Assessment of the appropriate cutoff points for anthropometric indices and their relationship with cardio-metabolic indices to predict the risk of metabolic associated fatty liver disease.

BACKGROUND: Research on Metabolic Associated Fatty Liver Disease (MAFLD) is still in its early stages, with few studies available to identify and predict effective indicators of this disease. On the other hand, early diagnosis and intervention are crucial to reduce the burden of MAFLD. Therefore, the aim of this research was to investigate the effectiveness of eleven anthropometric indices and their appropriate cut-off values as a non-invasive method to predict and diagnose MAFLD in the Iranian population. METHODS: In this cross-sectional study, we analyzed baseline data from the Hoveyzeh Cohort Study, a prospective population-based study conducted in Iran that enrolled a total of 7836 subjects aged 35 to 70 years from May 2016 through August 2018. RESULTS: The optimal cut-off values of anthropometric indices for predicting MAFLD risk were determined for waist circumference(WC) (102.25 cm for males and 101.45 cm for females), body mass index (BMI) (27.80 kg/m2 for males and 28.75 kg/m2 for females), waist-to-hip ratio (WHR) (0.96 for both males and females), waist-to-height ratio (WHtR) (0.56 for males and 0.63 for females), body adiposity index (BAI) (23.24 for males and 32.97 for females), visceral adiposity index (VAI) (1.64 for males and 1.88 for females), weight-adjusted waist index (WWI) (10.63 for males and 11.71 for females), conicity index (CI) (1.29 for males and 1.36 for females), body roundness index (BRI) (4.52 for males and 6.45 for females), relative fat mass (RFM) (28.18 for males and 44.91 for females) and abdominal volume index (AVI) (18.85 for males and for 21.37 females). VAI in males (sensitivity: 77%, specificity: 60%, Youden's Index: 0.37) and RFM in females (sensitivity: 76%, specificity: 59%, Youden's Index: 0.35) were found to have higher sensitivity and specificity compared to other anthropometric indices. Furthermore, anthropometric indices demonstrated statistically significant correlations with various hepatic and cardiometabolic indices. Among these, the strongest positive correlations were observed between WC, BMI, BAI, BRI, and AVI with the Hepatic Steatosis Index (HSI), TyG-BMI, and TyG-WC, as well as between VAI and the Atherogenic Index of Plasma (AIP), Lipid Accumulation Product (LAP), Cardiometabolic Index (CMI), and the Triglyceride and Glucose (TyG) Index. CONCLUSION: Anthropometric indices are effective in predicting MAFLD risk among Iranian adults, with WWI, VAI, and RFM identified as the strongest predictors. The proposed cutoff values could serve as a straightforward and non-invasive methods for the early diagnosis of MAFLD.

The association between healthy eating index-2015 with anthropometric, cardiometabolic and hepatic indices among patients with non-alcoholic fatty liver disease.

BACKGROUND: Obesity, cardiovascular diseases, and metabolic disorders are common problems among participants with non-alcoholic fatty liver disease (NAFLD). However, the association between these problems and the healthy eating index-2015 (HEI-2015) remains unknown. Although the HEI-2015 originated from American dietary guidelines, its comprehensive evaluation of diet quality provides valuable insights for various populations, including Iranians. Therefore, the objective of this study was to investigate the association between anthropometric, hepatic, and cardio-metabolic indices with HEI-2015 scores in participants with NAFLD. METHODS: We conducted a cross-sectional analysis of data from the Hoveyzeh Cohort Study, which included adults aged 35 to 70 years between 2016 and 2018. A total of 664 participant with NAFLD (452 females and 212 males) were included in the analysis. The HEI-2015 was assessed using the Food Frequency Questionnaire (FFQ). Various indices, including the body shape index (ABSI), atherogenic index of plasma (AIP), visceral adiposity index (VAI), lipid accumulation product (LAP), cardiometabolic index (CMI), lipoprotein combine index (LCI), AST/ALT ratio, ALD/NAFLD index, and hepatic steatosis index (HSI), were calculated. RESULTS: No significant differences were observed in anthropometric, cardio-metabolic, and hepatic indices across the quartiles of HEI-2015. However, among participants with NAFLD, men had significantly higher AIP and LCI levels, while women had significantly higher BMI, ABSI, VAI, LAP, and CMI levels. Additionally, women with NAFLD exhibited higher AST/ALT and HSI levels but lower ALD/NAFLD levels compared to men with NAFLD. Linear regression analysis among men with NAFLD revealed a significant negative correlation between HEI-2015 score and HSI in both the unadjusted model (ß=-0.131, SE = 0.058, p = 0.024) and the adjusted model for energy intake (ß=-0.129, SE = 0.058, p = 0.028). CONCLUSION: The present study demonstrated a correlation between lower HEI-2015 scores and an increased risk of steatosis in men with NAFLD. Moreover, our findings highlighted gender-related differences in NAFLD and cardio-metabolic disorders.

Comparison of metabolic risk factors, lipid indices, healthy eating index, and physical activity among premenopausal, menopausal, and postmenopausal women.

INTRODUCTION: In this study, we aimed to compare metabolic risk factors, lipid indices, healthy eating index, and physical activity among premenopausal, menopausal, and postmenopausal women. METHODS: In this cross-sectional study, a total of 4,732 women participating in the Hoveyzeh Cohort Study were placed into three groups of premenopausal (n=736), menopausal (n=396), and postmenopausal (n=917) women, according to the inclusion and exclusion criteria . RESULTS: The prevalence of metabolic syndrome was 43.3%, 55.6%, and 62.8% in premenopausal, menopausal, and postmenopausal women, respectively. After menopause, the prevalence of hypertension (50.2%), dyslipidemia (61.2%), diabetes (37.7%), and abdominal obesity according to the Iranian guidelines (75.9%) was higher than before menopause. Based on the results, cardiovascular disease had the highest prevalence after menopause (23%). The weight-adjusted waist index (WWI) had the highest odds ratio (OR) among indices, with values of 2.94 and 1.93 in menopausal and postmenopausal women, respectively (P<0.001). According to the Healthy Eating Index-2015 (HEI-2015), the total consumption of fruits, vegetables, seafood, and protein was higher in premenopausal women than in postmenopausal women, and the consumption of foods containing sugar was higher in menopausal women than in premenopausal women. The results showed that the level of physical activity was the highest and the lowest in premenopausal and postmenopausal women, respectively (P<0.001). CONCLUSION: Menopause leads to an increase in the prevalence of metabolic syndrome. The Atherogenic Index of Plasma (AIP), Triglyceride Glucose (TyG) index, WWI, and physical activity index increased in postmenopausal women compared to premenopausal women. The TyG index, WWI, and HEI-2015 did not show significant differences between the groups, based on the multiple regression analysis.

Are young Iranian women with metabolically healthy obesity at increased risk of CVD incidence? / Jovens iranianas obesas metabolicamente saudáveis têm maior risco de incidência de DCV?

Abstract Background The association between the Metabolically Healthy Obese (MHO) phenotype in the absence of metabolic syndrome and subsequent cardiovascular disease remains unclear. Objectives We examined the association between MHO and CVD risk in young Iranian women. Methods We studied 183 women aged 20-35 years from a population of 308 candidates. We classified participants into 4 phenotypes. We measured body composition, blood pressure, and biochemical factors in all participants. Results The Metabolically Healthy Normal Weight (MHNW) and Normal Weight Obese (NWO) phenotypes had no statistical differences in any biochemistry variables. FBS, TG, LDL/HDL, Cholesterol/HDL, hs-CRP, and atherogenic index of plasma (AIP) were all higher in Metabolically Unhealthy Obese (MUO) than MHO individuals, whereas HDL was higher in MHO than in MUO individuals. LDL/HDL and hs-CRP were higher in MHO participants than MHNW participants, whereas HDL-c was higher in MHNW than MHO. Conclusions Results of the present study demonstrate that young women displaying the MHO phenotype have a favorable metabolic profile as shown by lower FBS, TG, LDL-c/HDL, Cho/HDL, hs-CRP, and AIP and higher HDL levels than the MUO phenotype. However, MHO individuals were still at greater risk of CVD incidence (lower HDL and higher hs-CRP levels) than MHNW individuals.

Resumo Contexto A associação entre o fenótipo obeso metabolicamente saudável (OMS) na ausência de síndrome metabólica e doença cardiovascular subsequente permanece incerta. Objetivos Examinamos a associação entre o fenótipo OMS e risco de DCV em jovens iranianas. Métodos Analisamos 183 mulheres com idade de 20-35 anos de uma população de 308 candidatas. Classificamos as participantes em quatro fenótipos. Mensuramos composição corporal, pressão arterial e fatores bioquímicos em todas as participantes. Resultados Os fenótipos com peso normal metabolicamente saudável (PNMS) e obeso com peso normal não apresentaram diferenças estatísticas em nenhuma das variáveis bioquímicas. Os níveis de glicemia sanguínea em jejum (GSJ), triglicerídeos (TG), relação LDL/HDL, HDL, proteína C reativa ultrassensível (PCR-us) e índice aterogênico do plasma (IAP) foram mais elevados em obesas metabolicamente não saudáveis (OMNS) do que em indivíduos OMSs, enquanto o HDL foi maior em OMSs do que em indivíduos OMNSs. A relação LDL/HDL e o nível de PCR-us foram mais elevados em participantes OMSs do que em participantes com PNMS, enquanto o HDL foi maior naquelas com PNMS do que nas OMSs. Conclusões Os resultados do presente estudo demonstram que mulheres jovens com o fenótipo OMS têm um perfil metabólico favorável, conforme demonstrado pelos níveis menores de GSJ, TG, relação LDL/HDL, HDL, PCR-us e IAP e pelos níveis maiores de HDL em comparação às mulheres com o fenótipo OMNS. Entretanto, indivíduos OMSs ainda apresentavam maior risco de DCV incidente (níveis menores de HDL e maiores de PCR-us) do que indivíduos com PNMS.