Waist-to-height ratio as the optimal predictor of non-alcoholic fatty liver disease among medical staff: a cross-sectional study

Abstract

This study aimed to assess the health of medical staff via body composition analysis, examine associations between anthropometric indices and NAFLD, evaluate their predictive value for NAFLD, and compare their performance in identifying NAFLD. A total of 622 medical staff in the employee physical examination in September 2021 were involved in this retrospective study. Body composition, blood parameters, and abdominal color Doppler ultrasound findings were collected. Logistic regression analyses were performed to analyze the associations between NAFLD and anthropometric indices, including body mass index (BMI), percent body fat (PBF), waist-to-hip ratio (WHR), waist circumference (WC), obesity degree (OD), visceral fat level (VFL), and waist-to-height ratio (WHtR). ROC curve analysis assessed the potential predictive value of these anthropometric indices for NAFLD as well as their optimal cut-off values. The total body score of medical staff was 71.30 ± 4.46, and the total prevalence of NAFLD was 19.5%. BMI (OR = 1.295, 95% CI: 1.074–1.563) and WHtR (OR = 2.747, 95% CI: 1.191–6.337) significantly associated with NAFLD. ROC curve analysis indicated that WHtR was a superior predictor when stratified by gender(females: AUC = 0.840; males: AUC = 0.777), while WC performed slightly better in the overall population analysis(AUC = 0.850). The optimal cut-off values of WHtR for NAFLD prediction, derived from the Youden index, were 0.496 for females and 0.508 for males. In the overall analysis, WC might be a better predictive indicator; In terms of gender grouping, the WHtR may be the best predictor of NAFLD in the medical staff. Moreover, WHtR is a cost-effective, practical, and easily accessible measurement, which holds important guiding significance for the early recognition of NAFLD. However, the cutoff values for WHtR by gender require further validation.