Association between weight-adjusted-waist index with hepatic steatosis and liver fibrosis: a nationally representative cross-sectional study from NHANES 2017 to 2020

Front Endocrinol (Lausanne). 2023 May 19:14:1159055. doi: 10.3389/fendo.2023.1159055. eCollection 2023.

Abstract

Background: The negative effects of obesity on hepatic steatosis and fibrosis have received considerable attention in recent years. The weight-adjusted-waist index (WWI) reflects weight-independent centripetal obesity. Herein, we provide the first investigation of a link between WWI, hepatic steatosis, and liver fibrosis.

Methods: We used data from the National Health and Nutrition Examination Survey 2017-2020 to conduct a cross-sectional study. The linear relationship between WWI, controlled attenuation parameters, and liver stiffness measurements (LSM) was investigated using multivariate linear regression models. The nonlinear relationship was described using fitted smoothed curves and threshold effect analyses. Subgroup analyses were performed based on gender, age, body mass index, diabetes, hypertension, drinking, and smoking.

Results: This population-based study included 7,594 people, 50.74% of whom were men and 49.26% of whom were women. Multivariate linear regression analysis revealed a significant positive relationship between WWI and hepatic steatosis [CAP, β=7.60, 95% confidence interval (CI) (4.42, 10.78), P<0.0001]. This positive association was stronger when excessive alcohol intake was present compared to when it was absent (P for interaction = 0.031), and when hypertension was present compared to when it was not (P for interaction = 0.014). The linear relationship between WWI and liver fibrosis was not statistically significant on multiple regression analysis [LSM, β=0.03, 95% CI (-0.26, 0.32), P=0.84]. However, a U-shaped association was seen between WWI and LSM, with a negative correlation when WWI< 10.92 and a positive correlation when WWI > 10.92.

Conclusion: We report a strong association between WWI and hepatic steatosis, and suggest that it may potentially be used as a simple anthropometric index to predict hepatic steatosis.

Keywords: NAFLD; NHANES; VCTE; WWI; and fibrosis weight-adjusted-waist index; hepatic steatosis; liver fibrosis; steatosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cross-Sectional Studies
  • Elasticity Imaging Techniques*
  • Fatty Liver* / diagnosis
  • Fatty Liver* / epidemiology
  • Female
  • Humans
  • Hypertension*
  • Liver Cirrhosis / diagnosis
  • Liver Cirrhosis / epidemiology
  • Liver Cirrhosis / etiology
  • Male
  • Nutrition Surveys
  • Obesity
  • Prospective Studies

Grants and funding

This work was supported by the Key Research and Development Projects in Shanxi Province (201903D321032) and the Scientific Research Project of Shanxi Provincial Health Commission (2019142). The study was funded by the Four “Batches” Innovation Project of Invigorating Medical through Science and Technology of Shanxi Province (Key Laboratory of Esophageal Cancer Basic Research and Clinical Transformation, Heping Hospital Affiliated to Changzhi Medical College, 2020SYS22).