The relationship between abdominal obesity indices and the risk of metabolic dysfunction-associated fatty liver disease: a prospective cohort study

Abdominal obesity is a crucial risk factor for the onset of metabolic dysfunction-associated fatty liver disease (MAFLD). Chinese visceral adiposity index (CVAI), body roundness index (BRI), lipid accumulation product (LAP), and waist-to-hip ratio (WHR) are established indices of abdominal obesity. This study investigates the relations between these abdominal obesity indices and MAFLD onset. A total of 10,703 rural residents were included in this cohort study. Kaplan-Meier graphs, Cox regression modeling, restricted cubic spline (RCS) scores, Subgroup analyses and sensitivity analysis were used to conduct the study. During the median follow-up period of 5.79 years, 596 participants (5.57%) developed MAFLD. As the quartiles of the abdominal obesity indices increased, the incidence of MAFLD exhibited an increasing pattern. CVAI had the strongest association with MAFLD risk both before and after adjusting for confounders(P < 0.05). The associations between the indices and MAFLD risk were largely consistent across most subgroups, and the findings remained robust in sensitivity analyses. The RCS curves displayed linear correlations of CVAI with MAFLD risk (p for non-linear = 0.146) . CVAI, LAP, BRI, and WHR are all significantly and positively correlated with the risk of MAFLD. Among the female population, CVAI exhibited the strongest correlation with MAFLD risk. CVAI could serve as the preferred indicator for developing future risk prediction models for MAFLD in women.