Comparison of Obesity-Related Indicators for Nonalcoholic Fatty Liver Disease Diagnosed by Transient Elastography
Open accessAbstract
BACKGROUND/AIMS: This study aimed to assess obesity-related indices in predicting nonalcoholic fatty liver disease (NAFLD) in the United States. These indices were analyzed separately in previous studies, but evidence comparing them together was still lacking. MATERIALS AND METHODS: We analyzed data from 8126 individuals in the National Health and Nutrition Examination Survey (NHANES) database and measured their body mass index (BMI), body roundness index (BRI), a body shape index, conicity index, body adiposity index, abdominal volume index (AVI), and waist-hip ratio. We used logistic analyses with odds ratios to evaluate the association between obesity-related indices and NAFLD and compared their diagnostic ability by receiver operating characteristic (ROC) curves, areas under the curve (AUCs), and net reclassification improvement (NRI). RESULTS: The AVI had the highest AUC (0.835 at controlled attenuation parameter [CAP] scores 263 dB/m and 0.831 at CAP scores 285 dB/m) in the ROC curve analysis. The AVI also showed better discriminatory ability than BMI (NRI = 0.0331 at CAP scores 263 dB/m and 0.0328 at CAP scores 285 dB/m), the same as BRI (NRI = 0.0283 at CAP scores 263 dB/m and 0.0272 at CAP scores 285 dB/m). In males, AVI (AUC = 0.8501 at CAP scores 263 dB/m and 0.8466 at CAP scores 285 dB/m) and BRI (AUC = 0.8517 at CAP scores 263 dB/m and 0.8497 at CAP scores 285 dB/m) had better predictive ability than BMI and similar to females. This was consistent across different age and race groups. CONCLUSION: AVI and BRI were better predictors of NAFLD than BMI.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In Tian et al. [26], the OR for the 4th quartile of BRI compared to the first quartile for NAFLD was 72.08 (95% CI 48.66-106.77).
“In the study by Tian et al. [26], each quartile of BRI was compared to the first quartile regarding association with NAFLD, and their result showed the OR for the 4th quartile was 72.08 (95%CI: 48.66-106.77).”
From Effectiveness of body roundness index for the prediction of nonalcoholic fatty liver disease: a systematic review and meta-analysis (2025) · cites this paper as [26]
The Results section (Characteristics of the Study Population; page unavailable) says that NAFLD odds ratios increased across quartiles of each obesity-related index, which includes BRI. Our copy does not provide the claimed fourth-versus-first-quartile OR of 72.08 or its 95% CI of 48.66–106.77. (LLM, conf=0.84)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
The citation lists haven’t been fetched yet
References 27 · Cited by 14
Research works printed but not linked: 25
- [1]Younossi ZM. Non-alcoholic fatty liver disease - A global public health perspective. J Hepatol. 2019; 70(3): 531 544. (10.1016/j.jhep.2018.10.033) 30414863 · DOI · Paper page
- [2]Ratziu V Charlotte F Heurtier A, et al. Sampling variability of liver biopsy in nonalcoholic fatty liver disease. Gastroenterology. 2005; 128(7): 1898 1906. (10.1053/j.gastro.2005.03.084) 15940625 · DOI · Paper page
- [3]Zhou JH Cai JJ She ZG Li HL. Noninvasive evaluation of nonalcoholic fatty liver disease: current evidence and practice. World J Gastroenterol. 2019; 25(11): 1307 1326. (10.3748/wjg.v25.i11.1307) 30918425 PMC6429343 · DOI
- [4]Myers RP Pollett A Kirsch R, et al. Controlled attenuation parameter (CAP): a noninvasive method for the detection of hepatic steatosis based on transient elastography. Liver Int. 2012; 32(6): 902 910. (10.1111/j.1478-3231.2012.02781.x) 22435761 · DOI
- [5]de Lédinghen V Wong GL Vergniol J, et al. Controlled attenuation parameter for the diagnosis of steatosis in non-alcoholic fatty liver disease. J Gastroenterol Hepatol. 2016; 31(4): 848 855. (10.1111/jgh.13219) 26514665 · DOI
- [6]de Lédinghen V Vergniol J Foucher J Merrouche W le Bail B. Non-invasive diagnosis of liver steatosis using controlled attenuation parameter (CAP) and transient elastography. Liver Int. 2012; 32(6): 911 918. (10.1111/j.1478-3231.2012.02820.x) 22672642 · DOI
- [7]Siddiqui MS Vuppalanchi R Van Natta ML, et al. Vibration-controlled transient elastography to assess fibrosis and steatosis in patients with nonalcoholic fatty liver disease. Clin Gastroenterol Hepatol. 2019; 17(1): 156 163.e2. (10.1016/j.cgh.2018.04.043) 29705261 PMC6203668 · DOI
- [8]Kim D Konyn P Cholankeril G Ahmed A. Physical activity is associated with nonalcoholic fatty liver disease and significant fibrosis measured by FibroScan. Clin Gastroenterol Hepatol. 2022; 20(6): e1438 e1455. (10.1016/j.cgh.2021.06.029) 34214678 · DOI
- [9]Zhou J Long Y Ding N Su Y. Association between bedtime at night and nonalcoholic fatty liver disease diagnosed by liver ultrasound transient elastography. Diabetes Res Clin Pract. 2022; 184: 109195. (10.1016/j.diabres.2022.109195) 35033597 · DOI
- [10]Global Burden of Metabolic Risk Factors for Chronic Diseases Collaboration (BMI Mediated Effects), Lu Y Hajifathalian K, et al. Metabolic mediators of the effects of body-mass index, overweight, and obesity on coronary heart disease and stroke: a pooled analysis of 97 prospective cohorts with 1·8 million participants. Lancet. 2014; 383(9921): 970 983. (10.1016/S0140-6736(13)61836-X) 24269108 PMC3959199 · DOI · Paper page
- [11]Zheng RD Chen ZR Chen JN Lu YH Chen J. Role of body mass index, waist-to-height and waist-to-hip ratio in prediction of nonalcoholic fatty liver disease. Gastroenterol Res Pract. 2012; 2012: 362147. (10.1155/2012/362147) 22701476 PMC3369513 · DOI
- [13]Procino F Misciagna G Veronese N, et al. Reducing NAFLD-screening time: a comparative study of eight diagnostic methods offering an alternative to ultrasound scans. Liver Int. 2019; 39(1): 187 196. (10.1111/liv.13970) 30248233 · DOI
- [14]Xie F Pei Y Zhou Q Cao D Wang Y. Comparison of obesity-related indices for identifying nonalcoholic fatty liver disease: a population-based cross-sectional study in China. Lipids Health Dis. 2021; 20(1): 132. (10.1186/s12944-021-01560-3) 34629056 PMC8502306 · DOI · Paper page
- [15]Guerrero-Romero F Rodríguez-Morán M. Abdominal volume index. An anthropometry-based index for estimation of obesity is strongly related to impaired glucose tolerance and type 2 diabetes mellitus. Arch Med Res. 2003; 34(5): 428 432. (10.1016/S0188-4409(03)00073-0) 14602511 · DOI
- [16]Krakauer NY Krakauer JC. A new body shape index predicts mortality hazard independently of body mass index. PLoS One. 2012; 7(7): e39504. (10.1371/journal.pone.0039504) 22815707 PMC3399847 · DOI
- [17]Thomas DM Bredlau C Bosy-Westphal A, et al. Relationships between body roundness with body fat and visceral adipose tissue emerging from a new geometrical model. Obesity (Silver Spring) 2013; 21(11): 2264 2271. (10.1002/oby.20408) 23519954 PMC3692604 · DOI · Paper page
- [18]Bergman RN Stefanovski D Buchanan TA, et al. A better index of body adiposity. Obesity (Silver Spring) 2011; 19(5): 1083 1089. (10.1038/oby.2011.38) 21372804 PMC3275633 · DOI
- [19]Valdez R. A simple model-based index of abdominal adiposity. J Clin Epidemiol. 1991; 44(9): 955 956. (10.1016/0895-4356(91)90059-i) 1890438 · DOI
- [20]Cobbina E Akhlaghi F. Non-alcoholic fatty liver disease (NAFLD) - pathogenesis, classification, and effect on drug metabolizing enzymes and transporters. Drug Metab Rev. 2017; 49(2): 197 211. (10.1080/03602532.2017.1293683) 28303724 PMC5576152 · DOI
- [21]Polyzos SA Kountouras J Mantzoros CS. Obesity and nonalcoholic fatty liver disease: from pathophysiology to therapeutics. Metabolism. 2019; 92: 82 97. (10.1016/j.metabol.2018.11.014) 30502373 · DOI
- [22]Frankenfield DC Rowe WA Cooney RN Smith JS Becker D. Limits of body mass index to detect obesity and predict body composition. Nutrition. 2001; 17(1): 26 30. (10.1016/s0899-9007(00)00471-8) 11165884 · DOI
- [23]Chung W Park CG Ryu OH. Association of a new measure of obesity with hypertension and health-related quality of life. PLoS One. 2016; 11(5): e0155399. (10.1371/journal.pone.0155399) 27183311 PMC4868302 · DOI
- [24]Stefanescu A Revilla L Lopez T Sanchez SE Williams MA Gelaye B. Using A body shape index (ABSI) and Body Roundness Index (BRI) to predict risk of metabolic syndrome in Peruvian adults. J Int Med Res. 2020; 48(1): 300060519848854. (10.1177/0300060519848854) 31144540 PMC7140225 · DOI · Paper page
- [26]Quaye L Owiredu WKBA Amidu N Dapare PPM Adams Y. Comparative abilities of body mass index, waist circumference, abdominal volume index, body adiposity index, and conicity index as predictive screening tools for metabolic syndrome among apparently healthy Ghanaian adults. J Obes. 2019; 2019: 8143179. (10.1155/2019/8143179) 31565431 PMC6745169 · DOI
- [27]Khan SH Shahid R Fazal N Ijaz A. Comparison of various abdominal obesity measures for predicting metabolic syndrome, diabetes, nephropathy, and dyslipidemia. J Coll Physicians Surg Pak. 2019; 29(12): 1159 1164. (10.29271/jcpsp.2019.12.1159) 31839087 · DOI
- Authors
- Tian, X., Ding, N., Su, Y., & Qin, J.
- Affiliations
- Changsha Central Hospital (CN)
- Corresponding author
- Ding, Ning
- Su, Yingjie
- Qin, Jiao
- Venue
- Turkish Journal of Gastroenterology
- Publisher
- AVES YAYINCILIK A.Ş.
- Published
- 2023-10-15
- Volume
- 34
- Issue
- 10
- Pages
- 1078-1087
- ISSN
- 1300-4948 (ISSN-L)
- 2148-5607
- PMC
- PMC10645279
- OpenAlex
- W4386945591
- Cited by
- 14
- References
- 27
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 2
- FWCI
- 2.80
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by
- Locations
- The Turkish Journal of Gastroenterology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Natural Science Foundation of Hunan Province
- Topics
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- non-alcoholic fatty liver disease, abdominal volume index, body roundness index, body mass index, transient elastography, controlled attenuation parameter, NAFLD prediction, waist-to-hip ratio, body adiposity index, conicity index, body shape index
- MeSH terms
- Female, Humans, Male, Nutrition Surveys, Obesity, ROC Curve, Body Mass Index, Elasticity Imaging Techniques, Non-alcoholic Fatty Liver Disease
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
