Waist-to-Height Ratio Surpasses BMI in Identifying Liver Disease Risks

A new study reveals that waist-to-height ratio outperforms BMI in predicting fatty liver and cirrhosis risk, offering an accessible tool for early detection globally.

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Recent research indicates that measuring the waist-to-height ratio (WHtR) is more effective than body mass index (BMI) in predicting the risk of fatty liver disease and liver cirrhosis. Conducted at the University of Eastern Finland, a comprehensive study analyzed data from 6,464 participants aged 12 to 80 years from the U.S. National Health and Nutrition Examination Survey (NHANES) between 2021 and 2023.

The study employed transient elastography scans to non-invasively assess liver health, revealing that over a quarter of participants showed signs of liver steatosis, and approximately 7.1% had significant fibrosis or cirrhosis. While BMI-diagnosed obesity has traditionally been linked to liver issues, new consensus suggests that BMI alone may underestimate true risk.

In contrast, WHtR, a simple and cost-effective measurement, was validated as a highly sensitive predictor of excess visceral and total body fat, correlating strongly with liver health outcomes. Specifically, the study found that individuals with high or excess fat mass, estimated through WHtR cut-offs, had significantly increased odds of developing liver steatosis and fibrosis. Those with an excess fat mass ratio were four times more likely to have liver steatosis and had considerably higher chances of fibrosis or cirrhosis.

Remarkably, these findings were consistent across different ages, sexes, and racial groups including White, Black, Mexican-American, and Hispanic populations. The simplicity of measuring waist-to-height ratio makes it an accessible tool for routine clinical screening, public health initiatives, and early intervention strategies worldwide.

Andrew Agbaje, a physician and associate professor at the University of Eastern Finland, emphasizes that WHtR could be instrumental in global efforts to identify at-risk individuals more accurately than BMI. He also highlighted the development of a clinical calculator based on this metric to facilitate widespread use.

This study underscores the importance of adopting more precise, non-invasive tools like waist-to-height ratio for diagnosing and managing liver disease risks, ultimately contributing to better preventive healthcare on a global scale.

Source: https://medicalxpress.com/news/2025-06-waist-height-ratio-outperforms-bmi.html