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. 2023 Nov 27:14:1281524.
doi: 10.3389/fendo.2023.1281524. eCollection 2023.

The newly proposed Metabolic Score for Visceral Fat is a reliable tool for identifying non-alcoholic fatty liver disease, requiring attention to age-specific effects in both sexes

Maobin Kuang #  1   2   3 , Jiajun Qiu #  1   2   3 , Dongdong Li #  1   2   3   4 , Chong Hu  5 , Shuhua Zhang  2 , Guotai Sheng  3 , Yang Zou  2
Affiliations

The newly proposed Metabolic Score for Visceral Fat is a reliable tool for identifying non-alcoholic fatty liver disease, requiring attention to age-specific effects in both sexes

Maobin Kuang et al. Front Endocrinol (Lausanne). .

Abstract

Objective: The newly proposed Metabolic Visceral Fat Score (METS-VF) is considered a more effective measure for visceral adipose tissue (VAT) than other obesity indicators. This study aimed to reveal the association between METS-VF and non-alcoholic fatty liver disease (NAFLD), and its variations across age groups within both sexes.

Methods: Data from 14,251 medical examiners in the NAGALA project were employed in this study. 3D fitted surface plots were constructed based on multivariate logistic regression models to visualize the isolated and combined effects of aging and METS-VF on NAFLD. Receiver operating characteristic curve (ROC) analysis was conducted to compare the diagnostic performance of METS-VF with other VAT surrogate markers in predicting NAFLD.

Results: The results of multivariate logistic regression analysis showed that each unit increase in METS-VF was independently associated with a 333% and 312% increase in the odds of NAFLD in males and females, respectively. Additionally, the 3D fitted surface plot showed that age significantly influenced the association between METS-VF and the odds of NAFLD in both sexes, as follows: (i) In males, when METS-VF was less than 6.2, the METS-VF-related odds of NAFLD increased gradually with age in the 20-45 age group, reached a plateau in the 45-65 age group, and then decreased in the group above 65 years old; however, when male METS-VF exceeded 6.2, aging and METS-VF combined to further increase the odds of NAFLD in all age groups, particularly in the 45-65 age group. (ii) In females, aging seemed to reduce METS-VF-related odds of NAFLD in the 18-40 age group, but significantly increased it in the 40-60 age group, particularly for those with higher METS-VF levels. Further ROC analysis revealed that compared to other VAT surrogate markers, METS-VF showed the highest diagnostic accuracy for NAFLD in females, especially in those under 45 years of age [area under the curve (AUC) = 0.9256].

Conclusions: This study firstly revealed a significant positive correlation between METS-VF and the odds of NAFLD, with METS-VF surpassing other VAT surrogate markers in NAFLD diagnosis. Moreover, age significantly influenced the METS-VF-related odds of NAFLD and METS-VF's diagnostic efficacy for NAFLD in both sexes.

Keywords: METS-VF; Metabolic Visceral Fat Score; NAFLD; sex; visceral adipose tissue.

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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
Flowchart of the selection process of study subjects.
Figure 2
Figure 2
3D fitting surface plot of age, METS-VF and the odds of NAFLD in females. METS-VF, Metabolic Visceral Fat Score.
Figure 3
Figure 3
3D fitting surface plot of age, METS-VF and the odds of NAFLD in males. METS-VF, Metabolic Visceral Fat Score.
Figure 4
Figure 4
Receiver operating characteristic curves for predicting diabetes using BMI, WC, WHtR, VAI, METS-VF in males and females. METS-VF, Metabolic Score for Visceral Fat; BMI, body mass index; WC, waist circumference; WHtR, waist to height ratio; VAI, visceral adiposity Index.
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