Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 May 31:15:1385002.
doi: 10.3389/fendo.2024.1385002. eCollection 2024.

Bioelectrical impedance parameters add incremental value to waist-to-hip ratio for prediction of metabolic dysfunction associated steatotic liver disease in youth with overweight and obesity

Kyungchul Song  1 , Eun Gyung Seol  2 , Hyejin Yang  3 , Soyoung Jeon  3 , Hyun Joo Shin  4 , Hyun Wook Chae  1 , Eun-Kyung Kim  4 , Yu-Jin Kwon  5 , Ji-Won Lee  6   7
Affiliations

Bioelectrical impedance parameters add incremental value to waist-to-hip ratio for prediction of metabolic dysfunction associated steatotic liver disease in youth with overweight and obesity

Kyungchul Song et al. Front Endocrinol (Lausanne). .

Abstract

Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD) presents a growing health concern in pediatric populations due to its association with obesity and metabolic syndrome. Bioelectrical impedance analysis (BIA) offers a non-invasive and potentially effective alternative for identifying MASLD risk in youth with overweight or obesity. Therefore, this study aimed to assess the utility of BIA for screening for MASLD in the youth.

Method: This retrospective, cross-sectional study included 206 children and adolescents aged <20 years who were overweight and obese. The correlations between anthropometric measurements and BIA parameters and alanine aminotransferase (ALT) levels were assessed using Pearson's correlation analysis. Logistic regression analysis was performed to examine the associations between these parameters and ALT level elevation and MASLD score. Receiver operating characteristic (ROC) curves were generated to assess the predictive ability of the parameters for MASLD.

Results: Pearson's correlation analysis revealed that waist-to-hip ratio (WHR), percentage body fat (PBF), and BIA parameters combined with anthropometric measurements were correlated with ALT level. Logistic regression revealed that WHR, skeletal muscle mass/WHR, PBF-WHR, fat-free mass/WHR, and appendicular skeletal muscle mass/WHR were correlated with ALT level elevation after adjusting for age, sex, and puberty. WHR, PBF-WHR, and visceral fat area (VFA)-WHR were positively correlated with the MASLD score in the total population after adjusting for age, sex, and puberty. PBF-WHR and VFA-WHR were correlated with the MASLD score even in youth with a normal ALT level. The cutoff points and area under the ROC curves were 34.6 and 0.69 for PBF-WHR, respectively, and 86.6 and 0.79 for VFA-WHR, respectively.

Discussion: This study highlights the utility of combining BIA parameters and WHR in identifying the risk of MASLD in overweight and obese youth, even in those with a normal ALT level. BIA-based screening offers a less burdensome and more efficient alternative to conventional MASLD screening methods, facilitating early detection and intervention in youth at risk of MASLD.

Keywords: adolescent; bioelectric impedance; child; metabolic dysfunction associated steatotic liver disease; obesity.

PubMed Disclaimer

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
Logistic regression of WHR and BIA parameters for MASLD. (A) Logistic regression of WHR and BIA parameters for MASLD in the total cohort after adjusting for age, sex, and puberty. (B) Logistic regression of WHR and BIA parameters for MASLD in boys after adjusting for age and puberty. (C) Logistic regression of WHR and BIA parameters for MASLD in girls after adjusting for age and puberty. (D) Logistic regression of WHR and BIA parameters for MASLD in the prepubertal group after adjusting for age and sex. (E) Logistic regression of WHR and BIA parameters for MASLD in the pubertal group after adjusting for age and sex. *Adjusted for age, sex, and puberty. **Adjusted for age and puberty. ***Adjusted for age and sex. WHR, waist-to-hip ratio; BIA, bioelectrical impedance analysis; MASLD, metabolic dysfunction associated steatotic liver disease; SMM, skeletal muscle mass; PBF, percentage of body fat; FFM, fat-free mass; ASM, appendicular skeletal mass; VFA, visceral fat area; BMI, body mass index; SDS, standard deviation score.
Figure 2
Figure 2
Logistic regression of WHR and BIA parameters for MASLD in participants with normal ALT. *Adjusted for age, sex, and puberty. WHR, waist-to-hip ratio; BIA, bioelectrical impedance analysis; MASLD, metabolic dysfunction-associated steatotic liver disease; ALT, alanine aminotransferase; SMM, skeletal muscle mass; PBF, percentage of body fat; FFM, fat-free mass; ASM, appendicular skeletal mass; VFA, visceral fat area.
Figure 3
Figure 3
Comparison of the AUC and the corresponding cutoff points for WHR, PBF-WHR, and VFA-WHR. The dots on the curves represent the cutoff points for WHR, PBF-WHR, and VFA-WHR. AUC, area under the receiver operating characteristic curve; WHR, waist-to-hip ratio; SMM, skeletal muscle mass; PBF, percentage of body fat; VFA, visceral fat areaTables.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Song K, Kim HS, Chae HW. Nonalcoholic fatty liver disease and insulin resistance in children. Clin Exp Pediatr. (2023) 66(12):512–9. doi: 10.3345/cep.2022.01312 - DOI - PMC - PubMed
    1. Song K, Park G, Lee HS, Lee M, Lee HI, Ahn J, et al. . Trends in prediabetes and non-alcoholic fatty liver disease associated with abdominal obesity among Korean children and adolescents: based on the Korea national health and nutrition examination survey between 2009 and 2018. Biomedicines. (2022) 10(3):584. doi: 10.3390/biomedicines10030584 - DOI - PMC - PubMed
    1. Song K, Park G, Lee HS, Lee M, Lee HI, Choi HS, et al. . Comparison of the triglyceride glucose index and modified triglyceride glucose indices to predict nonalcoholic fatty liver disease in youths. J Pediatr. (2022) 242:79–85.e1. doi: 10.1016/j.jpeds.2021.11.042 - DOI - PubMed
    1. Crespo M, Lappe S, Feldstein AE, Alkhouri N. Similarities and differences between pediatric and adult nonalcoholic fatty liver disease. Metabolism. (2016) 65:1161–71. doi: 10.1016/j.metabol.2016.01.008 - DOI - PubMed
    1. Li J, Ha A, Rui F, Zou B, Yang H, Xue Q, et al. . Meta-analysis: global prevalence, trend and forecasting of non-alcoholic fatty liver disease in children and adolescents, 2000–2021. Aliment Pharmacol Ther. (2022) 56:396–406. doi: 10.1111/apt.17096 - DOI - PubMed

LinkOut - more resources