Association of waist-to-height ratio with nonalcoholic fatty liver disease and liver fibrosis detected by vibration-controlled transient elastography - Article overview

Sep 30, 2026

Uploaded by Mary Man

The waist-to-height ratio (WHtR) is evaluated as an obesity marker and investigated for its relationship with nonalcoholic fatty liver disease (NAFLD) and liver fibrosis. Using NHANES 2017–2020 data, analyses applied multiple linear regression and smoothed curve fitting to characterize associations. Results show a positive correlation between WHtR and hepatic and liver fat, with stronger correlations in males and non-Hispanic White participants. The findings support WHtR as an important indicator for NAFLD and liver fibrosis risk in U.S. adults.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages8

Reading Time20 min

AccessFree to download

Introduction

Association of NAFLD with obesity and WHtR

Assessment methods: liver biopsy vs transient elastography

Methods and Analysis (from abstract)

Regression and smoothed curve fitting

® Observational Study Association of waist-to-height ratio with nonalcoholic fatty liver disease and liver fibrosis detected by vibration-controlled transient elastography NHANES 2017-2020 Kongting Xing, BSa ,* , Chaoying Ge, BSa , Lingli Xu, BSa , Linjian Liu, BSb | Abstract
The waist-to-height ratio (WHtR) is a simple and superior indicator for assessing obesity compared with waist circumference alone. The current guidelines for nonalcoholic fatty liver disease (NAFLD), the most common chronic liver disease worldwide, do not provide any recommendations regarding WHtR. Therefore, we aimed to investigate the relationship between WHtR and NAFLD. The study analyzed the association between WHtR and NAFLD and liver fibrosis using the 2017 to 2020 National Health and Nutrition Examination Survey data. Multiple linear regression analysis and smoothed curve fitting were used to examine the relationship between WHtR and NAFLD as well as liver fibrosis. The study found a positive correlation between WHtR and hepatic and liver fat. The effect size for the correlation between WHtR and hepatic fat was (β = 18.28, 95% confidence interval: 16.16–20.41), while the effect size for the correlation between WHtR and liver fat was (β = 401.97, 95% confidence interval: 385.58–418.37) . The correlation was stronger in male, non-Hispanic White participants. This study suggests a positive correlation between WHtR, NAFLD, and liver fibrosis in adults in the United States. Therefore, WHtR can be considered an important indicator for identifying the risk of NAFLD and liver fibrosis. | | --- | | Abbreviations: BMI = body mass index, CAP = controlled attenuation parameter, IR = insulin resistance, LSM = liver stiffness measurement, LUTE = liver ultrasound transient elastography, NAFLD = non-nonalcoholic fatty liver disease, NHANES = National Health and Nutrition Examination Survey, FPIR = family income poverty rate, WC = waist circumference, WHtR = waist-to-height ratio. | | Keywords: elastography, liver fbrosis, NAFLD, obesity, waist-to-height ratio | 1. Introduction Nonalcoholic fatty liver disease (NAFLD) affects 25.24% of adults,[1] making it the most common chronic liver disease. In the United States alone, over 80 million people have been diagnosed with NAFLD. [2] The prevalence of NAFLD has steadily increased in recent years, and its mortality rate is higher than that of the general population. [3,4] NAFLD is defined as the excessive accumulation of lipids in the liver without alcohol abuse. It can progress to nonalcoholic steatohepatitis, hepatic fibrosis, and eventually hepatocellular carcinoma. [5] Liver biopsy is currently the gold standard for assessing the degree of hepatic steatosis and fibrosis, but it isan invasive procedure used with caution in clinical practice. [6] The liver ultrasound transient elastography (LUTE) test is anoninvasive method used to assess the degree of hepatic fibrosis and steatosis. [7] The prevalence of NAFLD has increased with the rise in obesity rates. [8–11] NAFLD risk is associated with increased obesity,[12] and excessive fat accumulation can worsen NAFLD. [13–15] In recent years, the waist-to-height ratio (WHtR) has gained significant attention due to its strong correlation with several chronic diseases, particularly obesity. WHtR is calculated by dividing the This work was supported by the Project of Ningbo Health Science and Technology Programme, Zhejiang Province, China (2024Y36) and Key Disciplines of Longsai Medical Group, Ningbo, Zhejiang Province, China (2023-Y04). Prior to participation in the study, each participant completed a written informed consent form. Patients/participants provided written informed consent to participate in this study. The authors have no conflicts of interest to disclose. The datasets generated during and/or analyzed during the current study are publicly available. Studies involving human participants were reviewed and approved by the Research

FAQs

What is the main goal of the study regarding WHtR?

To investigate the relationship between waist-to-height ratio (WHtR) and NAFLD, including liver fibrosis, using NHANES 2017–2020 data.

How is liver fat and fibrosis assessed in the study?

Liver steatosis and fibrosis are assessed using vibration-controlled transient elastography, described as a noninvasive method.

What overall association did the study find between WHtR and liver outcomes?

WHtR showed a positive correlation with hepatic fat and liver fat, supporting WHtR as an indicator for identifying risk of NAFLD and liver fibrosis in adults.

Sep 30, 2026

Uploaded by Mary Man