Comparative diagnostic value of novel and traditional anthropometric indices in FibroScan-diagnosed NAFLD among Turkish adults

Abstract

Aims: Nonalcoholic fatty liver disease (NAFLD) is a growing global health concern associated with chronic liver damage and metabolic comorbidities. Traditional anthropometric measures—such as body-mass index (BMI) and waist circumference (WC), have known limitations. This study aimed to compare the diagnostic performance of novel obesity indices, including a body shape index (ABSI) and body roundness index (BRI), with conventional parameters in predicting NAFLD. Methods: A retrospective study was conducted with 430 Turkish adults (aged 18–74) undergoing FibroScan assessments. Anthropometric data (body weight, height, WC) and controlled attenuation parameter (CAP) values were collected. NAFLD was defined as CAP ≥257 dB/m. Predictive capabilities of BMI, WC, ABSI, BRI, waist-to-height ratio (WHtR), and body weight were compared using receiver operating characteristic (ROC) curve analyses. Pairwise area under-the-curve (AUC) comparisons were performed using the DeLong test, with significance set at p<0.05. Results: Body weight displayed the highest area under the ROC curve (AUC) for NAFLD diagnosis (AUC=0.766; 95% CI: 0.716 0.816). BMI (AUC=0.695; 95% CI: 0.637–0.753) and WC (AUC=0.693; 95% CI: 0.636–0.750) had comparable performance. BRI and WHtR demonstrated lower AUC values (AUC=0.621), while ABSI had insufficient discriminatory ability (AUC=0.485). NAFLD prevalence was significantly higher in males (71% vs. 50%, p<0.001), aligning with prior epidemiological reports. Conclusion: Among Turkish patients diagnosed via FibroScan, body weight emerged as the strongest predictor of NAFLD, with BMI and WC remaining reliable alternatives. Novel indices such as BRI and ABSI showed limited utility for clinical diagnosis. These findings highlight the continued relevance of simple and traditional measurements for identifying NAFLD risk.

Keywords

• Nonalcoholic fatty liver disease (NAFLD)
• anthropometric indices
• a body shape index (ABSI)
• body roundness index (BRI)
• FibroScan

Comparative diagnostic value of novel and traditional anthropometric indices in FibroScan-diagnosed NAFLD among Turkish adults

Abstract

ABSTRACT Background/Aim: Nonalcoholic fatty liver disease (NAFLD) is a growing global health concern associated with chronic liver damage and metabolic comorbidities. Traditional anthropometric measures—such as body mass index (BMI) and waist circumference (WC)—have known limitations. This study aimed to compare the diagnostic performance of novel obesity indices, including A Body Shape Index (ABSI) and Body Roundness Index (BRI), with conventional parameters in predicting NAFLD. Methods: In this retrospective study, 430 Turkish adults (aged 18–74 years) who underwent FibroScan examinations were evaluated. Anthropometric data (body weight, height, WC) and controlled attenuation parameter (CAP) values were collected. NAFLD was defined as CAP ≥257 dB/m. Predictive capabilities of each anthropometric index (BMI, WC, ABSI, BRI, waist-to-height ratio [WHtR], and body weight) were compared using receiver operating characteristic (ROC) curve analyses. Results: Body weight displayed the highest area under the ROC curve (AUC) for diagnosing NAFLD, followed by BMI and WC with comparable performance. In contrast, BRI and WHtR demonstrated lower AUC values, whereas ABSI showed insufficient discriminatory ability. Males were more commonly affected by NAFLD, which is consistent with previous literature. Conclusion: Among Turkish patients diagnosed via FibroScan, body weight emerged as the strongest predictor of NAFLD, with BMI and WC remaining reliable alternatives. Novel indices such as BRI and ABSI showed limited utility for clinical diagnosis. These findings highlight the continued relevance of simple and traditional measurements for identifying NAFLD risk.

Keywords

• Nonalcoholic fatty liver disease (NAFLD)
• Anthropometric indices
• A Body Shape Index (ABSI)
• Body Roundness Index (BRI)
• FibroScan

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