Association of waist-to-height ratio with nonalcoholic fatty liver disease and liver fibrosis detected by vibration-controlled transient elastography: NHANES 2017-2020

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.