ArticleBMC gastroenterology2026
Comparison of diagnostic value of abdominal obesity and metabolism-related indicators for non-alcoholic fatty liver disease in lean individuals.
Article in BMC gastroenterology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundNon-alcoholic fatty liver disease (NAFLD) has become the most prevalent chronic liver disease globally. The present study aims to investigate the diagnostic value of abdominal obesity and metabolism-related indicators for NAFLD in lean individuals.
methodsThis cross-sectional study enrolled 894 participants diagnosed with fatty liver via ultrasound between July 2023 and July 2024. Patients with a body mass index (BMI) < 24 kg/m2 were defined as having “lean NAFLD”. Exclusion criteria included excessive alcohol consumption, viral hepatitis, and other conditions that may affect liver function. The normal control group comprised 1000 individuals with a BMI < 24 kg/m2 who underwent a normal physical examination during the same period. Basic characteristics and biochemical test results were compared between the two groups. Additionally, abdominal obesity and metabolism-related indicators were calculated, including the lipid accumulation product (LAP), waist-triglyceride index (WTI), body roundness index (BRI), waist-to-height ratio (WHtR), cardiometabolic index (CMI), triglyceride-glucose (TyG) index, and visceral adiposity index (VAI).
resultsWe found that BMI, waist circumference, waist-hip ratio, fasting blood glucose, blood pressure and blood lipids in the group of lean NAFLD were higher than those of normal control group and statistically different (P < 0.001). Abdominal obesity and metabolism-related indexes were significantly higher than those of the control group (P < 0.001). The receiver operating characteristic (ROC) curves analyzed the diagnostic effect of the seven indexes for lean NAFLD, and found that LAP had the best effect (area under curve (AUC) = 0.889; 95% confidence interval (CI):0.874–0.903, sensitivity was 81.4%, specificity was 82.5%, and the Youden’s index was 0.639). Regression analysis after categorization based on cutoff values and adjusting for multiple confounders showed that LAP still had good risk prediction ability. The BMI < 24 kg/m2 population was stratified based on the presence of central obesity, and it was determined that LAP and BRI maintain their capacity to predict lean NAFLD in subjects with non-central obesity.
conclusionsCompared with other indicators, LAP has highest value in the diagnosis of NAFLD in normal BMI population, while BRI has some application value as a morphologic indicator. LAP and BRI still have diagnostic effect in people with normal BMI and non-central obesity.
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