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April 19, 2026Scientific Reports0 citationsOpen Access

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

SLShi-Long LiSGShu-Xia GuoMZMing-Han Zhang

Key Points

  • This study aims to explore the relationship between various abdominal obesity indices and the risk of metabolic dysfunction-associated fatty liver disease (MAFLD).
  • Conducted a prospective cohort study with 10,703 rural residents.

Structured PICO

Do higher abdominal obesity indices predict the onset of metabolic dysfunction-associated fatty liver disease in a rural Uyghur population?

P
Population
10,703 rural Uyghur residents aged 18 years and older without baseline MAFLD, mean age 36.78, 49.2% female, from Xinjiang, China.
I
Intervention
Higher quartiles of abdominal obesity indices (Chinese visceral adiposity index [CVAI], body roundness index [BRI], lipid accumulation product [LAP], and waist-to-hip ratio [WHR])
C
Comparator
Lowest quartile (Q1) of the respective abdominal obesity indices
O
Outcome
Onset of metabolic dysfunction-associated fatty liver disease (MAFLD)

Abdominal obesity indices, particularly the Chinese visceral adiposity index (CVAI), are strong independent predictors of incident MAFLD, especially in women and younger individuals.

Limitations

  • Diagnosis based on hepatic steatosis detected by abdominal ultrasound, which has limited sensitivity for mild steatosis
  • Based on a rural Uyghur population in Xinjiang, limiting extrapolation to broader populations with different genetic backgrounds and lifestyles
  • Did not account for the temporal trajectories of abdominal obesity indicators or their dynamic effects on MAFLD risk

Abstract

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.

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Cite This Study

Li et al. (2026) studied this question.

synapsesocial.com/papers/69e470e9010ef96374d8dad4https://doi.org/10.1038/s41598-026-49030-z
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