	0.88
	Male	0.5	0.80	93	87	0.75	0.96	0.87
	Female	0.5	0.84	96	88	0.86	0.95	0.90
LAP
	Sample	26.7	0.83	91	82	0.89	0.81	0.84
	Male	32.7	0.80	93	87	0.81	0.82	0.82
	Female	23.3	0.77	93	84	0.92	0.80	0.86
C Index
	Sample	1.2	0.79	89	91	0.88	0.83	0.85
	Male	1.1	0.66	86	80	0.81	0.82	0.82
	Female	1.1	0.78	90	88	0.90	0.85	0.88
BMI
	Sample	26.7	0.56	78	78	0.68	0.94	0.77
	Male	27.3	0.63	80	83	0.53	1.00	0.70
	Female	25.9	0.67	87	80	0.80	0.90	0.83

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[1] *Corresponding author: naiade.silveira@hotmail.com