Prediction of nonalcoholic fatty liver disease using anthropometry and body fat measures by sex and race/ethnicity in the United States.

Abstract

The prevalence of nonalcoholic fatty liver disease (NAFLD) is increasing in the United States and is strongly linked to obesity in many, but not all, racial/ethnic groups. It is conceivable that the lack of correspondence is related to differential fat distribution. The study objective was to examine which fat distribution measures best predicted NAFLD by sex within racial/ethnic groups. The analysis included 1,404 participants from the 2017-2018 National Health and Nutrition Examination Survey (NHANES). Area under the receiver operating characteristic curve (AUC) analyses compared the ability of dual-energy x-ray absorptiometry-measured percentage total fat and abdominal fat with measured BMI, waist circumference, and waist to height ratio to predict ultrasound transient-elastography-assessed NAFLD in each sex and racial/ethnic group. AUC analysis found the best predictors of NAFLD among men were waist circumference and total abdominal fat area (AUC: 84.1%) and the best predictor among women was visceral fat (AUC: 85.2). NAFLD prediction by body fat measures, however, was similar between racial/ethnic groups. The best predictors of NAFLD, using body fat distribution measures, vary by sex but not by racial/ethnic group.