Association of metabolic evaluation of visceral fat score with nonalcoholic fatty liver disease and liver fibrosis: A cross-sectional study based on NHANES

The aim of this study was to investigate the correlation between the metabolic evaluation of visceral fat score (METS-VF) with nonalcoholic fatty liver disease (NAFLD) and liver fibrosis within an adolescent population. A cross-sectional analysis of data from the National Health and Nutrition Examination Survey (NHANES) involving 1274 subjects was conducted. Multiple linear regression was employed to ascertain the association between METS-VF with NAFLD and liver fibrosis. Smoothed curve fitting and threshold effect models were utilized to explore potential nonlinear relationships. Subgroup analyses were conducted to assess the stability of the relationship across different demographic groups. METS-VF exhibited a positive association with both NAFLD and liver fibrosis. In models adjusted for all covariates, the odd ratios (ORs) for METS-VF with NAFLD and liver fibrosis were 15.74 (95% CI: 10.44-23.72) and 1.85 (95% CI: 1.27-2.70), respectively. This positive correlation strengthened with increasing METS-VF when expressed in tertiles (P-value for trend < 0.01). Smoothed curve fitting and threshold effect analysis revealed a nonlinear correlation between METS-VF and NAFLD (log-likelihood ratio [LLR] < 0.01), with a more significant positive correlation observed when METS-VF exceeded 5.75 (OR = 104.42, 95% CI: 17.40-626.58). Similarly, a nonlinear correlation was observed between METS-VF and liver fibrosis (LLR < 0.01), with a stronger positive correlation noted when METS-VF surpassed 4.94 (OR = 34.87, 95% CI: 19.85-64.24). Subgroup analyses by age, ethnicity, and gender indicated that for NAFLD, the positive association with METS-VF was more pronounced in Mexican American female adolescents aged 16 to 19 years, whereas for liver fibrosis, the positive association was stronger in Mexican American female adolescents aged 12 to 16 years. METS-VF was positively associated with the prevalence of NAFLD and hepatic fibrosis in American adolescents. Adolescents with a METS-VF exceeding 5.75 should exercise caution, as higher METS-VF levels may elevate the risk of developing NAFLD and hepatic fibrosis. Additionally, Mexican American female adolescents should be particularly vigilant, as increased METS-VF may heighten the risk of NAFLD and liver fibrosis in this demographic group.