A new study revealed that the weight-adjusted waist index may demonstrate a significant positive correlation with non-alcoholic fatty liver disease in U.S. adolescents, particularly among males aged 16 and older.
In the study, published in Frontiers in Medicine, investigators analyzed data from 1,711 participants aged 12 to 19 years using the 2017 to 2020 National Health and Nutrition Examination Survey (NHANES). The investigators found that increased weight-adjusted waist index (WWI) was associated with higher non-alcoholic fatty liver disease (NAFLD) prevalence, with an adjusted odds ratio (OR) of 3.37 (95% confidence interval [CI] = 2.74–4.15).
"WWI is positively correlated with NAFLD in American adolescents and offers a straightforward and cost-effective method for identifying hepatic steatosis," the study authors wrote in their conclusion.
The investigation demonstrated a particularly strong correlation when WWI values fell below 10.65, showing an OR of 5.25 (95% CI = 3.77–7.31). This association proved more robust than traditional obesity measurements like body mass index (BMI) and waist circumference.
In the study cohort, 80.13% of the adolescents in the NAFLD group were classified as overweight or obese compared with 29.17% in the non-NAFLD group. The NAFLD group showed significantly higher mean WWI values (10.69 ± 0.77) compared with the non-NAFLD group (9.94 ± 0.70).
Subgroup analysis demonstrated that male participants aged 16 years and older showed the strongest association between WWI and NAFLD. This finding may be particularly relevant given that NAFLD is now the most prevalent chronic liver condition in pediatric and adolescent patients worldwide, with prevalence rates ranging from 5% to 11%.
The study utilized liver ultrasound transient elastography for NAFLD diagnosis, with the investigators defining hepatic steatosis as a median Controlled Attenuation Parameter of 248 dB/m or higher.
The research team, led by Xiaoling Cui from the Department of Infectious Diseases at The First Affiliated Hospital of Anhui Medical University, conducted multiple logistic regression analyses adjusting for various factors including age, race, sex, and multiple clinical parameters.
While BMI and waist circumference have traditionally been used as obesity indicators, the study suggested that WWI may offer superior predictive value for NAFLD risk in adolescents. The investigators noted that WWI, calculated by dividing the square root of body weight by waist circumference, provided a more precise measure of visceral obesity.
The investigation also revealed that participants with NAFLD demonstrated higher rates of diabetes, prediabetes, and hypertension, along with elevated levels of various clinical markers including alanine aminotransferase, gamma-glutamyl transaminase, uric acid, and triglycerides.
The World Health Organization reported that over 340 million children and teenagers aged 5 to 19 years were classified as overweight or obese in 2016.
The investigators noted study limitations including the cross-sectional design and potential limitations of ultrasound-based diagnostic methods.
The authors declared having no competing interests.
