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. 2022 Dec 1:13:1035418.
doi: 10.3389/fendo.2022.1035418. eCollection 2022.

Optimum non-invasive predictive indicators for metabolic dysfunction-associated fatty liver disease and its subgroups in the Chinese population: A retrospective case-control study

Jing Liu  1   2 , Shaojie Duan  3 , Che Wang  4 , Yutong Wang  4 , Hongye Peng  5 , Zuohu Niu  3 , Shukun Yao  2
Affiliations

Optimum non-invasive predictive indicators for metabolic dysfunction-associated fatty liver disease and its subgroups in the Chinese population: A retrospective case-control study

Jing Liu et al. Front Endocrinol (Lausanne). .

Abstract

Objective: Metabolic dysfunction-associated fatty liver disease (MAFLD) affects 25% of the population without approved drug therapy. According to the latest consensus, MAFLD is divided into three subgroups based on different diagnostic modalities, including Obesity, Lean, and Type 2 diabetes mellitus (T2DM) MAFLD subgroups. This study aimed to find out the optimum non-invasive metabolism-related indicators to respectively predict MAFLD and its subgroups.

Design: 1058 Chinese participants were enrolled in this study. Anthropometric measurements, laboratory data, and ultrasonography features were collected. 22 metabolism-related indexes were calculated, including fatty liver index (FLI), lipid accumulation product (LAP), waist circumference-triglyceride index (WTI), etc. Logistic regression analyzed the correlation between indexes and MAFLD. Receiver operating characteristics were conducted to compare predictive values among 22 indicators for screening the best indicators to predict MAFLD in different subgroups.

Results: FLI was the best predictor with the maximum odds ratio (OR) values of overall MAFLD (OR: 6.712, 95%CI: 4.766-9.452, area under the curve (AUC): 0.879, P < 0.05) and T2DM MAFLD subgroup (OR: 14.725, 95%CI: 3.712-58.420, AUC: 0.958, P < 0.05). LAP was the best predictor with the maximum OR value of Obesity MAFLD subgroup (OR: 2.689, 95%CI: 2.182-3.313, AUC: 0.796, P < 0.05). WTI was the best predictor with the maximum OR values of Lean MAFLD subgroup (OR: 3.512, 95%CI: 2.286-5.395, AUC: 0.920, P < 0.05).

Conclusion: The best predictors of overall MAFLD, Obesity, Lean, and T2DM MAFLD subgroups were respectively FLI, LAP, WTI, and FLI.

Keywords: fatty liver index; lipid accumulation product; metabolic disorders; metabolic dysfunction-associated fatty liver disease; non-invasive predictive indicators; waist circumference-triglyceride index.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram of research procedure. MAFLD, metabolic dysfunction-associated fatty liver disease; T2DM, type 2 diabetes mellitus.
Figure 2
Figure 2
Logistic regression and ROC analysis of indicators in overall MAFLD. (A) ORs in overall MAFLD. (B) adjusted ORs in overall MAFLD. (C) ROC of overall MAFLD. MAFLD, metabolic dysfunction-associated fatty liver disease; OR, odds ratio; adjusted ORs: the values of ORs adjusted for gender and age (for age of LAP); ROC, receiver operating characteristic; ZJU index, Zhejiang University index; BRI, body roundness index; WTI, waist triglyceride index; LAP, lipid accumulation product; FLI, fatty liver index; FLDI, fatty liver disease index; BMI, body mass index.
Figure 3
Figure 3
Logistic regression and ROC analysis of indicators in Obesity MAFLD subgroup. (A) ORs in Obesity MAFLD subgroup. (B) adjusted ORs in Obesity MAFLD subgroup. (C) ROC of Obesity MAFLD subgroup. MAFLD, metabolic dysfunction-associated fatty liver disease; OR, odds ratio; adjusted ORs: the values of ORs adjusted for gender and age (for age of LAP); ROC, receiver operating characteristic; BRI, body roundness index; CMI, cardiometabolic index; FLI, fatty liver index; WTI, waist triglyceride index; LAP, lipid accumulation product; BAI, body adiposity index; ZJU index, Zhejiang University index; LAP, lipid accumulation product; BMI, body mass index.
Figure 4
Figure 4
Logistic regression and ROC analysis of indicators in Lean MAFLD subgroup. (A) ORs in Lean MAFLD subgroup. (B) adjusted ORs in Lean MAFLD subgroup. (C) ROC of Lean MAFLD subgroup. MAFLD, metabolic dysfunction-associated fatty liver disease; OR, odds ratio; adjusted ORs: the value of ORs adjusted for gender and age (for age of LAP); ROC, receiver operating characteristic; FLDI, fatty liver disease index; ZJU index, Zhejiang University index; FLI, fatty liver index; LAP, lipid accumulation product; WTI, waist triglyceride index; BMI, body mass index; OR, odds ratio; adjusted ORs: The value of ORs after being adjusted for gender and age; ROC, receiver operating characteristic; MAFLD, metabolic dysfunction-associated fatty liver disease.
Figure 5
Figure 5
Logistic regression and ROC analysis of indicators in T2DM MAFLD subgroup. (A) ORs in T2DM MAFLD subgroup. (B) adjusted ORs in T2DM MAFLD subgroup. (C) ROC of T2DM MAFLD subgroup. MAFLD, metabolic dysfunction-associated fatty liver disease; T2DM, type 2 diabetes mellitus; OR, odds ratio; adjusted ORs: the value of ORs adjusted for gender and age (for age of LAP); ROC, receiver operating characteristic; BMI, body mass index; WTI, waist triglyceride index; BRI, body roundness index; LAP, lipid accumulation product; FLI, fatty liver index.
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